The Association between Hantavirus Infection and Selenium Deficiency in Mainland China

Abstract

Hemorrhagic fever with renal syndrome (HFRS) caused by hantaviruses and transmitted by rodents is a significant public health problem in China, and occurs more frequently in selenium-deficient regions. To study the role of selenium concentration in HFRS incidence we used a multidisciplinary approach combining ecological analysis with preliminary experimental data. The incidence of HFRS in humans was about six times higher in severe selenium-deficient and double in moderate deficient areas compared to non-deficient areas. This association became statistically stronger after correction for other significant environment-related factors (low elevation, few grasslands, or an abundance of forests) and was independent of geographical scale by separate analyses for different climate regions. A case-control study of HFRS patients admitted to the hospital revealed increased activity and plasma levels of selenium binding proteins while selenium supplementation in vitro decreased viral replication in an endothelial cell model after infection with a low multiplicity of infection (MOI). Viral replication with a higher MOI was not affected by selenium supplementation. Our findings indicate that selenium deficiency may contribute to an increased prevalence of hantavirus infections in both humans and rodents. Future studies are needed to further examine the exact mechanism behind this observation before selenium supplementation in deficient areas could be implemented for HFRS prevention.

Mapping the epidemic changes and risks of hemorrhagic fever with renal syndrome in Shaanxi Province, China, 2005–2016

“…In China, HFRS is listed as a class B notifiable infectious disease, and cases diagnosed at medical institutions are required to be reported to CCDC through the national Notifiable Infectious Diseases Reporting Information System 33 . The case definition of HFRS is according to the guidelines of the World Health Organization (WHO).…”

Hantavirus infection: a global zoonotic challenge

“…In the Mekong Delta of Vietnam, rodents can be infected with DOBV and SEOV with a positive rate of 6.9% (Van Cuong et al, 2015). There have also been studies claiming that selenium deficiency is correlated with increased prevalence of hantavirus infections in both humans and rodents (Fang LQ et al, 2015).…”

Epidemic foci of hemorrhagic fever with renal syndrome in Shandong Province, China, based on patients, rodents and molecular epidemiology characteristics, 2012-2015

“…Although the HV carriage rates among rodents in Regions b and c were higher than that associated with Region a, the severity of the epidemic situation was less severe, suggesting that the HV-susceptible population appears to be more susceptible to the HV strains in Region a (which mainly belong to the HTNV genotype). Interestingly, the distance between Regions b and a is much smaller than that between Regions b and c. Despite this, the epidemic characteristics of Region b are quite different from those of Region a, and more similar to those of Region c. Although previous studies have shown that HTNV (which was the main genotype in Region a, where the epidemic situation was more serious) is more harmful to humans than SEOV (which was the main genotype in Regions b and c), local geographic conditions, climate, HFRS prevention and control measures and safety awareness among susceptible populations are also important factors[15,25–29]. Therefore, we believe that a further study should be performed to explore the factors underlying our result.…”

“…The data on S and M segments in this study were insufficient, so the phylogenetic analysis of HV may be biased. Second, there are many factors that can influence the distribution and severity of infectious disease, such as natural environmental factors, urbanization processes and local prevention efforts[29–31]. However, this research lacked information on these factors, so the HFRS spatio-temporal distribution analysis is inadequate.…”