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Ulrich RG, Drewes S, Haring V, Panajotov J, Pfeffer M, Rubbenstroth D, Dreesman J, Beer M, Dobler G, Knauf S, Johne R, Böhmer MM. [Viral zoonoses in Germany: a One Health perspective]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023:10.1007/s00103-023-03709-0. [PMID: 37261460 DOI: 10.1007/s00103-023-03709-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/26/2023] [Indexed: 06/02/2023]
Abstract
The COVID-19 pandemic and the increasing occurrence of monkeypox (mpox) diseases outside Africa have illustrated the vulnerability of populations to zoonotic pathogens. In addition, other viral zoonotic pathogens have gained importance in recent years.This review article addresses six notifiable viral zoonotic pathogens as examples to highlight the need for the One Health approach in order to understand the epidemiology of the diseases and to derive recommendations for action by the public health service. The importance of environmental factors, reservoirs, and vectors is emphasized, the diseases in livestock and wildlife are analyzed, and the occurrence and frequency of diseases in the population are described. The pathogens selected here differ in their reservoirs and the role of vectors for transmission, the impact of infections on farm animals, and the disease patterns observed in humans. In addition to zoonotic pathogens that have been known in Germany for a long time or were introduced recently, pathogens whose zoonotic potential has only lately been shown are also considered.For the pathogens discussed here, there are still large knowledge gaps regarding the transmission routes. Future One Health-based studies must contribute to the further elucidation of their transmission routes and the development of prevention measures. The holistic approach does not necessarily include a focus on viral pathogens/diseases, but also includes the question of the interaction of viral, bacterial, and other pathogens, including antibiotic resistance and host microbiomes.
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Affiliation(s)
- Rainer G Ulrich
- Institut für neue und neuartige Tierseuchenerreger, Friedrich-Loeffler-Institut, Bundesforschungsinstitut für Tiergesundheit, Südufer 10, 17493, Greifswald-Insel Riems, Deutschland.
| | - Stephan Drewes
- Institut für neue und neuartige Tierseuchenerreger, Friedrich-Loeffler-Institut, Bundesforschungsinstitut für Tiergesundheit, Südufer 10, 17493, Greifswald-Insel Riems, Deutschland
| | - Viola Haring
- Institut für neue und neuartige Tierseuchenerreger, Friedrich-Loeffler-Institut, Bundesforschungsinstitut für Tiergesundheit, Südufer 10, 17493, Greifswald-Insel Riems, Deutschland
| | - Jessica Panajotov
- Fachgruppe Viren in Lebensmitteln, Bundesinstitut für Risikobewertung, Berlin, Deutschland
| | - Martin Pfeffer
- Institut für Tierhygiene und Öffentliches Veterinärwesen, Universität Leipzig, Leipzig, Deutschland
| | - Dennis Rubbenstroth
- Institut für Virusdiagnostik, Friedrich-Loeffler-Institut, Bundesforschungsinstitut für Tiergesundheit, Greifswald-Insel Riems, Deutschland
| | | | - Martin Beer
- Institut für Virusdiagnostik, Friedrich-Loeffler-Institut, Bundesforschungsinstitut für Tiergesundheit, Greifswald-Insel Riems, Deutschland
| | - Gerhard Dobler
- Abteilung Virologie und Rickettsiologie, Institut für Mikrobiologie der Bundeswehr, München, Deutschland
| | - Sascha Knauf
- Institut für Internationale Tiergesundheit/One Health, Friedrich-Loeffler-Institut, Bundesforschungsinstitut für Tiergesundheit, Greifswald-Insel Riems, Deutschland
| | - Reimar Johne
- Fachgruppe Viren in Lebensmitteln, Bundesinstitut für Risikobewertung, Berlin, Deutschland
| | - Merle M Böhmer
- Landesinstitut Gesundheit II - Task Force Infektiologie, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL), München, Deutschland
- Institut für Sozialmedizin und Gesundheitssystemforschung, Otto-von-Guericke Universität, Magdeburg, Deutschland
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Kazasidis O, Jacob J. Machine learning identifies straightforward early warning rules for human Puumala hantavirus outbreaks. Sci Rep 2023; 13:3585. [PMID: 36869118 PMCID: PMC9984366 DOI: 10.1038/s41598-023-30596-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
Human Puumala virus (PUUV) infections in Germany fluctuate multi-annually, following fluctuations of the bank vole population size. We applied a transformation to the annual incidence values and established a heuristic method to develop a straightforward robust model for the binary human infection risk at the district level. The classification model was powered by a machine-learning algorithm and achieved 85% sensitivity and 71% precision, despite using only three weather parameters from the previous years as inputs, namely the soil temperature in April of two years before and in September of the previous year, and the sunshine duration in September of two years before. Moreover, we introduced the PUUV Outbreak Index that quantifies the spatial synchrony of local PUUV-outbreaks, and applied it to the seven reported outbreaks in the period 2006-2021. Finally, we used the classification model to estimate the PUUV Outbreak Index, achieving 20% maximum uncertainty.
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Affiliation(s)
- Orestis Kazasidis
- Julius Kühn Institute (JKI) - Federal Research Centre for Cultivated Plants, Institute for Plant Protection in Horticulture and Forests / Institute for Epidemiology and Pathogen Diagnostics, Rodent Research, Toppheideweg 88, 48161, Münster, Germany.
| | - Jens Jacob
- Julius Kühn Institute (JKI) - Federal Research Centre for Cultivated Plants, Institute for Plant Protection in Horticulture and Forests / Institute for Epidemiology and Pathogen Diagnostics, Rodent Research, Toppheideweg 88, 48161, Münster, Germany
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3
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Schlohsarczyk EK, Drewes S, Koteja P, Röhrs S, Ulrich RG, Teifke JP, Herden C. Tropism of Puumala orthohantavirus and Endoparasite Coinfection in the Bank Vole Reservoir. Viruses 2023; 15:v15030612. [PMID: 36992321 PMCID: PMC10058470 DOI: 10.3390/v15030612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/08/2023] [Accepted: 02/12/2023] [Indexed: 02/25/2023] Open
Abstract
In Europe, most cases of human hantavirus disease are caused by Puumala orthohantavirus (PUUV) transmitted by bank voles (Clethrionomys glareolus, syn. Myodes glareolus), in which PUUV causes inconspicuous infection. Little is known about tropism and endoparasite coinfections in PUUV-infected reservoir and spillover-infected rodents. Here, we characterized PUUV tropism, pathological changes and endoparasite coinfections. The voles and some non-reservoir rodents were examined histologically, immunohistochemically, by in situ hybridization, indirect IgG enzyme-linked immunosorbent assay and reverse transcription-polymerase chain reaction. PUUV RNA and anti-PUUV antibodies were detected simultaneously in a large proportion of the bank voles, indicating persistent infection. Although PUUV RNA was not detected in non-reservoir rodents, the detection of PUUV-reactive antibodies suggests virus contact. No specific gross and histological findings were detected in the infected bank voles. A broad organ tropism of PUUV was observed: kidney and stomach were most frequently infected. Remarkably, PUUV was detected in cells lacking the typical secretory capacity, which may contribute to the maintenance of virus persistence. PUUV-infected wild bank voles were found to be frequently coinfected with Hepatozoon spp. and Sarcocystis (Frenkelia) spp., possibly causing immune modulation that may influence susceptibility to PUUV infection or vice versa. The results are a prerequisite for a deeper understanding of virus–host interactions in natural hantavirus reservoirs.
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Affiliation(s)
- Elfi K. Schlohsarczyk
- Institute of Veterinary Pathology, FB10—Veterinary Medicine, Justus-Liebig-University Giessen, 35392 Giessen, Germany
- Friedrich-Loeffler-Institut, 17493 Greifswald-Insel Riems, Germany
| | - Stephan Drewes
- Friedrich-Loeffler-Institut, 17493 Greifswald-Insel Riems, Germany
| | - Paweł Koteja
- Institute of Environmental Sciences, Faculty of Biology, Jagiellonian University, 30-387 Kraków, Poland
| | - Susanne Röhrs
- Friedrich-Loeffler-Institut, 17493 Greifswald-Insel Riems, Germany
| | - Rainer G. Ulrich
- Friedrich-Loeffler-Institut, 17493 Greifswald-Insel Riems, Germany
| | - Jens P. Teifke
- Institute of Veterinary Pathology, FB10—Veterinary Medicine, Justus-Liebig-University Giessen, 35392 Giessen, Germany
- Friedrich-Loeffler-Institut, 17493 Greifswald-Insel Riems, Germany
| | - Christiane Herden
- Institute of Veterinary Pathology, FB10—Veterinary Medicine, Justus-Liebig-University Giessen, 35392 Giessen, Germany
- Correspondence: ; Tel.: +49-6419938201
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4
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Steininger P, Herbst L, Bihlmaier K, Willam C, Körper S, Schrezenmeier H, Klüter H, Pfister F, Amann K, Weiss S, Krüger DH, Zimmermann R, Korn K, Hofmann J, Harrer T. Fatal Puumala Hantavirus Infection in a Patient with Common Variable Immunodeficiency (CVID). Microorganisms 2023; 11:microorganisms11020283. [PMID: 36838248 PMCID: PMC9966676 DOI: 10.3390/microorganisms11020283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
Puumala hantavirus (PUUV) infections usually show a mild or moderate clinical course, but may sometimes also lead to life-threatening disease. Here, we report on a 60-year-old female patient with common variable immunodeficiency (CVID) who developed a fatal PUUV infection with persistent renal failure, thrombocytopenia, and CNS infection with impaired consciousness and tetraparesis. Hantavirus-specific antibodies could not be detected due to the humoral immunodeficiency. Diagnosis and virological monitoring were based on the quantitative detection of PUUV RNA in blood, cerebrospinal fluid, bronchial lavage, and urine, where viral RNA was found over an unusually extended period of one month. Due to clinical deterioration and virus persistence, treatment with ribavirin was initiated. Additionally, fresh frozen plasma (FFP) from convalescent donors with a history of PUUV infection was administered. Despite viral clearance, the clinical condition of the patient did not improve and the patient died on day 81 of hospitalization. This case underlines the importance of the humoral immune response for the course of PUUV disease and illustrates the need for PCR-based virus diagnostics in those patients. Due to its potential antiviral activity, convalescent plasma should be considered in the therapy of severe hantavirus diseases.
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Affiliation(s)
- Philipp Steininger
- Institute of Clinical and Molecular Virology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
- Correspondence:
| | - Larissa Herbst
- Department of Nephrology and Hypertension, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Karl Bihlmaier
- Department of Nephrology and Hypertension, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Carsten Willam
- Department of Nephrology and Hypertension, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Sixten Körper
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, 89081 Ulm, Germany
- Institute of Transfusion Medicine, University of Ulm, 89081 Ulm, Germany
| | - Hubert Schrezenmeier
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, 89081 Ulm, Germany
- Institute of Transfusion Medicine, University of Ulm, 89081 Ulm, Germany
| | - Harald Klüter
- Institute of Transfusion Medicine and Immunology, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Frederick Pfister
- Department of Nephropathology, Institute of Pathology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Kerstin Amann
- Department of Nephropathology, Institute of Pathology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Sabrina Weiss
- Institute of Virology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Detlev H. Krüger
- Institute of Virology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Robert Zimmermann
- Department of Transfusion Medicine and Hemostaseology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Klaus Korn
- Institute of Clinical and Molecular Virology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Jörg Hofmann
- Institute of Virology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Thomas Harrer
- Infectious Disease and Immunodeficiency Section, Department of Internal Medicine 3, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
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5
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A Portable Diagnostic Assay, Genetic Diversity, and Isolation of Seoul Virus from Rattus norvegicus Collected in Gangwon Province, Republic of Korea. Pathogens 2022; 11:pathogens11091047. [PMID: 36145479 PMCID: PMC9503505 DOI: 10.3390/pathogens11091047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
Seoul virus (SEOV), an etiological agent for hemorrhagic fever with renal syndrome, poses a significant public health threat worldwide. This study evaluated the feasibility of a mobile Biomeme platform for facilitating rapid decision making of SEOV infection. A total of 27 Rattus norvegicus were collected from Seoul Metropolitan City and Gangwon Province in Republic of Korea (ROK), during 2016–2020. The serological and molecular prevalence of SEOV was 5/27 (18.5%) and 2/27 (7.4%), respectively. SEOV RNA was detected in multiple tissues of rodents using the Biomeme device, with differences in Ct values ranging from 0.6 to 2.1 cycles compared to a laboratory benchtop system. Using amplicon-based next-generation sequencing, whole-genome sequences of SEOV were acquired from lung tissues of Rn18-1 and Rn19-5 collected in Gangwon Province. Phylogenetic analysis showed a phylogeographical diversity of rat-borne orthohantavirus collected in Gangwon Province. We report a novel isolate of SEOV Rn19-5 from Gangwon Province. Our findings demonstrated that the Biomeme system can be applied for the molecular diagnosis of SEOV comparably to the laboratory-based platform. Whole-genome sequencing of SEOV revealed the phylogeographical diversity of orthohantavirus in the ROK. This study provides important insights into the field-deployable diagnostic assays and genetic diversity of orthohantaviruses for the rapid response to hantaviral outbreaks in the ROK.
