Preliminary trials of inactivated vaccine against haemorrhagic fever with renal syndrome

Hantavirus infections in humans and animals, China

Hemorrhagic fever with renal syndrome (HFRS) is a serious public health problem in the People's Republic of China. Although 7 sero/genotypes of hantaviruses have been found in rodents, only Hantaan virus (carried by Apodemus agrarius mice) and Seoul virus (carried by Rattus norvegicus rats) reportedly cause disease in humans. During 1950-2007, a total of 1,557,622 cases of HFRS in humans and 46,427 deaths (3%) were reported in China. HFRS has been reported in 29 of 31 provinces in China. After implementation of comprehensive preventive measures, including vaccination, in the past decade in China, incidence of HFRS has dramatically decreased; only 11,248 HFRS cases were reported in 2007. Mortality rates also declined from the highest level of 14.2% in 1969 to ?1% during 1995-2007. However, the numbers of HFRS cases and deaths in China remain the highest in the world.

Clinical aspects of nephropathia epidemica (Puumala virus infection) in Europe: a review

Nephropathia epidemica (NE) is a prevalent zoonosis throughout Europe and is caused by the Puumala type of hantavirus. The incidence of NE varies in a cyclic fashion, with peaks occurring every 3rd to 4th year, coinciding with peaks in vole populations. The clinical course of NE is generally milder than haemorrhagic fever with renal syndrome caused by hantaviruses in other parts of the world. Typically, NE has a sudden onset with fever, headache, backpain and gastrointestinal symptoms. However, severe complications, e.g. gastrointestinal haemorrhage, occur and fatal cases have been reported. Renal involvement is prominent and manifests as initial oliguria and later as marked polyuria. Tests of renal function show pronounced glomerular and tubular involvement. Vaccine against Puumala virus infection as well as specific treatment for NE are still lacking.

A vaccinia virus-vectored Hantaan virus vaccine protects hamsters from challenge with Hantaan and Seoul viruses but not Puumala virus

To investigate the ability of a vaccinia virus-vectored vaccine expressing the M and the S segments of Hantaan (HTN) virus (C. S. Schmaljohn, S. E. Hasty, and J. M. Dalrymple, Vaccine 10:10-13, 1992) to elicit a protective immune response against other hantaviruses, we vaccinated hamsters with the recombinant vaccine and challenged them with HTN, Seoul (SEO), or Puumala (PUU) virus. Neutralizing antibodies to HTN virus were found in all vaccinated hamsters both before and after challenge. Neutralizing antibody titers to SEO virus were present at low levels or were undetectable after two immunizations with the vaccine but were positive in all vaccinated hamsters after challenge with SEO virus and were also positive in control animals that were not challenged. Neutralizing antibodies to PUU virus were observed only in hamsters previously challenged with PUU virus. To assay for virus in the blood and tissues of the hamsters, we developed a nested reverse transcriptase (RT)-PCR with cross-reactive outer primers and serotype-specific inner primers. The RT-PCR specifically detected as little as 1 PFU of virus in serum containing high-titer neutralizing antibodies and was more sensitive than immunofluorescent antibody staining for detecting virus in lung and kidney specimens of infected hamsters. By using the RT-PCR, we found that vaccinated hamsters, challenged with HTN or SEO virus, neither were viremic nor had evidence of virus in their lungs or kidneys. In contrast, vaccinated hamsters challenged with PUU virus were viremic and had PUU virus-specific nucleic acid in their organs.