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Hofmann J, Loyen M, Faber M, Krüger DH. [Hantavirus Disease: An Update]. Dtsch Med Wochenschr 2022; 147:312-318. [PMID: 35291036 DOI: 10.1055/a-1664-7259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In addition to the well-known clinical early symptoms of hantavirus disease (fever, flank and abdominal pain as well as arthralgia), unusual neurological changes in the context of infection come into focus. The spectrum of neurological symptoms ranges from transient myopia to severe pareses in the context of Guillain-Barré syndrome. In endemic areas, rapid IgM tests for initial assessment are of certain value for differential diagnosis. For therapeutic approaches, only supportive measures up to transient dialysis are available.Molecular genetic analysis and comparison of hantavirus strains of patients and mice from the same geographical area allowed molecular characterization of different outbreak regions. In the meantime, the Puumala viruses of the main outbreak regions in Germany are molecularly well characterized; therefore, the nucleotide sequence of the virus strain detected in a patient makes it possible to draw conclusions about the geographic region where the patient's infection took place.The human pathogenic hantaviruses being prevalent in Germany are the Puumala virus (reservoir: bank vole) and the Dobrava-Belgrade virus, genotype Kurkino (reservoir: striped field mouse). Recently, the molecular detection of further hantaviruses in patients with hantavirus disease was achieved. It can be concluded that also the Seoul virus (reservoir: rats) and the Tulavirus (reservoir: field mouse and related species) occasionally cause hantavirus disease in Germany.New results revealed that human infections can occur not only by the generally accepted route of inhalation of virus-containing aerosols, but also by ingestion of virus-containing materials.For patients with hantavirus infection or disease, it can be assumed that they are not infectious for their environment. A new systematic review could not confirm a human-to-human transmission previously postulated for South American hantaviruses.While all known human pathogenic hantaviruses are transmitted by rodents, other hantaviruses have been recently detected in shrews, moles, and bats. The clinical significance of these new viruses is quite unclear as yet.
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Affiliation(s)
- Jörg Hofmann
- Institut für Virologie, Helmut-Ruska-Haus, Charité - Universitätsmedizin Berlin, 10117 Berlin
| | - Martin Loyen
- Klinik für Innere Medizin, Nephrologie und Dialyse, Herz-Jesu-Krankenhaus, Münster-Hiltrup
| | - Mirko Faber
- Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin
| | - Detlev H Krüger
- Institut für Virologie, Helmut-Ruska-Haus, Charité - Universitätsmedizin Berlin, 10117 Berlin
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Kabwe E, Al Sheikh W, Shamsutdinov AF, Ismagilova RK, Martynova EV, Ohlopkova OV, Yurchenko YA, Savitskaya TA, Isaeva GS, Khaiboullina SF, Rizvanov AA, Morzunov SP, Davidyuk YN. Analysis of Puumala orthohantavirus Genome Variants Identified in the Territories of Volga Federal District. Trop Med Infect Dis 2022; 7:tropicalmed7030046. [PMID: 35324593 PMCID: PMC8952242 DOI: 10.3390/tropicalmed7030046] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/20/2022] [Accepted: 03/04/2022] [Indexed: 12/10/2022] Open
Abstract
Hemorrhagic fever with renal syndrome (HFRS) is a zoonotic disease commonly diagnosed in the Volga Federal District (VFD). HFRS is caused by Puumala orthohantavirus (PUUV), and this virus is usually detected in bank voles as its natural host (Myodes glareolus). The PUUV genome is composed of the single-stranded, negative-sense RNA containing three segments. The goal of the current study is to identify genome variants of PUUV strains circulating in bank voles captured in the Udmurt Republic (UR) and Ulyanovsk region (ULR). The comparative and phylogenetic analysis of PUUV strains revealed that strains from Varaksino site UR are closely related to strains previously identified in the Pre-Kama area of the Republic of Tatarstan (RT), whilst strains from Kurlan and Mullovka sites ULR are similar to strains from the Trans-Kama area of the RT. It was also found that Barysh ULR strains form a separate distinct group phylogenetically equidistant from Varaksino and Kurlan−Mullovka groups. The identified groups of strains can be considered as separate sub-lineages in the PUUV Russian genetic lineage. In addition, the genomes of the strains from the UR, most likely, were formed as a result of reassortment.
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Affiliation(s)
- Emmanuel Kabwe
- OpenLab “Gene and Cell Technologies ”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (W.A.S.); (A.F.S.); (E.V.M.); (S.F.K.); (A.A.R.); (S.P.M.)
- Kazan Research Institute of Epidemiology and Microbiology, 420012 Kazan, Russia; (T.A.S.); (G.S.I.)
- Correspondence: (E.K.); (Y.N.D.)
| | - Walaa Al Sheikh
- OpenLab “Gene and Cell Technologies ”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (W.A.S.); (A.F.S.); (E.V.M.); (S.F.K.); (A.A.R.); (S.P.M.)
| | - Anton F. Shamsutdinov
- OpenLab “Gene and Cell Technologies ”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (W.A.S.); (A.F.S.); (E.V.M.); (S.F.K.); (A.A.R.); (S.P.M.)
| | - Ruzilya K. Ismagilova
- OpenLab “Omics Technology”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia;
| | - Ekaterina V. Martynova
- OpenLab “Gene and Cell Technologies ”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (W.A.S.); (A.F.S.); (E.V.M.); (S.F.K.); (A.A.R.); (S.P.M.)
| | - Olesia V. Ohlopkova
- State Research Center of Virology and Biotechnology “Vector”, Rospotrebnadzor, World-Class Genomic Research Center for Biological Safety and Technological Independence, Federal Scientific and Technical Program on the Development of Genetic Technologies, 630559 Koltsovo, Russia;
| | - Yuri A. Yurchenko
- Hygienic and Epidemiological Center for Novosibirsk Region, 630099 Novosibirsk, Russia;
- Institute of Systematics and Ecology of Animals, Siberian Branch of the Russian Academy of Sciences, 630091 Novosibirsk, Russia
| | - Tatiana A. Savitskaya
- Kazan Research Institute of Epidemiology and Microbiology, 420012 Kazan, Russia; (T.A.S.); (G.S.I.)
| | - Guzel S. Isaeva
- Kazan Research Institute of Epidemiology and Microbiology, 420012 Kazan, Russia; (T.A.S.); (G.S.I.)
| | - Svetlana F. Khaiboullina
- OpenLab “Gene and Cell Technologies ”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (W.A.S.); (A.F.S.); (E.V.M.); (S.F.K.); (A.A.R.); (S.P.M.)
| | - Albert A. Rizvanov
- OpenLab “Gene and Cell Technologies ”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (W.A.S.); (A.F.S.); (E.V.M.); (S.F.K.); (A.A.R.); (S.P.M.)
| | - Sergey P. Morzunov
- OpenLab “Gene and Cell Technologies ”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (W.A.S.); (A.F.S.); (E.V.M.); (S.F.K.); (A.A.R.); (S.P.M.)
- Department of Pathology, University of Nevada, Reno, NV 89557, USA
| | - Yuriy N. Davidyuk
- OpenLab “Gene and Cell Technologies ”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (W.A.S.); (A.F.S.); (E.V.M.); (S.F.K.); (A.A.R.); (S.P.M.)
- Correspondence: (E.K.); (Y.N.D.)
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8
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Koehler FC, Di Cristanziano V, Späth MR, Hoyer-Allo KJR, Wanken M, Müller RU, Burst V. OUP accepted manuscript. Clin Kidney J 2022; 15:1231-1252. [PMID: 35756741 PMCID: PMC9217627 DOI: 10.1093/ckj/sfac008] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Indexed: 01/18/2023] Open
Abstract
Hantavirus-induced diseases are emerging zoonoses with endemic appearances and frequent outbreaks in different parts of the world. In humans, hantaviral pathology is characterized by the disruption of the endothelial cell barrier followed by increased capillary permeability, thrombocytopenia due to platelet activation/depletion and an overactive immune response. Genetic vulnerability due to certain human leukocyte antigen haplotypes is associated with disease severity. Typically, two different hantavirus-caused clinical syndromes have been reported: hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). The primarily affected vascular beds differ in these two entities: renal medullary capillaries in HFRS caused by Old World hantaviruses and pulmonary capillaries in HCPS caused by New World hantaviruses. Disease severity in HFRS ranges from mild, e.g. Puumala virus-associated nephropathia epidemica, to moderate, e.g. Hantaan or Dobrava virus infections. HCPS leads to a severe acute respiratory distress syndrome with high mortality rates. Due to novel insights into organ tropism, hantavirus-associated pathophysiology and overlapping clinical features, HFRS and HCPS are believed to be interconnected syndromes frequently involving the kidneys. As there are no specific antiviral treatments or vaccines approved in Europe or the USA, only preventive measures and public awareness may minimize the risk of hantavirus infection. Treatment remains primarily supportive and, depending on disease severity, more invasive measures (e.g., renal replacement therapy, mechanical ventilation and extracorporeal membrane oxygenation) are needed.
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Affiliation(s)
- Felix C Koehler
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Veronica Di Cristanziano
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Martin R Späth
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - K Johanna R Hoyer-Allo
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Manuel Wanken
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Roman-Ulrich Müller
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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9
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Koehler FC, Blomberg L, Brehm TT, Büttner S, Cornely OA, Degen O, Di Cristanziano V, Dolff S, Eberwein L, Hoxha E, Hoyer-Allo KJR, Rudolf S, Späth MR, Wanken M, Müller RU, Burst V. Development and design of the Hantavirus registry - HantaReg - for epidemiological studies, outbreaks and clinical studies on hantavirus disease. Clin Kidney J 2021; 14:2365-2370. [PMID: 34754431 PMCID: PMC8573013 DOI: 10.1093/ckj/sfab053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/02/2021] [Indexed: 11/21/2022] Open
Abstract
Background Frequent outbreaks around the globe and endemic appearance in different parts of the world emphasize the substantial risk of hantavirus diseases. Increasing incidence rates, trends of changing distribution of hantavirus species and new insights into clinical courses of hantavirus diseases call for multinational surveillance. Furthermore, evidence-based guidelines for the management of hantavirus diseases and scoring systems, which allow stratification of patients into risk categories, are lacking. Methods Hantavirus registry (HantaReg) is a novel registry platform facilitating multinational research of hantavirus-caused diseases, such as haemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). HantaReg provides an electronic case report form and uses the General Data Protection Regulation compliant platform clinicalsurveys.net, which can be accessed from any internet browser in the world. Having a modular structure, the registry platform is designed to display or hide questions and items according to the documented case (e.g. patient with HFRS versus HCPS) to facilitate fast, but standardized, data entry. Information categories documented in HantaReg are demographics, pre-existing diseases, clinical presentation, diagnostic and therapeutic approaches, as well as outcome. Conclusions HantaReg is a novel, ready-to-use platform for clinical and epidemiological studies on hantavirus diseases and facilitates the documentation of the disease course associated with hantavirus infections. HantaReg is expected to promote international collaboration and contributes to improving patient care through the analysis of diagnostic and treatment pathways for hantavirus diseases, providing evidence for robust treatment recommendations. Moreover, HantaReg enables the development of prognosis-indicating scoring systems for patients with hantavirus disease.
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Affiliation(s)
- Felix C Koehler
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Linda Blomberg
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Thomas Theo Brehm
- I. Department of Internal Medicine, Division of Infectious Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Büttner
- Department I of Internal Medicine, Klinikum Aschaffenburg-Alzenau, Aschaffenburg, Germany
| | - Oliver A Cornely
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Olaf Degen
- I. Department of Internal Medicine, Division of Infectious Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Veronica Di Cristanziano
- Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Sebastian Dolff
- Department of Infectious Diseases, University Hospital Essen, Essen, Germany
| | - Lukas Eberwein
- 4th Department of Internal Medicine, Klinikum Leverkusen gGmbH, Leverkusen, Germany
| | - Elion Hoxha
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Johanna R Hoyer-Allo
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Sarah Rudolf
- Department of Nephrology, Medical Clinic III, University Hospital Frankfurt, Frankfurt, Germany
| | - Martin R Späth
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Manuel Wanken
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Roman-Ulrich Müller
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Volker Burst
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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10
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Davidyuk YN, Kabwe E, Shamsutdinov AF, Knyazeva AV, Martynova EV, Ismagilova RK, Trifonov VA, Savitskaya TA, Isaeva GS, Urbanowicz RA, Khaiboullina SF, Rizvanov AA, Morzunov SP. The Distribution of Puumala orthohantavirus Genome Variants Correlates with the Regional Landscapes in the Trans-Kama Area of the Republic of Tatarstan. Pathogens 2021; 10:pathogens10091169. [PMID: 34578200 PMCID: PMC8471081 DOI: 10.3390/pathogens10091169] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/19/2022] Open
Abstract
In the European part of Russia, the highest number of hemorrhagic fever with renal syndrome (HFRS) cases are registered in the Volga Federal District (VFD), which includes the Republic of Tatarstan (RT). Puumala orthohantavirus (PUUV) is the main causative agent of HFRS identified in the RT. The goal of the current study is to analyze the genetic variations of the PUUV strains and possible presence of chimeric and reassortant variants among the PUUV strains circulating in bank vole populations in the Trans-Kama area of the RT. Complete S segment CDS as well as partial M and L segment coding nucleotide sequences were obtained from 40 PUUV-positive bank voles and used for the analysis. We found that all PUUV strains belonged to RUS genetic lineage and clustered in two subclades corresponding to the Western and Eastern Trans-Kama geographic areas. PUUV strains from Western Trans-Kama were related to the previously identified strain from Teteevo in the Pre-Kama area. It can be suggested that the PUUV strains were introduced to the Teteevo area as a result of the bank voles’ migration from Western Trans-Kama. It also appears that physical obstacles, including rivers, could be overcome by migrating rodents under favorable circumstances. Based on results of the comparative and phylogenetic analyses, we propose that bank vole distribution in the Trans-Kama area occurred upstream along the river valleys, and that watersheds could act as barriers for migrations. As a result, the diverged PUUV strains could be formed in closely located populations. In times of extensive bank vole population growth, happening every 3–4 years, some regions of watersheds may become open for contact between individual rodents from neighboring populations, leading to an exchange of the genetic material between divergent PUUV strains.
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Affiliation(s)
- Yuriy N. Davidyuk
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (Y.N.D.); (E.K.); (A.F.S.); (A.V.K.); (E.V.M.); (A.A.R.)
| | - Emmanuel Kabwe
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (Y.N.D.); (E.K.); (A.F.S.); (A.V.K.); (E.V.M.); (A.A.R.)
- Kazan Research Institute of Epidemiology and Microbiology, 420012 Kazan, Russia; (V.A.T.); (T.A.S.); (G.S.I.)
| | - Anton F. Shamsutdinov
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (Y.N.D.); (E.K.); (A.F.S.); (A.V.K.); (E.V.M.); (A.A.R.)
| | - Anna V. Knyazeva
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (Y.N.D.); (E.K.); (A.F.S.); (A.V.K.); (E.V.M.); (A.A.R.)
| | - Ekaterina V. Martynova
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (Y.N.D.); (E.K.); (A.F.S.); (A.V.K.); (E.V.M.); (A.A.R.)
| | - Ruzilya K. Ismagilova
- OpenLab “Omics Technology”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia;
| | - Vladimir A. Trifonov
- Kazan Research Institute of Epidemiology and Microbiology, 420012 Kazan, Russia; (V.A.T.); (T.A.S.); (G.S.I.)
- Medical Academy of the Ministry of Health of the Russian Federation, 420012 Kazan, Russia
| | - Tatiana A. Savitskaya
- Kazan Research Institute of Epidemiology and Microbiology, 420012 Kazan, Russia; (V.A.T.); (T.A.S.); (G.S.I.)
| | - Guzel S. Isaeva
- Kazan Research Institute of Epidemiology and Microbiology, 420012 Kazan, Russia; (V.A.T.); (T.A.S.); (G.S.I.)
| | - Richard A. Urbanowicz
- Department of Infection Biology and Microbiomes, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool L3 5RF, UK;
| | - Svetlana F. Khaiboullina
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (Y.N.D.); (E.K.); (A.F.S.); (A.V.K.); (E.V.M.); (A.A.R.)
- Correspondence: (S.F.K.); (S.P.M.)
| | - Albert A. Rizvanov
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (Y.N.D.); (E.K.); (A.F.S.); (A.V.K.); (E.V.M.); (A.A.R.)
| | - Sergey P. Morzunov
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Russia; (Y.N.D.); (E.K.); (A.F.S.); (A.V.K.); (E.V.M.); (A.A.R.)
- Department of Pathology, University of Nevada, Reno, NV 89557, USA
- Correspondence: (S.F.K.); (S.P.M.)
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11
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Faber M, Krüger DH, Auste B, Stark K, Hofmann J, Weiss S. Molecular and epidemiological characteristics of human Puumala and Dobrava-Belgrade hantavirus infections, Germany, 2001 to 2017. ACTA ACUST UNITED AC 2020; 24. [PMID: 31411134 PMCID: PMC6693291 DOI: 10.2807/1560-7917.es.2019.24.32.1800675] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Introduction Two hantavirus species, Puumala (PUUV) and Dobrava-Belgrade (DOBV) virus (genotype Kurkino), are endemic in Germany. Recent PUUV outbreaks raised questions concerning increasing frequency of outbreaks and expansion of PUUV endemic areas. Aims To describe the epidemiology of human PUUV and DOBV infections in Germany. Methods We conducted an observational retrospective study analysing national hantavirus surveillance data notified to the national public health institute and hantavirus nucleotide sequences from patients collected at the national consultation laboratory between 2001 and 2017. Matching molecular sequences with surveillance data, we conducted epidemiological, phylogenetic and phylogeographic analyses. Results In total, 12,148 cases of symptomatic hantavirus infection were notified 2001–17 (mean annual incidence: 0.87/100,000; range: 0.09–3.51). PUUV infections showed a highly variable space-time disease incidence pattern, causing large outbreaks every 2–3 years with peaks in early summer and up to 3,000 annually reported cases. Sex-specific differences in disease presentation were observed. Of 202 PUUV nucleotide sequences obtained from cases, 189 (93.6%) fall into well-supported phylogenetic clusters corresponding to different endemic areas in Germany. DOBV infections caused few, mostly sporadic cases in autumn and winter in the north and east of Germany. Conclusions The frequency of PUUV outbreaks increased between 2001 and 2017 but our data does not support the suggested expansion of endemic areas. The epidemiology of PUUV and DOBV-Kurkino infections differs in several aspects. Moreover, the latter are relatively rare and combining efforts and data of several countries to identify risk factors and develop specific recommendations for prevention could be worthwhile.
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Affiliation(s)
- Mirko Faber
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Detlev H Krüger
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
| | - Brita Auste
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
| | - Klaus Stark
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Jörg Hofmann
- These authors contributed equally and share last authorship.,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
| | - Sabrina Weiss
- These authors contributed equally and share last authorship.,Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
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12
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Spatial and Temporal Evolutionary Patterns in Puumala Orthohantavirus (PUUV) S Segment. Pathogens 2020; 9:pathogens9070548. [PMID: 32650456 PMCID: PMC7400055 DOI: 10.3390/pathogens9070548] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/24/2020] [Accepted: 06/28/2020] [Indexed: 12/12/2022] Open
Abstract
The S segment of bank vole (Clethrionomys glareolus)-associated Puumala orthohantavirus (PUUV) contains two overlapping open reading frames coding for the nucleocapsid (N) and a non-structural (NSs) protein. To identify the influence of bank vole population dynamics on PUUV S segment sequence evolution and test for spillover infections in sympatric rodent species, during 2010–2014, 883 bank voles, 357 yellow-necked mice (Apodemus flavicollis), 62 wood mice (A. sylvaticus), 149 common voles (Microtus arvalis) and 8 field voles (M. agrestis) were collected in Baden-Wuerttemberg and North Rhine-Westphalia, Germany. In total, 27.9% and 22.3% of bank voles were positive for PUUV-reactive antibodies and PUUV-specific RNA, respectively. One of eight field voles was PUUV RNA-positive, indicating a spillover infection, but none of the other species showed evidence of PUUV infection. Phylogenetic and isolation-by-distance analyses demonstrated a spatial clustering of PUUV S segment sequences. In the hantavirus outbreak years 2010 and 2012, PUUV RNA prevalence was higher in our study regions compared to non-outbreak years 2011, 2013 and 2014. NSs amino acid and nucleotide sequence types showed temporal and/or local variation, whereas the N protein was highly conserved in the NSs overlapping region and, to a lower rate, in the N alone coding part.
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13
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Isolation and characterization of new Puumala orthohantavirus strains from Germany. Virus Genes 2020; 56:448-460. [PMID: 32328924 PMCID: PMC7329759 DOI: 10.1007/s11262-020-01755-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 04/03/2020] [Indexed: 12/28/2022]
Abstract
Orthohantaviruses are re-emerging rodent-borne pathogens distributed all over the world. Here, we report the isolation of a Puumala orthohantavirus (PUUV) strain from bank voles caught in a highly endemic region around the city Osnabrück, north-west Germany. Coding and non-coding sequences of all three segments (S, M, and L) were determined from original lung tissue, after isolation and after additional passaging in VeroE6 cells and a bank vole-derived kidney cell line. Different single amino acid substitutions were observed in the RNA-dependent RNA polymerase (RdRP) of the two stable PUUV isolates. The PUUV strain from VeroE6 cells showed a lower titer when propagated on bank vole cells compared to VeroE6 cells. Additionally, glycoprotein precursor (GPC)-derived virus-like particles of a German PUUV sequence allowed the generation of monoclonal antibodies that allowed the reliable detection of the isolated PUUV strain in the immunofluorescence assay. In conclusion, this is the first isolation of a PUUV strain from Central Europe and the generation of glycoprotein-specific monoclonal antibodies for this PUUV isolate. The obtained virus isolate and GPC-specific antibodies are instrumental tools for future reservoir host studies.
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14
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Liu R, Ma H, Shu J, Zhang Q, Han M, Liu Z, Jin X, Zhang F, Wu X. Vaccines and Therapeutics Against Hantaviruses. Front Microbiol 2020; 10:2989. [PMID: 32082263 PMCID: PMC7002362 DOI: 10.3389/fmicb.2019.02989] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/10/2019] [Indexed: 12/16/2022] Open
Abstract
Hantaviruses (HVs) are rodent-transmitted viruses that can cause hantavirus cardiopulmonary syndrome (HCPS) in the Americas and hemorrhagic fever with renal syndrome (HFRS) in Eurasia. Together, these viruses have annually caused approximately 200,000 human infections worldwide in recent years, with a case fatality rate of 5–15% for HFRS and up to 40% for HCPS. There is currently no effective treatment available for either HFRS or HCPS. Only whole virus inactivated vaccines against HTNV or SEOV are licensed for use in the Republic of Korea and China, but the protective efficacies of these vaccines are uncertain. To a large extent, the immune correlates of protection against hantavirus are not known. In this review, we summarized the epidemiology, virology, and pathogenesis of four HFRS-causing viruses, HTNV, SEOV, PUUV, and DOBV, and two HCPS-causing viruses, ANDV and SNV, and then discussed the existing knowledge on vaccines and therapeutics against these diseases. We think that this information will shed light on the rational development of new vaccines and treatments.
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Affiliation(s)
- Rongrong Liu
- Department of Microbiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Hongwei Ma
- Department of Microbiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Jiayi Shu
- Scientific Research Center, Shanghai Public Health Clinical Center & Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education & Health, Shanghai Medical College, Fudan University, Shanghai, China.,Viral Disease and Vaccine Translational Research Unit, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Qiang Zhang
- School of Biology and Basic Medical Sciences, Soochow University, Suzhou, China
| | - Mingwei Han
- Cadet Brigade, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Ziyu Liu
- Department of Microbiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Xia Jin
- Scientific Research Center, Shanghai Public Health Clinical Center & Institutes of Biomedical Sciences, Key Laboratory of Medical Molecular Virology of Ministry of Education & Health, Shanghai Medical College, Fudan University, Shanghai, China
| | - Fanglin Zhang
- Department of Microbiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Xingan Wu
- Department of Microbiology, School of Basic Medicine, Fourth Military Medical University, Xi'an, China
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15
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Binder F, Drewes S, Imholt C, Saathoff M, Below DA, Bendl E, Conraths FJ, Tenhaken P, Mylius M, Brockmann S, Oehme R, Freise J, Jacob J, Ulrich RG. Heterogeneous Puumala orthohantavirus situation in endemic regions in Germany in summer 2019. Transbound Emerg Dis 2019; 67:502-509. [PMID: 31674714 DOI: 10.1111/tbed.13408] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/10/2019] [Accepted: 10/25/2019] [Indexed: 12/19/2022]
Abstract
Puumala orthohantavirus (PUUV) causes most human hantavirus disease cases in Europe. PUUV disease outbreaks are usually synchronized Germany-wide driven by beech mast-induced irruptions of its host (bank vole, Myodes glareolus). Recent data indicate high vole abundance, high PUUV prevalence and high human incidence in summer 2019 for some regions, but elsewhere values were low to moderate. This significant lack of synchrony among regions in Germany is in contrast to previous studies. Health institutions need to be informed about the heterogeneous distribution of human PUUV infection risk to initiate appropriate actions.
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Affiliation(s)
- Florian Binder
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany
| | - Stephan Drewes
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany
| | - Christian Imholt
- Julius Kühn-Institut, Federal Research Centre for Cultivated Plants, Institute for Plant Protection in Horticulture and Forests, Vertebrate Research, Münster, Germany
| | - Marion Saathoff
- Lower Saxony State Office for Consumer Protection and Food Safety, Veterinary Task-Force, Department of Pest Control, Oldenburg, Germany
| | - Diana Alexandra Below
- Julius Kühn-Institut, Federal Research Centre for Cultivated Plants, Institute for Plant Protection in Horticulture and Forests, Vertebrate Research, Münster, Germany
| | - Elias Bendl
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany
| | - Franz J Conraths
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Greifswald-Insel Riems, Germany
| | | | - Maren Mylius
- The Governmental Institute of Public Health of Lower Saxony, Hannover, Germany
| | | | - Rainer Oehme
- State Health Office Baden-Württemberg, Stuttgart, Germany
| | - Jona Freise
- Lower Saxony State Office for Consumer Protection and Food Safety, Veterinary Task-Force, Department of Pest Control, Oldenburg, Germany
| | - Jens Jacob
- Julius Kühn-Institut, Federal Research Centre for Cultivated Plants, Institute for Plant Protection in Horticulture and Forests, Vertebrate Research, Münster, Germany
| | - Rainer G Ulrich
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany
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16
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Davidyuk YN, Kabwe E, Shakirova VG, Martynova EV, Ismagilova RK, Khaertynova IM, Khaiboullina SF, Rizvanov AA, Morzunov SP. Characterization of the Puumala orthohantavirus Strains in the Northwestern Region of the Republic of Tatarstan in Relation to the Clinical Manifestations in Hemorrhagic Fever With Renal Syndrome Patients. Front Pharmacol 2019; 10:970. [PMID: 31543819 PMCID: PMC6739438 DOI: 10.3389/fphar.2019.00970] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 07/29/2019] [Indexed: 12/11/2022] Open
Abstract
Over 1,000 cases of hemorrhagic fever with renal syndrome (HFRS) were recorded in the Republic of Tatarstan (RT) in 2015. HFRS is a zoonotic disease caused by several different Old World hantaviruses. In RT, Puumala orthohantavirus (PUUV) is a prevalent etiological agent of HFRS. We looked for the genetic link between the PUUV strains isolated from the bank voles and from the infected humans. In addition, possible correlation between the genetic makeup of the PUUV strain involved and different clinical picture of HFRS was investigated. Partial PUUV small (S) genome segment sequences were retrieved from 37 small animals captured in the northwestern region of RT in 2015. Phylogenetic analysis revealed that 34 PUUV sequences clustered with strains of the previously identified “Russia” (RUS) genetic lineage, while 3 remaining PUUV sequences clustered with the known lineage from Finland (FIN). Sequence comparisons showed that the majority of the S-segment sequences isolated in the current study displayed 98.2–100.0% sequence identity when compared with the strains isolated earlier from the HFRS patients hospitalized in Kazan city. HFRS patients infected with PUUV strains of either RUS or FIN genetic lineages were observed to have consistent differences in clinical presentation of the disease and laboratory findings. These findings indicated a strong genetic link between the infected bank voles and human HFRS cases from the same localities. Thus, S-segment sequences of the PUUV strains isolated from HFRS patients could serve as a molecular marker for determining the likely geographic area where infection occurred.
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Affiliation(s)
- Yuriy N Davidyuk
- OpenLab Gene and Cell Technologies, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Emmanuel Kabwe
- OpenLab Gene and Cell Technologies, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Venera G Shakirova
- Department of Infectious Diseases, Kazan State Medical Academy, Kazan, Russia
| | - Ekaterina V Martynova
- OpenLab Gene and Cell Technologies, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Ruzilya K Ismagilova
- Research Laboratory "Omics technology", Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | | | - Svetlana F Khaiboullina
- OpenLab Gene and Cell Technologies, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia.,Department of Microbiology and Immunology, University of Nevada, Reno, NV, United States
| | - Albert A Rizvanov
- OpenLab Gene and Cell Technologies, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Sergey P Morzunov
- Department of Pathology, University of Nevada, Reno, NV, United States
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17
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Filippone C, Castel G, Murri S, Ermonval M, Korva M, Avšič-Županc T, Sironen T, Vapalahati O, McElhinney LM, Ulrich RG, Groschup MH, Caro V, Sauvage F, van der Werf S, Manuguerra JC, Gessain A, Marianneau P, Tordo N. Revisiting the genetic diversity of emerging hantaviruses circulating in Europe using a pan-viral resequencing microarray. Sci Rep 2019; 9:12404. [PMID: 31455867 PMCID: PMC6712034 DOI: 10.1038/s41598-019-47508-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 06/21/2019] [Indexed: 11/09/2022] Open
Abstract
Hantaviruses are zoonotic agents transmitted from small mammals, mainly rodents, to humans, where they provoke diseases such as Hemorrhagic fever with Renal Syndrome (HFRS) and its mild form, Nephropathia Epidemica (NE), or Hantavirus Cardio-Pulmonary Syndrome (HCPS). Hantaviruses are spread worldwide and monitoring animal reservoirs is of primary importance to control the zoonotic risk. Here, we describe the development of a pan-viral resequencing microarray (PathogenID v3.0) able to explore the genetic diversity of rodent-borne hantaviruses endemic in Europe. Among about 800 sequences tiled on the microarray, 52 correspond to a tight molecular sieve of hantavirus probes covering a large genetic landscape. RNAs from infected animal tissues or from laboratory strains have been reverse transcribed, amplified, then hybridized to the microarray. A classical BLASTN analysis applied to the sequence delivered through the microarray allows to identify the hantavirus species up to the exact geographical variant present in the tested samples. Geographical variants of the most common European hantaviruses from France, Germany, Slovenia and Finland, such as Puumala virus, Dobrava virus and Tula virus, were genetically discriminated. Furthermore, we precisely characterized geographical variants still unknown when the chip was conceived, such as Seoul virus isolates, recently emerged in France and the United Kingdom.
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Affiliation(s)
- Claudia Filippone
- Institut Pasteur, Antiviral Strategies Unit, Department of Virology, Paris, France.,Institut Pasteur, Unit of Epidemiology and Physiopathology of Oncogenic Viruses, CNRS, UMR 3569, Department of Virology, Paris, France.,Virology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Guillaume Castel
- CBGP, INRA, CIRAD, IRD, Montpellier SupAgro, Univ Montpellier, Montpellier, France, Montpellier, France
| | | | - Myriam Ermonval
- Institut Pasteur, Antiviral Strategies Unit, Department of Virology, Paris, France
| | - Misa Korva
- University of Ljubljana, Microbiology and Immunology Institute, Faculty of Medicine, Ljubljana, Slovenia
| | - Tatjana Avšič-Županc
- University of Ljubljana, Microbiology and Immunology Institute, Faculty of Medicine, Ljubljana, Slovenia
| | - Tarja Sironen
- Haartman Institute, Department of Virology, Helsinki, Finland
| | - Olli Vapalahati
- Haartman Institute, Department of Virology, Helsinki, Finland
| | - Lorraine M McElhinney
- Animal and Plant Health Agency (APHA), Surrey, UK. University of Liverpool, South Wirral, United Kingdom
| | - Rainer G Ulrich
- Friedrich-Loeffler-Institut, Institute for Novel and Emerging Infectious Diseases, Greifswald, Insel Riems, Germany
| | - Martin H Groschup
- Friedrich-Loeffler-Institut, Institute for Novel and Emerging Infectious Diseases, Greifswald, Insel Riems, Germany
| | - Valérie Caro
- Institut Pasteur, Laboratory for Urgent Response to Biological Threats - CIBU Unit, Paris, France
| | - Frank Sauvage
- University of Lyon, UMR- CNRS, 5558, Villeurbanne, France
| | - Sylvie van der Werf
- Institut Pasteur, Unit of Molecular Genetics of RNA viruses, Department of Virology, Paris, France
| | - Jean-Claude Manuguerra
- Institut Pasteur, Laboratory for Urgent Response to Biological Threats - CIBU Unit, Paris, France
| | - Antoine Gessain
- Institut Pasteur, Unit of Epidemiology and Physiopathology of Oncogenic Viruses, CNRS, UMR 3569, Department of Virology, Paris, France
| | | | - Noël Tordo
- Institut Pasteur, Antiviral Strategies Unit, Department of Virology, Paris, France. .,Institut Pasteur de Guinée, Conakry, Guinea.
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Weiss S, Klempa B, Tenner B, Kruger DH, Hofmann J. Prediction of the Spatial Origin of Puumala Virus Infections Using L Segment Sequences Derived from a Generic Screening PCR. Viruses 2019; 11:v11080694. [PMID: 31366168 PMCID: PMC6724045 DOI: 10.3390/v11080694] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/12/2019] [Accepted: 07/27/2019] [Indexed: 11/16/2022] Open
Abstract
To screen diagnostic specimens for the presence of hantavirus genomes or to identify new hantaviruses in nature, the pan-hanta L-PCR assay, a broadly reactive nested reverse transcription polymerase chain reaction (RT-PCR) assay targeting the L segment, is highly preferred over other assays because of its universality and high sensitivity. In contrast, the geographic allocation of Puumala virus strains to defined outbreak regions in Germany was previously done based on S segment sequences. We show that the routinely generated partial L segment sequences resulting from the pan-hanta L-PCR assay provide sufficient phylogenetic signal to inform the molecular epidemiology of the Puumala virus. Consequently, an additional S segment analysis seems no longer necessary for the identification of the spatial origin of a virus strain.
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Affiliation(s)
- Sabrina Weiss
- Institute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany.
| | - Boris Klempa
- Institute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
- Institute of Virology, Biomedical Research Center, Slovak Academy of Sciences, 84505 Bratislava, Slovakia
| | - Beate Tenner
- Institute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Detlev H Kruger
- Institute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
| | - Jörg Hofmann
- Institute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany
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Salehi-Vaziri M, Kaleji AS, Fazlalipour M, Jalali T, Mohammadi T, Khakifirouz S, Baniasadi V, Pouriayevali MH, Mahmoudi A, Tordo N, Mostafavi E. Hantavirus infection in Iranian patients suspected to viral hemorrhagic fever. J Med Virol 2019; 91:1737-1742. [PMID: 31218696 DOI: 10.1002/jmv.25522] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/12/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Hantaviruses are a group of emerging pathogens causing hemorrhagic fever with renal syndrome and Hantavirus cardiopulmonary syndrome in human. This study was conducted to investigate Hantavirus infection among Iranian viral hemorrhagic fever suspected patients. METHODS From April 2014 to June 2016, 113 cases from 25 different provinces of Iran were analyzed for Hantavirus infection by IgM/IgG ELISA and pan-Hantavirus RT-PCR tests. RESULTS Although, viral genome was detected in none of the subjects, IgM and IgG antibodies were detected in 19 and 4 cases, respectively. Differentiation of the anti-Hantavirus antibodies according to virus species by EUROLINE Anti-Hantavirus Profile Kit revealed three Puumala virus IgM positive, one Hantaan virus IgM positive, one Hantaan virus IgM borderline, and two Puumala virus IgG borderline cases. CONCLUSIONS This study demonstrates the circulation of Hantaviruses in Iran and calls for further investigations of these life-threatening viruses in the country.
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Affiliation(s)
- Mostafa Salehi-Vaziri
- Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran.,Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | | | - Mehdi Fazlalipour
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | - Tahmineh Jalali
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran.,Department of Biology, Shahed University, Tehran, Iran
| | - Tahereh Mohammadi
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | - Sahar Khakifirouz
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | - Vahid Baniasadi
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | - Mohammad Hassan Pouriayevali
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | - Ahmad Mahmoudi
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Noel Tordo
- Department of Virology, Unit Antiviral Strategies, Institut Pasteur, Paris, France.,Institut Pasteur de Guinée, route de Donka, Conakry, Guinea
| | - Ehsan Mostafavi
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
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20
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Clinical course of hantavirus-induced nephropathia epidemica in children compared to adults in Germany-analysis of 317 patients. Pediatr Nephrol 2019; 34:1247-1252. [PMID: 30874941 DOI: 10.1007/s00467-019-04215-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 01/13/2019] [Accepted: 02/11/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Hantavirus infections are endemic worldwide, and its incidence in Europe has been steadily increasing. In Western Europe, hantavirus infections are typically caused by Puumala hantavirus and cause nephropathia epidemica (NE), a mild form of haemorrhagic fever with renal syndrome. Up to now, there is only little data about the course of acute NE in children, but it has been suggested that hantavirus infections take a lighter course in children when compared to adults. We performed a retrospective analysis of adults and children diagnosed with acute NE in two counties in South-Western Germany to investigate if there are differences in the course of the disease. METHODS We reviewed the medical records of 295 adults and 22 children with acute NE regarding clinical presentation, laboratory findings, complications and outcome. RESULTS Acute kidney injury (AKI) and thrombocytopenia occurred at similar frequencies and severity in both groups. Sudden onset of fever and back/loin pain were two of the three most common symptoms in both adults and children. However, adults presented more frequently with arthralgia and visual disturbances, whereas abdominal pain and nausea/vomiting could be detected more often in children. No significant differences were found in the incidence of complications (haemodialysis, long-term outcome of kidney function, length of hospital stay). CONCLUSIONS The clinical course of acute NE was similar in adults and children with high frequency of AKI as well as thrombocytopenia, but with full recovery of all patients.
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21
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Hofmann J, Weiss S, Kuhns M, Zinke A, Heinsberger H, Kruger DH. Importation of Human Seoul Virus Infection to Germany from Indonesia. Emerg Infect Dis 2019; 24:1099-1102. [PMID: 29774860 PMCID: PMC6004851 DOI: 10.3201/eid2406.172044] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Seoul hantavirus–associated hemorrhagic fever with renal syndrome cases are rare outside Asia and have not yet been found in Germany. We report clinical and molecular evidence for a Seoul virus infection in a patient in Germany. The infection was most likely acquired during a stay in Sulawesi, Indonesia.
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22
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Spatial dynamics of a zoonotic orthohantavirus disease through heterogenous data on rodents, rodent infections, and human disease. Sci Rep 2019; 9:2329. [PMID: 30787344 PMCID: PMC6382775 DOI: 10.1038/s41598-019-38802-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 12/31/2018] [Indexed: 02/08/2023] Open
Abstract
Zoonotic diseases are challenging to study from the ecological point of view as, broadly speaking, datasets tend to be either detailed on a small spatial extent, or coarse on a large spatial extent. Also, there are many ways to assess zoonotic disease transmission systems, from pathogens to hosts to humans. We explore the complementarity of datasets considering the pathogen in its host, the host and human cases in the context of Puumala orthohantavirus infection in Germany. We selected relevant environmental predictors using a conceptual framework based on resource-based habitats. This framework assesses the functions, and associated environmental resources of the pathogen and associated host. A resource-based habitat framework supports variable selection and result interpretation. Multiplying ‘keyholes’ to view a zoonotic disease transmission system is valuable, but requires a strong conceptual framework to select and interpret environmental explanatory variables. This study highlights the usefulness of a structured, ecology-based approach to study drivers of zoonotic diseases at the level of virus, host, and human - not only for PUUV but also for other zoonotic pathogens. Our results show that human disease cases are best explained by a combination of variables related to zoonotic pathogen circulation and human exposure.
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23
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Drewes S, Ali HS, Saxenhofer M, Rosenfeld UM, Binder F, Cuypers F, Schlegel M, Röhrs S, Heckel G, Ulrich RG. Host-Associated Absence of Human Puumala Virus Infections in Northern and Eastern Germany. Emerg Infect Dis 2018; 23:83-86. [PMID: 27983499 PMCID: PMC5176216 DOI: 10.3201/eid2301.160224] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Human hantavirus disease cases, caused by Puumala virus (PUUV), are mainly recorded in western and southern areas of Germany. This bank vole reservoir survey confirmed PUUV presence in these regions but its absence in northern and eastern regions. PUUV occurrence is associated with the presence of the Western bank vole phylogroup.
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24
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Szabó R, Radosa L, Ličková M, Sláviková M, Heroldová M, Stanko M, Pejčoch M, Osterberg A, Laenen L, Schex S, Ulrich RG, Essbauer S, Maes P, Klempa B. Phylogenetic analysis of Puumala virus strains from Central Europe highlights the need for a full-genome perspective on hantavirus evolution. Virus Genes 2017; 53:913-917. [PMID: 28664467 DOI: 10.1007/s11262-017-1484-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 06/21/2017] [Indexed: 11/25/2022]
Abstract
Puumala virus (PUUV), carried by bank voles (Myodes glareolus), is the medically most important hantavirus in Central and Western Europe. In this study, a total of 523 bank voles (408 from Germany, 72 from Slovakia, and 43 from Czech Republic) collected between the years 2007-2012 were analyzed for the presence of hantavirus RNA. Partial PUUV genome segment sequences were obtained from 51 voles. Phylogenetic analyses of all three genome segments showed that the newfound strains cluster with other Central and Western European PUUV strains. The new sequences from Šumava (Bohemian Forest), Czech Republic, are most closely related to the strains from the neighboring Bavarian Forest, a known hantavirus disease outbreak region. Interestingly, the Slovak strains clustered with the sequences from Bohemian and Bavarian Forests only in the M but not S segment analyses. This well-supported topological incongruence suggests a segment reassortment event or, as we analyzed only partial sequences, homologous recombination. Our data highlight the necessity of sequencing all three hantavirus genome segments and of a broader bank vole screening not only in recognized endemic foci but also in regions with no reported human hantavirus disease cases.
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Affiliation(s)
- Róbert Szabó
- Biomedical Research Center, Institute of Virology, Slovak Academy of Sciences, Bratislava, Slovakia
- Faculty of Natural Sciences, Comenius University in Bratislava, Bratislava, Slovakia
- Department of Biomedical Sciences, University of Cagliari, Monserrato, CA, Italy
| | - Lukáš Radosa
- Institute of Virology, Charité University Hospital, Helmut-Ruska-Haus, Berlin, Germany
- Department of Infectious Diseases, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Martina Ličková
- Biomedical Research Center, Institute of Virology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Monika Sláviková
- Biomedical Research Center, Institute of Virology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Marta Heroldová
- Department of Forest Ecology, Mendel University in Brno, Brno, Czech Republic
| | - Michal Stanko
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Slovakia
| | - Milan Pejčoch
- National Institute of Public Health, Prague, Czech Republic
| | - Anja Osterberg
- Department of Virology & Rickettsiology, Bundeswehr Institute of Microbiology, Munich, Germany
| | - Lies Laenen
- Division of Clinical and Epidemiological Virology, Zoonotic Infectious Diseases Unit, KU Leuven, Rega Institute, Leuven, Belgium
| | - Susanne Schex
- Department of Virology & Rickettsiology, Bundeswehr Institute of Microbiology, Munich, Germany
| | - Rainer G Ulrich
- Institute for Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germany
| | - Sandra Essbauer
- Department of Virology & Rickettsiology, Bundeswehr Institute of Microbiology, Munich, Germany
| | - Piet Maes
- Division of Clinical and Epidemiological Virology, Zoonotic Infectious Diseases Unit, KU Leuven, Rega Institute, Leuven, Belgium
| | - Boris Klempa
- Biomedical Research Center, Institute of Virology, Slovak Academy of Sciences, Bratislava, Slovakia.
- Institute of Virology, Charité University Hospital, Helmut-Ruska-Haus, Berlin, Germany.
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Obiegala A, Albrecht C, Dafalla M, Drewes S, Oltersdorf C, Turni H, Imholt C, Jacob J, Wagner-Wiening C, Ulrich RG, Pfeffer M. Leptospira spp. in Small Mammals from Areas with Low and High Human Hantavirus Incidences in South-West Germany. Vector Borne Zoonotic Dis 2017; 17:312-318. [PMID: 28332927 DOI: 10.1089/vbz.2016.2036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Leptospirosis is caused by Leptospira spp. and is considered the most widespread zoonotic disease worldwide. It mimics nephropathia epidemica in humans, a disease mainly caused by Puumala hantavirus (PUUV). Small mammals are reservoirs for Leptospira spp. and PUUV. Seewis virus (SWSV) is a shrew-borne hantavirus with unknown pathogenicity. The objective of this study was to estimate the prevalence for Leptospira spp. and the frequency of Leptospira-hantavirus co-infections in small mammals collected at locations with high and low incidences in humans. MATERIALS AND METHODS In 2012 and 2013, 736 small mammals belonging to seven species (Apodemus flavicollis, Microtus agrestis, Microtus arvalis, Myodes glareolus, Sorex araneus, S. coronatus, and S. minutus) were collected at four high incidence sites (H1-H4) and four low (L1-L4) incidence sites for PUUV infection in humans. Kidney-derived DNA samples were tested for Leptospira spp. by real-time PCR targeting the lipl 32 gene and further analyzed by duplex PCR targeting the flaB and the secY genes. For the detection of Seewis virus, lung-derived DNA was tested via RT-PCR targeting the nucleocapsid gene. RESULTS Altogether, 42 of the 736 small mammals including 27 of 660 bank voles and 11 of 66 shrews, were positive for Leptospira spp., while Sorex spp. (14.7%) showed significantly higher prevalences compared to bank voles (4.1%). Detected Leptospira spp. were pathogenic species other than L. kirschneri. Significantly more Leptospira-positive bank voles were found at H sites than at L sites. Altogether 22.2% of positive bank voles were infected with PUUV. Double infection of PUUV and Leptospira spp. occurrence in bank voles is 1.86 times (OR = 1.86; 95% CI: 0.72-4.73) more likely than infections with each pathogen separately. DISCUSSION Leptospira- positive bank voles are focally positively associated with PUUV infection in bank voles and with human hantavirus cases. It should be considered that shrews may serve as Leptospira spp. reservoirs.
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Affiliation(s)
- Anna Obiegala
- 1 Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig , Leipzig, Germany
| | - Christoph Albrecht
- 1 Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig , Leipzig, Germany
| | - Maysaa Dafalla
- 2 Institute for Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health , Greifswald-Insel Riems, Germany
| | - Stephan Drewes
- 2 Institute for Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health , Greifswald-Insel Riems, Germany
| | - Carolin Oltersdorf
- 1 Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig , Leipzig, Germany
| | | | - Christian Imholt
- 4 Institute for Plant Protection in Horticulture and Forests, Julius Kühn-Institute , Federal Research Centre for Cultivated Plants, Vertebrate Research, Münster, Germany
| | - Jens Jacob
- 4 Institute for Plant Protection in Horticulture and Forests, Julius Kühn-Institute , Federal Research Centre for Cultivated Plants, Vertebrate Research, Münster, Germany
| | | | - Rainer G Ulrich
- 2 Institute for Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health , Greifswald-Insel Riems, Germany
| | - Martin Pfeffer
- 1 Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig , Leipzig, Germany
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Reil D, Rosenfeld UM, Imholt C, Schmidt S, Ulrich RG, Eccard JA, Jacob J. Puumala hantavirus infections in bank vole populations: host and virus dynamics in Central Europe. BMC Ecol 2017; 17:9. [PMID: 28245831 PMCID: PMC5331674 DOI: 10.1186/s12898-017-0118-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 02/08/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In Europe, bank voles (Myodes glareolus) are widely distributed and can transmit Puumala virus (PUUV) to humans, which causes a mild to moderate form of haemorrhagic fever with renal syndrome, called nephropathia epidemica. Uncovering the link between host and virus dynamics can help to prevent human PUUV infections in the future. Bank voles were live trapped three times a year in 2010-2013 in three woodland plots in each of four regions in Germany. Bank vole population density was estimated and blood samples collected to detect PUUV specific antibodies. RESULTS We demonstrated that fluctuation of PUUV seroprevalence is dependent not only on multi-annual but also on seasonal dynamics of rodent host abundance. Moreover, PUUV infection might affect host fitness, because seropositive individuals survived better from spring to summer than uninfected bank voles. Individual space use was independent of PUUV infections. CONCLUSIONS Our study provides robust estimations of relevant patterns and processes of the dynamics of PUUV and its rodent host in Central Europe, which are highly important for the future development of predictive models for human hantavirus infection risk.
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Affiliation(s)
- Daniela Reil
- Institute for Plant Protection in Horticulture and Forests, Vertebrate Research, Julius Kühn-Institute, Toppheideweg 88, 48161 Muenster, Germany
- Institute of Biochemistry and Biology, Animal Ecology, University of Potsdam, Maulbeerallee 1, 14469 Potsdam, Germany
| | - Ulrike M. Rosenfeld
- Institute for Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17493 Greifswald-Insel Riems, Germany
| | - Christian Imholt
- Institute for Plant Protection in Horticulture and Forests, Vertebrate Research, Julius Kühn-Institute, Toppheideweg 88, 48161 Muenster, Germany
| | - Sabrina Schmidt
- Institute for Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17493 Greifswald-Insel Riems, Germany
| | - Rainer G. Ulrich
- Institute for Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17493 Greifswald-Insel Riems, Germany
| | - Jana A. Eccard
- Institute of Biochemistry and Biology, Animal Ecology, University of Potsdam, Maulbeerallee 1, 14469 Potsdam, Germany
| | - Jens Jacob
- Institute for Plant Protection in Horticulture and Forests, Vertebrate Research, Julius Kühn-Institute, Toppheideweg 88, 48161 Muenster, Germany
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27
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Rosenfeld UM, Drewes S, Ali HS, Sadowska ET, Mikowska M, Heckel G, Koteja P, Ulrich RG. A highly divergent Puumala virus lineage in southern Poland. Arch Virol 2017; 162:1177-1185. [PMID: 28093611 DOI: 10.1007/s00705-016-3200-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 11/24/2016] [Indexed: 12/31/2022]
Abstract
Puumala virus (PUUV) represents one of the most important hantaviruses in Central Europe. Phylogenetic analyses of PUUV strains indicate a strong genetic structuring of this hantavirus. Recently, PUUV sequences were identified in the natural reservoir, the bank vole (Myodes glareolus), collected in the northern part of Poland. The objective of this study was to evaluate the presence of PUUV in bank voles from southern Poland. A total of 72 bank voles were trapped in 2009 at six sites in this part of Poland. RT-PCR and IgG-ELISA analyses detected three PUUV positive voles at one trapping site. The PUUV-infected animals were identified by cytochrome b gene analysis to belong to the Carpathian and Eastern evolutionary lineages of bank vole. The novel PUUV S, M and L segment nucleotide sequences showed the closest similarity to sequences of the Russian PUUV lineage from Latvia, but were highly divergent to those previously found in northern Poland, Slovakia and Austria. In conclusion, the detection of a highly divergent PUUV lineage in southern Poland indicates the necessity of further bank vole monitoring in this region allowing rational public health measures to prevent human infections.
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Affiliation(s)
- Ulrike M Rosenfeld
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute for Novel and Emerging Infectious Diseases, Südufer 10, Greifswald-Insel Riems, 17493, Germany
| | - Stephan Drewes
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute for Novel and Emerging Infectious Diseases, Südufer 10, Greifswald-Insel Riems, 17493, Germany
| | - Hanan Sheikh Ali
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute for Novel and Emerging Infectious Diseases, Südufer 10, Greifswald-Insel Riems, 17493, Germany
| | - Edyta T Sadowska
- Institute of Environmental Sciences, Jagiellonian University, Kraków, 30-387, Poland
| | - Magdalena Mikowska
- Institute of Environmental Sciences, Jagiellonian University, Kraków, 30-387, Poland
| | - Gerald Heckel
- Computational and Molecular Population Genetics (CMPG), Institute of Ecology and Evolution, University of Bern, Bern, CH-3012, Switzerland.,Swiss Institute of Bioinformatics, Genopode, Lausanne, CH-1015, Switzerland
| | - Paweł Koteja
- Institute of Environmental Sciences, Jagiellonian University, Kraków, 30-387, Poland
| | - Rainer G Ulrich
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute for Novel and Emerging Infectious Diseases, Südufer 10, Greifswald-Insel Riems, 17493, Germany.
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28
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Drewes S, Turni H, Rosenfeld UM, Obiegala A, Straková P, Imholt C, Glatthaar E, Dressel K, Pfeffer M, Jacob J, Wagner-Wiening C, Ulrich RG. Reservoir-Driven Heterogeneous Distribution of Recorded Human Puumala virus Cases in South-West Germany. Zoonoses Public Health 2016; 64:381-390. [PMID: 27918151 DOI: 10.1111/zph.12319] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Indexed: 01/19/2023]
Abstract
Endemic regions for Puumala virus (PUUV) are located in the most affected federal state Baden-Wuerttemberg, South-West Germany, where high numbers of notified human hantavirus disease cases have been occurring for a long time. The distribution of human cases in Baden-Wuerttemberg is, however, heterogeneous, with a high number of cases recorded during 2012 in four districts (H districts) but a low number or even no cases recorded in four other districts (L districts). Bank vole monitoring during 2012, following a beech (Fagus sylvatica) mast year, resulted in the trapping of 499 bank voles, the host of PUUV. Analyses indicated PUUV prevalences of 7-50% (serological) and 1.8-27.5% (molecular) in seven of eight districts, but an absence of PUUV in one L district. The PUUV prevalence differed significantly between bank voles in H and L districts. In the following year 2013, 161 bank voles were trapped, with reduced bank vole abundance in almost all investigated districts except one. In 2013, no PUUV infections were detected in voles from seven of eight districts. In conclusion, the linear modelling approach indicated that the heterogeneous distribution of human PUUV cases in South-West Germany was caused by different factors including the abundance of PUUV RNA-positive bank voles, as well as by the interaction of beech mast and the proportional coverage of beech and oak (Quercus spec.) forest per district. These results can aid developing local public health risk management measures and early warning models.
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Affiliation(s)
- S Drewes
- Friedrich-Loeffler-Institut, Institute for Novel and Emerging Infectious Diseases, Greifswald - Insel Riems, Germany
| | - H Turni
- Stauss & Turni Gutachterbüro, Tübingen, Germany
| | - U M Rosenfeld
- Friedrich-Loeffler-Institut, Institute for Novel and Emerging Infectious Diseases, Greifswald - Insel Riems, Germany
| | - A Obiegala
- Veterinärmedizinische Fakultät, Institut für Tierhygiene und Öffentliches Veterinärwesen, University Leipzig, Leipzig, Germany
| | - P Straková
- Friedrich-Loeffler-Institut, Institute for Novel and Emerging Infectious Diseases, Greifswald - Insel Riems, Germany.,Institute of Vertebrate Biology v.v.i., Academy of Sciences, Masaryk University, Brno, Czech Republic.,Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - C Imholt
- Julius Kühn-Institute, Federal Research Centre for Cultivated Plants, Institute for Plant Protection in Horticulture and Forests, Vertebrate Research, Münster, Germany
| | - E Glatthaar
- Forstzoologisches Institut, Arbeitsbereich Wildtierökologie und Wildtiermanagement, Universität Freiburg, Freiburg, Germany
| | - K Dressel
- sine-Institut gGmbH, Munich, Germany
| | - M Pfeffer
- Veterinärmedizinische Fakultät, Institut für Tierhygiene und Öffentliches Veterinärwesen, University Leipzig, Leipzig, Germany
| | - J Jacob
- Julius Kühn-Institute, Federal Research Centre for Cultivated Plants, Institute for Plant Protection in Horticulture and Forests, Vertebrate Research, Münster, Germany
| | - C Wagner-Wiening
- Landesgesundheitsamt Baden-Württemberg, Referat 95 - Epidemiologie und Gesundheitsberichterstattung, Sachgebietsleitung: Infektionsepidemiologische Meldesysteme (SG4), Stuttgart, Germany
| | - R G Ulrich
- Friedrich-Loeffler-Institut, Institute for Novel and Emerging Infectious Diseases, Greifswald - Insel Riems, Germany
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Crystal Structure of Glycoprotein C from a Hantavirus in the Post-fusion Conformation. PLoS Pathog 2016; 12:e1005948. [PMID: 27783673 PMCID: PMC5081248 DOI: 10.1371/journal.ppat.1005948] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 09/22/2016] [Indexed: 01/02/2023] Open
Abstract
Hantaviruses are important emerging human pathogens and are the causative agents of serious diseases in humans with high mortality rates. Like other members in the Bunyaviridae family their M segment encodes two glycoproteins, GN and GC, which are responsible for the early events of infection. Hantaviruses deliver their tripartite genome into the cytoplasm by fusion of the viral and endosomal membranes in response to the reduced pH of the endosome. Unlike phleboviruses (e.g. Rift valley fever virus), that have an icosahedral glycoprotein envelope, hantaviruses display a pleomorphic virion morphology as GN and GC assemble into spikes with apparent four-fold symmetry organized in a grid-like pattern on the viral membrane. Here we present the crystal structure of glycoprotein C (GC) from Puumala virus (PUUV), a representative member of the Hantavirus genus. The crystal structure shows GC as the membrane fusion effector of PUUV and it presents a class II membrane fusion protein fold. Furthermore, GC was crystallized in its post-fusion trimeric conformation that until now had been observed only in Flavi- and Togaviridae family members. The PUUV GC structure together with our functional data provides intriguing evolutionary and mechanistic insights into class II membrane fusion proteins and reveals new targets for membrane fusion inhibitors against these important pathogens. Hantaviruses (family: Bunyaviridae) encompass pathogens responsible to serious human diseases and economic burden worldwide. Following endocytosis, these enveloped RNA viruses are directed to an endosomal compartment where a sequence of pH-dependent conformational changes of the viral envelope glycoproteins mediates the fusion between the viral and endosomal membranes. The lack of high-resolution structural information for the entry of hantaviruses impair our ability to rationalize new treatments and prevention strategies. We determined the three-dimensional structure of a glycoprotein C from Puumala virus (PUUV) using X-ray crystallography. The two structures (at pH 6.0 and 8.0) were determined to 1.8 Å and 2.3 Å resolutions, respectively. Both structures reveal a class II membrane fusion protein in its post-fusion trimeric conformation with novel structural features in the trimer assembly and stabilization. Our structures suggest that neutralizing antibodies against GC target its conformational changes as inhibition mechanism and highlight new molecular targets for hantavirus-specific membrane fusion inhibitors. Furthermore, combined with the available structures of other class II proteins, we remodeled the evolutionary relationships between virus families encompassing these proteins.
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Kitterer D, Segerer S, Dippon J, Alscher MD, Braun N, Latus J. Smoking Is a Risk Factor for Severe Acute Kidney Injury in Hantavirus-Induced Nephropathia Epidemica. Nephron Clin Pract 2016; 134:89-94. [PMID: 27388481 DOI: 10.1159/000447783] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 06/21/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Hantaviruses are zoonotic pathogens causing emerging diseases worldwide. Patients typically present with fever, acute kidney injury (AKI) and thrombocytopenia. Puumala virus (PUUV) that causes nephropathia epidemica (NE) is common in Germany. Recently, a study from Finland revealed an association between nicotine consumption and the severity of AKI in NE. Differences between individuals in Finland and Germany might modulate the effect; therefore, the aim of our study was to prove that smoking is a risk factor for a severe course of NE in Germany. METHODS A cross-sectional prospective survey of 485 patients with hantavirus infections was performed. Clinical and laboratory data during the acute course of the disease were obtained from medical reports and files, while follow-up (including smoking status) data were collected prospectively. RESULTS Smoking information was available for 298 out of 485 patients (61%). Male was the predominant gender (67%), median age at the time of diagnosis was 50 (interquartile range, IQR 41-60) years and 34% of patients were current smokers during the phase of acute NE. Patients in the smoking group were significantly younger than in the non-smoking group (p < 0.0001). Peak serum creatinine levels were significantly higher in the smoking group than in the non-smoking patients (median 301 (IQR 186-469 μmol/l) vs. median 240 (IQR 137-469 μmol/l), p < 0.05). In addition, severe AKI (stages 2 and 3 using KDIGO criteria) was more common in current smokers (80%) than in the non-smokers (68%, p < 0.05). CONCLUSION Current smoking is a risk factor for severity of AKI in patients with acute PUUV infection in Germany. Therefore, information about smoking habits needs to be an integral part of the documentation in patients with suspected acute PUUV infection, and increased monitoring of kidney function should be done in NE patients who are current smokers.
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Affiliation(s)
- Daniel Kitterer
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch Hospital, Stuttgart, Germany
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31
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de Vries A, Vennema H, Bekker DL, Maas M, Adema J, Opsteegh M, van der Giessen JWB, Reusken CBEM. Characterization of Puumala hantavirus in bank voles from two regions in the Netherlands where human cases occurred. J Gen Virol 2016; 97:1500-1510. [PMID: 27075118 DOI: 10.1099/jgv.0.000481] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Puumala hantavirus (PUUV) is the most common and widespread hantavirus in Europe and is associated with a mild form of haemorrhagic fever with renal syndrome in humans, called nephropathia epidemica. This study presents the molecular characterization of PUUV circulating in bank voles in two regions of the Netherlands. Most human cases of hantavirus infection are from these two regions. Phylogenetic analysis of the (partial) S, M and L-segments indicated that the Dutch strains belong to the CE lineage, which includes PUUV strains from France, Germany and Belgium. We have identified two distinct groups of PUUV, corresponding with their geographic origin and with adjoining regions in neighbouring countries.
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Affiliation(s)
- A de Vries
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - H Vennema
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - D L Bekker
- Dutch Mammal Society, P.O. Box 6531, NL-6503 GA Nijmegen, The Netherlands
| | - M Maas
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - J Adema
- Fluidigm, Europe B.V, Amsterdam, The Netherlands
| | - M Opsteegh
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - J W B van der Giessen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - C B E M Reusken
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,Department of Viroscience, WHO Collaborating Centre for Arbovirus and Haemorrhagic Fever Reference and Research, Erasmus MC, Rotterdam, The Netherlands
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Molecular Diagnosis of Hemorrhagic Fever with Renal Syndrome Caused by Puumala Virus. J Clin Microbiol 2016; 54:1335-9. [PMID: 26962084 PMCID: PMC4844727 DOI: 10.1128/jcm.00113-16] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 02/29/2016] [Indexed: 11/20/2022] Open
Abstract
Rodent-borne hantaviruses cause two severe acute diseases: hemorrhagic fever with renal syndrome (HFRS) in Eurasia, and hantavirus pulmonary syndrome (HPS; also called hantavirus cardiopulmonary syndrome [HCPS]) in the Americas. Puumala virus (PUUV) is the most common causative agent of HFRS in Europe. Current routine diagnostic methods are based on serological analyses and can yield inconclusive results. Hantavirus-infected patients are viremic during the early phase of disease; therefore, detection of viral RNA genomes can be a valuable complement to existing serological methods. However, the high genomic sequence diversity of PUUV has hampered the development of molecular diagnostics, and currently no real-time reverse transcription-quantitative (RT)-PCR assay is available for routine diagnosis of HFRS. Here, we present a novel PUUV RT-PCR assay. The assay was validated for routine diagnosis of HFRS on samples collected in Sweden during the winter season from 2013 to 2014. The assay allowed detection of PUUV RNA in 98.7% of confirmed clinical HFRS samples collected within 8 days after symptomatic onset. In summary, this study shows that real-time RT-PCR can be a reliable alternative to serological tests during the early phase of HFRS.
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Latus J, Schwab M, Tacconelli E, Pieper FM, Wegener D, Dippon J, Müller S, Zakim D, Segerer S, Kitterer D, Priwitzer M, Mezger B, Walter-Frank B, Corea A, Wiedenmann A, Brockmann S, Pöhlmann C, Alscher MD, Braun N. Clinical course and long-term outcome of hantavirus-associated nephropathia epidemica, Germany. Emerg Infect Dis 2015; 21:76-83. [PMID: 25533268 PMCID: PMC4285283 DOI: 10.3201/eid2101.140861] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The consequences of associated hematuria may be long-lasting, and hantavirus IgG is detectable years after acute infection. Human infection with Puumala virus (PUUV), the most common hantavirus in Central Europe, causes nephropathia epidemica (NE), a disease characterized by acute kidney injury and thrombocytopenia. To determine the clinical phenotype of hantavirus-infected patients and their long-term outcome and humoral immunity to PUUV, we conducted a cross-sectional prospective survey of 456 patients in Germany with clinically and serologically confirmed hantavirus-associated NE during 2001–2012. Prominent clinical findings during acute NE were fever and back/limb pain, and 88% of the patients had acute kidney injury. At follow-up (7–35 mo), all patients had detectable hantavirus-specific IgG; 8.5% had persistent IgM; 25% had hematuria; 23% had hypertension (new diagnosis for 67%); and 7% had proteinuria. NE-associated hypertension and proteinuria do not appear to have long-term consequences, but NE-associated hematuria may. All patients in this study had hantavirus-specific IgG up to years after the infection.
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Hofmann J, Grunert HP, Donoso-Mantke O, Zeichhardt H, Kruger DH. Does proficiency testing improve the quality of hantavirus serodiagnostics? Experiences with INSTAND EQA schemes. Int J Med Microbiol 2015; 305:607-11. [PMID: 26342877 DOI: 10.1016/j.ijmm.2015.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Hantavirus infections in Germany appear periodically with peak numbers every 2-3 years. The reported cases in the years 2007, 2010 and 2012 exceeded many times over those in the years in-between. In order to reveal faults of certain in vitro diagnostic assays (IVDs), to harmonize the performances of the individual assays and to improve the users' competence in interpreting the results, the National Consiliary Laboratory for Hantaviruses and INSTAND e.V. (Society for Promoting Quality Assurance in Medical Laboratories e.V.) established an external quality assessment (EQA) scheme for proficiency testing of hantavirus serodiagnostics. The first EQA scheme (pilot study) started in March 2009 with 58 participating laboratories from Germany and neighboring countries. Twice a year four serum samples were sent out to the participants to investigate whether the sample reflects an acute or past infection and to distinguish between infections with the hantavirus types Puumala virus (PUUV) and Dobrava-Belgrade virus (DOBV), both endemic in Central Europe. In addition, samples negative for anti-hantavirus antibodies were tested in order to examine the specificity of the IVDs applied in the participating laboratories. An increasing number of laboratories participated, with a maximum of 92 in March 2014. When summarizing in total 2592 test results, the laboratories reached an overall specificity of 96.7% and a sensitivity of 95% in their detection of a hantavirus infection. A correct distinction between acute and past infections was forwarded in 90-96% of replies of laboratories. Exact serotyping (PUUV vs. DOBV) of the infection was reported in 81-96% of replies with the lowest accuracy for past DOBV infections; cross-reactivities between diagnostic antigens of the two viruses as well as persistent IgM titers in humans may interfere with exact testing. The EQAs revealed acceptable results for the serodiagnostic of hantavirus infection including serotyping but further improvement is still needed.
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Affiliation(s)
- Jörg Hofmann
- National Consultant Laboratory for Hantaviruses, Institute of Medical Virology, Helmut-Ruska-Haus, Charité-University Medicine, Charitéplatz 1, 10117 Berlin, Germany.
| | - Hans-Peter Grunert
- GBD Gesellschaft für Biotechnologische Diagnostik mbH, Potsdamer Chaussee 80, 14129 Berlin, Germany
| | - Oliver Donoso-Mantke
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Ubierstrasse 20, 40223 Düsseldorf, Germany
| | - Heinz Zeichhardt
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Ubierstrasse 20, 40223 Düsseldorf, Germany; Institute of Virology, Campus Benjamin Franklin, Charité-University Medicine, Hindenburgdamm 27, 12203 Berlin, Germany
| | - Detlev H Kruger
- National Consultant Laboratory for Hantaviruses, Institute of Medical Virology, Helmut-Ruska-Haus, Charité-University Medicine, Charitéplatz 1, 10117 Berlin, Germany
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Evaluation of lipase levels in patients with nephropathia epidemica--no evidence for acute pancreatitis. BMC Infect Dis 2015. [PMID: 26204892 PMCID: PMC4513752 DOI: 10.1186/s12879-015-1031-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The most common causative agent for hemorrhagic fever with renal syndrome in Germany is Puumala virus (PUUV) and a high percentage of patients with PUUV infection have gastrointestinal (GI) symptoms. The aim of the present study was to determine the prevalence of increased lipase levels and acute pancreatitis during nephropathia epidemica (NE) in 166 patients from Germany. METHODS Clinical and laboratory data during the acute phase of the disease were obtained from medical reports and files from 456 patients during acute hantavirus infection. Patients in whom serum lipase levels were determined during acute course of the disease were included in the study. RESULTS Lipase levels at the time of diagnosis were determined in 166 of the 456 NE patients (36%). Of the 166 patients, 25 (15%) had elevated lipase levels at the time of admission to hospital or first contact with general practitioner/nephrologist. In total 7 patients had a threefold increased serum lipase above the normal range. Abdominal pain was not more often present in the group of patients with elevated serum lipase compared to the lipase-negative group (9/25 vs 58/141). Abdominal ultrasound and CT scans revealed no signs of pancreatitis in any of the patients. Patients with elevated serum lipase had higher serum creatinine peak levels (p = 0.03) during the course of the disease. CONCLUSIONS Elevated lipase levels were common in our patient cohort and might reflect a more severe form of NE. NE does not lead to acute pancreatitis.
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Reil D, Imholt C, Drewes S, Ulrich RG, Eccard JA, Jacob J. Environmental conditions in favour of a hantavirus outbreak in 2015 in Germany? Zoonoses Public Health 2015; 63:83-8. [PMID: 26177110 DOI: 10.1111/zph.12217] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Indexed: 12/22/2022]
Abstract
Bank voles can harbour Puumala virus (PUUV) and vole populations usually peak in years after beech mast. A beech mast occurred in 2014 and a predictive model indicates high vole abundance in 2015. This pattern is similar to the years 2009/2011 when beech mast occurred, bank voles multiplied and human PUUV infections increased a year later. Given similar environmental conditions in 2014/2015, increased risk of human PUUV infections in 2015 is likely. Risk management measures are recommended.
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Affiliation(s)
- D Reil
- Julius Kühn-Institute, Institute for Plant Protection in Horticulture and Forests, Münster, Germany.,University of Potsdam, Institute of Biochemistry and Biology, Potsdam, Germany
| | - C Imholt
- Julius Kühn-Institute, Institute for Plant Protection in Horticulture and Forests, Münster, Germany
| | - S Drewes
- Friedrich-Loeffler-Institut, Institute for Novel and Emerging Infectious Diseases, Greifswald - Insel Riems, Germany
| | - R G Ulrich
- Friedrich-Loeffler-Institut, Institute for Novel and Emerging Infectious Diseases, Greifswald - Insel Riems, Germany
| | - J A Eccard
- University of Potsdam, Institute of Biochemistry and Biology, Potsdam, Germany
| | - J Jacob
- Julius Kühn-Institute, Institute for Plant Protection in Horticulture and Forests, Münster, Germany
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Witkowski PT, Leendertz SAJ, Auste B, Akoua-Koffi C, Schubert G, Klempa B, Muyembe-Tamfum JJ, Karhemere S, Leendertz FH, Krüger DH. Human seroprevalence indicating hantavirus infections in tropical rainforests of Côte d'Ivoire and Democratic Republic of Congo. Front Microbiol 2015; 6:518. [PMID: 26052326 PMCID: PMC4439549 DOI: 10.3389/fmicb.2015.00518] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 05/09/2015] [Indexed: 12/01/2022] Open
Abstract
Hantaviruses are members of the Bunyaviridae family carried by small mammals and causing human hemorrhagic fevers worldwide. In Western Africa, where a variety of hemorrhagic fever viruses occurs, indigenous hantaviruses have been molecularly found in animal reservoirs such as rodents, shrews, and bats since 2006. To investigate the human contact to hantaviruses carried by these hosts and to assess the public health relevance of hantaviruses for humans living in the tropical rainforest regions of Western and Central Africa, we performed a cross-sectional seroprevalence study in the region of Taï National Park in Côte d’Ivoire and the Bandundu region near the Salonga National Park in the Democratic Republic (DR) of Congo. Serum samples were initially screened with enzyme-linked immunosorbent assays using nucleoproteins of several hantaviruses as diagnostic antigens. Positive results were confirmed by Western blotting and immunofluorescence testing. Seroprevalence rates of 3.9% (27/687) and 2.4% (7/295), respectively, were found in the investigated regions in Côte d’Ivoire and the DR Congo. In Côte d’Ivoire, this value was significantly higher than the seroprevalence rates previously reported from the neighboring country Guinea as well as from South Africa. Our study indicates an exposure of humans to hantaviruses in West and Central African tropical rainforest areas. In order to pinpoint the possible existence and frequency of clinical disease caused by hantaviruses in this region of the world, systematic investigations of patients with fever and renal or respiratory symptoms are required.
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Affiliation(s)
- Peter T Witkowski
- Institute of Virology, Helmut-Ruska-Haus, Charité Medical School Berlin, Germany
| | - Siv A J Leendertz
- P3 - Epidemiology of Highly Pathogenic Viruses, Robert Koch Institute Berlin, Germany
| | - Brita Auste
- Institute of Virology, Helmut-Ruska-Haus, Charité Medical School Berlin, Germany
| | | | - Grit Schubert
- P3 - Epidemiology of Highly Pathogenic Viruses, Robert Koch Institute Berlin, Germany
| | - Boris Klempa
- Institute of Virology, Helmut-Ruska-Haus, Charité Medical School Berlin, Germany ; Institute of Virology, Slovak Academy of Sciences Bratislava, Slovakia
| | | | - Stomy Karhemere
- National Institute of Biomedical Research Kinshasa, Democratic Republic of Congo
| | - Fabian H Leendertz
- P3 - Epidemiology of Highly Pathogenic Viruses, Robert Koch Institute Berlin, Germany
| | - Detlev H Krüger
- Institute of Virology, Helmut-Ruska-Haus, Charité Medical School Berlin, Germany
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Jacob J, Ulrich RG, Freise J, Schmolz E. [Monitoring populations of rodent reservoirs of zoonotic diseases. Projects, aims and results]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 57:511-8. [PMID: 24781907 DOI: 10.1007/s00103-013-1924-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Rodents can harbor and transmit pathogens that can cause severe disease in humans, companion animals and livestock. Such zoonotic pathogens comprise more than two thirds of the currently known human pathogens. The epidemiology of some zoonotic pathogens, such as hantaviruses, can be linked to the population dynamics of the rodent host. In this case, during an outbreak of the rodent host population many human infections may occur. In other rodent-borne zoonotic diseases such phenomena are not known and in many cases the rodent host specificity of a given pathogen is unclear. The monitoring of relevant rodent populations and of the rodent-borne zoonotic pathogens is essential to (1) understand the distribution and epidemiology of pathogens and (2) develop forecasting tools to predict outbreaks of zoonoses. Presently, there are no systematic long-term monitoring programs in place for zoonoses in Germany. Rodent monitoring activities are largely restricted to the plant protection sector, such as for the common vole (Microtus arvalis) and forest-damaging rodents. However, during the last 10-15 years a number of specific research projects have been initiated and run for a few years and Norway rat (Rattus norvegicus) monitoring has been implemented in Hamburg and Lower Saxony. Based on close cooperation of federal and state authorities and research institutions these efforts could be utilized to gain information about the distribution and importance of rodent-borne zoonoses. Nevertheless, for the integration of rodent population dynamics and zoonotic disease patterns and especially for developing predictive models, long-term monitoring is urgently required. To establish a systematic long-term monitoring program, existing networks and cooperation need to be used, additional collaborators (e.g., pest control operators) should be included and synergetic effects of different scientific fields should be utilized.
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Affiliation(s)
- J Jacob
- Bundesforschungsinstitut für Kulturpflanzen, Institut für Pflanzenschutz in Gartenbau und Forst, Wirbeltierforschung, Julius Kühn-Institut, Toppheideweg 88, 48161, Münster, Deutschland,
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Witkowski PT, Heinemann P, Klempa B, Krüger DH. Molekulare Identifikation von Hantaviren in neuen Wirten. BIOSPEKTRUM : ZEITSCHRIFT DER GESELLSCHAFT FUR BIOLOGISHE CHEMIE (GBCH) UND DER VEREINIGUNG FUR ALLGEMEINE UND ANGEWANDTE MIKROBIOLOGIE (VAAM) 2015; 21:503-506. [PMID: 32218646 PMCID: PMC7090483 DOI: 10.1007/s12268-015-0609-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Peter T Witkowski
- Institut für Medizinische Virologie, Helmut-Ruska-Haus, Charité-Universitätsmedizin Berlin, Helmut-Ruska-Haus Charitéplatz 1, D-10117 Berlin, Germany
| | - Patrick Heinemann
- Institut für Medizinische Virologie, Helmut-Ruska-Haus, Charité-Universitätsmedizin Berlin, Helmut-Ruska-Haus Charitéplatz 1, D-10117 Berlin, Germany
| | - Boris Klempa
- Institut für Medizinische Virologie, Helmut-Ruska-Haus, Charité-Universitätsmedizin Berlin, Helmut-Ruska-Haus Charitéplatz 1, D-10117 Berlin, Germany
| | - Detlev H Krüger
- Institut für Medizinische Virologie, Helmut-Ruska-Haus, Charité-Universitätsmedizin Berlin, Helmut-Ruska-Haus Charitéplatz 1, D-10117 Berlin, Germany
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Ali HS, Drewes S, Weber de Melo V, Schlegel M, Freise J, Groschup MH, Heckel G, Ulrich RG. Complete genome of a Puumala virus strain from Central Europe. Virus Genes 2014; 50:292-8. [PMID: 25543297 DOI: 10.1007/s11262-014-1157-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 12/12/2014] [Indexed: 12/30/2022]
Abstract
Puumala virus (PUUV) is one of the predominant hantavirus species in Europe causing mild to moderate cases of haemorrhagic fever with renal syndrome. Parts of Lower Saxony in north-western Germany are endemic for PUUV infections. In this study, the complete PUUV genome sequence of a bank vole-derived tissue sample from the 2007 outbreak was determined by a combined primer-walking and RNA ligation strategy. The S, M and L genome segments were 1,828, 3,680 and 6,550 nucleotides in length, respectively. Sliding-window analyses of the nucleotide sequences of all available complete PUUV genomes indicated a non-homogenous distribution of variability with hypervariable regions located at the 3'-ends of the S and M segments. The overall similarity of the coding genome regions to the other PUUV strains ranged between 80.1 and 84.7 % at the level of the nucleotide sequence and between 89.5 and 98.1 % for the deduced amino acid sequences. In comparison to the phylogenetic trees of the complete coding sequences, trees based on partial segments revealed a general drop in phylogenetic support and a lower resolution. The Astrup strain S and M segment sequences showed the highest similarity to sequences of strains from geographically close sites in the Osnabrück Hills region. In conclusion, a primer-walking-mediated strategy resulted in the determination of the first complete nucleotide sequence of a PUUV strain from Central Europe. Different levels of variability along the genome provide the opportunity to choose regions for analyses according to the particular research question, e.g., large-scale phylogenetics or within-host evolution.
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Affiliation(s)
- Hanan Sheikh Ali
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, OIE Collaborating Centre for Zoonoses in Europe, Institute for Novel and Emerging Infectious Diseases, Südufer 10, 17493, Greifswald - Insel Riems, Germany
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Thoma BR, Müller J, Bässler C, Georgi E, Osterberg A, Schex S, Bottomley C, Essbauer SS. Identification of factors influencing the Puumala virus seroprevalence within its reservoir in aMontane Forest Environment. Viruses 2014; 6:3944-67. [PMID: 25341661 PMCID: PMC4213572 DOI: 10.3390/v6103944] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 09/03/2014] [Accepted: 09/29/2014] [Indexed: 12/28/2022] Open
Abstract
Puumala virus (PUUV) is a major cause of mild to moderate haemorrhagic fever with renal syndrome and is transmitted by the bank vole (Myodes glareolus). There has been a high cumulative incidence of recorded human cases in South-eastern Germany since 2004 when the region was first recognized as being endemic for PUUV. As the area is well known for outdoor recreation and the Bavarian Forest National Park (BFNP) is located in the region, the increasing numbers of recorded cases are of concern. To understand the population and environmental effects on the seroprevalence of PUUV in bank voles we trapped small mammals at 23 sites along an elevation gradient from 317 to 1420m above sea level. Generalized linear mixed effects models(GLMEM) were used to explore associations between the seroprevalence of PUUV in bank voles and climate and biotic factors. We found that the seroprevalence of PUUV was low (6%–7%) in 2008 and 2009, and reached 29% in 2010. PUUV seroprevalence was positively associated with the local species diversity and deadwood layer, and negatively associated with mean annual temperature, mean annual solar radiation, and herb layer. Based on these findings, an illustrative risk map for PUUV seroprevalence prediction in bank voles was created for an area of the national park. The map will help when planning infrastructure in the national park (e.g., huts, shelters, and trails).
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Affiliation(s)
- Bryan R Thoma
- Bundeswehr Institute of Microbiology, Neuherbergstr. 11, 80937 Munich, Germany.
| | - Jörg Müller
- Bavarian Forest National Park, Freyunger Str. 2, 94481 Grafenau, Germany.
| | - Claus Bässler
- Bavarian Forest National Park, Freyunger Str. 2, 94481 Grafenau, Germany.
| | - Enrico Georgi
- Bundeswehr Institute of Microbiology, Neuherbergstr. 11, 80937 Munich, Germany.
| | - Anja Osterberg
- Bundeswehr Institute of Microbiology, Neuherbergstr. 11, 80937 Munich, Germany.
| | - Susanne Schex
- Bundeswehr Institute of Microbiology, Neuherbergstr. 11, 80937 Munich, Germany.
| | - Christian Bottomley
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK.
| | - Sandra S Essbauer
- Bundeswehr Institute of Microbiology, Neuherbergstr. 11, 80937 Munich, Germany.
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Kruger DH, Figueiredo LTM, Song JW, Klempa B. Hantaviruses--globally emerging pathogens. J Clin Virol 2014; 64:128-36. [PMID: 25453325 DOI: 10.1016/j.jcv.2014.08.033] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 08/25/2014] [Indexed: 11/29/2022]
Abstract
Hantaviruses are emerging zoonotic viruses which cause human disease in Africa, America, Asia, and Europe. This review summarizes the progress in hantavirus epidemiology and diagnostics during the previous decade. Moreover, we discuss the influence of ecological factors on the worldwide virus distribution and give an outlook on research perspectives for the next years.
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Affiliation(s)
- Detlev H Kruger
- Institute of Medical Virology, Charité School of Medicine, Berlin, Germany.
| | | | - Jin-Won Song
- Department of Microbiology, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Boris Klempa
- Institute of Medical Virology, Charité School of Medicine, Berlin, Germany; Institute of Virology, Slovak Academy of Sciences, Bratislava, Slovakia
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Latus J, Schwab M, Tacconelli E, Pieper FM, Wegener D, Rettenmaier B, Schwab A, Hoffmann L, Dippon J, Müller S, Fritz P, Zakim D, Segerer S, Kitterer D, Kimmel M, Gußmann K, Priwitzer M, Mezger B, Walter-Frank B, Corea A, Wiedenmann A, Brockmann S, Pöhlmann C, Alscher MD, Braun N. Acute kidney injury and tools for risk-stratification in 456 patients with hantavirus-induced nephropathia epidemica. Nephrol Dial Transplant 2014; 30:245-51. [PMID: 25313168 DOI: 10.1093/ndt/gfu319] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Puumala virus (PUUV) is the most common species of hantavirus in Central Europe. Nephropathia epidemica (NE), caused by PUUV, is characterized by acute kidney injury (AKI) and thrombocytopenia. The major goals of this study were to provide a clear clinical phenotyping of AKI in patients with NE and to develop an easy prediction rule to identify patients, who are at lower risk to develop severe AKI. METHODS A cross-sectional prospective survey of 456 adult patients with serologically confirmed NE was performed. Data were collected from medical records and prospectively at follow-up visit. Severe AKI was defined by standard criteria according to the RIFLE (Risk, Injury, Failure, Loss, End-stage kidney disease) classification. Fuller statistical models were developed and validated to estimate the probability for severe AKI. RESULTS During acute NE, 88% of the patients had AKI according to the RILFE criteria during acute NE. A risk index score for severe AKI was derived by using three independent risk factors in patients with normal kidney function at time of diagnosis: thrombocytopenia [two points; odds ratios (OR): 3.77; 95% confidence intervals (CI): 1.82, 8.03], elevated C-reactive protein levels (one point; OR: 3.02; 95% CI: 1.42, 6.58) and proteinuria (one point; OR: 3.92; 95% CI: 1.33, 13.35). On the basis of a point score of one or two, the probability of severe AKI was 0.18 and 0.28 with an area under the curve of 0.71. CONCLUSION This clinical prediction rule provides a novel and diagnostically accurate strategy for the potential prevention and improved management of kidney complications in patients with NE and, ultimately, for a possible decrease in unnecessary hospitalization in a high number of patients.
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Affiliation(s)
- Joerg Latus
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Matthias Schwab
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany Department of Clinical Pharmacology, University Hospital Tuebingen, Tuebingen, Germany
| | - Evelina Tacconelli
- Department of Internal Medicine I, Division of Infectious Diseases, University Hospital Tuebingen, Tuebingen, Germany
| | - Friedrich-Michael Pieper
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Daniel Wegener
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Bianka Rettenmaier
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Andrea Schwab
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Larissa Hoffmann
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Juergen Dippon
- Department of Mathematics, University of Stuttgart, Stuttgart, Germany
| | - Simon Müller
- Department of Mathematics, University of Stuttgart, Stuttgart, Germany
| | - Peter Fritz
- Institute of Digital Medicine, Robert-Bosch-Hospital, Stuttgart, Germany
| | - David Zakim
- Institute of Digital Medicine, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Stephan Segerer
- Division of Nephrology, University Hospital Zurich, Zurich, Switzerland
| | - Daniel Kitterer
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Martin Kimmel
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany
| | | | | | | | | | | | | | | | - Christoph Pöhlmann
- Department of Diagnostic and Laboratory Medicine, Robert-Bosch-Hospital, Stuttgart, Germany
| | - M Dominik Alscher
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Niko Braun
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany
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Leptospira spp. in rodents and shrews in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:7562-74. [PMID: 25062275 PMCID: PMC4143818 DOI: 10.3390/ijerph110807562] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 07/08/2014] [Accepted: 07/15/2014] [Indexed: 12/13/2022]
Abstract
Leptospirosis is an acute, febrile disease occurring in humans and animals worldwide. Leptospira spp. are usually transmitted through direct or indirect contact with the urine of infected reservoir animals. Among wildlife species, rodents act as the most important reservoir for both human and animal infection. To gain a better understanding of the occurrence and distribution of pathogenic leptospires in rodent and shrew populations in Germany, kidney specimens of 2973 animals from 11 of the 16 federal states were examined by PCR. Rodent species captured included five murine species (family Muridae), six vole species (family Cricetidae) and six shrew species (family Soricidae). The most abundantly trapped animals were representatives of the rodent species Apodemus flavicollis, Clethrionomys glareolus and Microtus agrestis. Leptospiral DNA was amplified in 10% of all animals originating from eight of the 11 federal states. The highest carrier rate was found in Microtus spp. (13%), followed by Apodemus spp. (11%) and Clethrionomys spp. (6%). The most common Leptospira genomospecies determined by duplex PCR was L. kirschneri, followed by L. interrogans and L. borgpetersenii; all identified by single locus sequence typing (SLST). Representatives of the shrew species were also carriers of Leptospira spp. In 20% of Crocidura spp. and 6% of the Sorex spp. leptospiral DNA was detected. Here, only the pathogenic genomospecies L. kirschneri was identified.
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Svoboda P, Dobler G, Markotić A, Kurolt IC, Speck S, Habuš J, Vucelja M, Krajinović LC, Tadin A, Margaletić J, Essbauer S. Survey for hantaviruses, tick-borne encephalitis virus, and Rickettsia spp. in small rodents in Croatia. Vector Borne Zoonotic Dis 2014; 14:523-30. [PMID: 24866325 PMCID: PMC4098074 DOI: 10.1089/vbz.2013.1457] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In Croatia, several rodent- and vector-borne agents are endemic and of medical importance. In this study, we investigated hantaviruses and, for the first time, tick-borne encephalitis virus (TBEV) and Rickettsia spp. in small wild rodents from two different sites (mountainous and lowland region) in Croatia. In total, 194 transudate and tissue samples from 170 rodents (A. flavicollis, n=115; A. agrarius, n=2; Myodes glareolus, n=53) were tested for antibodies by indirect immunofluorescence assays (IIFT) and for nucleic acids by conventional (hantaviruses) and real-time RT-/PCRs (TBEV and Rickettsia spp.). A total of 25.5% (24/94) of the rodents from the mountainous area revealed specific antibodies against hantaviruses. In all, 21.3% (20/94) of the samples from the mountainous area and 29.0% (9/31) from the lowland area yielded positive results for either Puumala virus (PUUV) or Dobrava-Belgrade virus (DOBV) using a conventional RT-PCR. All processed samples (n=194) were negative for TBEV by IIFT or real-time RT-PCR. Serological evidence of rickettsial infection was detected in 4.3% (4/94) rodents from the mountainous region. Another 3.2% (3/94) rodents were positive for Rickettsia spp. by real-time PCR. None of the rodents (n=76) from the lowland area were positive for Rickettsia spp. by real-time PCR. Dual infection of PUUV and Rickettsia spp. was found in one M. glareolus from the mountainous area by RT-PCR and real-time PCR, respectively. To our knowledge, this is the first detection of Rickettsia spp. in small rodents from Croatia. Phylogenetic analyses of S- and M-segment sequences obtained from the two study sites revealed well-supported subgroups in Croatian PUUV and DOBV. Although somewhat limited, our data showed occurrence and prevalence of PUUV, DOBV, and rickettsiae in Croatia. Further studies are warranted to confirm these data and to determine the Rickettsia species present in rodents in these areas.
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Affiliation(s)
- Petra Svoboda
- University Hospital for Infectious Diseases “Dr. Fran Mihaljević”, Research Department, Zagreb, Croatia
| | - Gerhard Dobler
- Bundeswehr Institute of Microbiology, Department of Virology & Rickettsiology, Munich, Germany
| | - Alemka Markotić
- University Hospital for Infectious Diseases “Dr. Fran Mihaljević”, Research Department, Zagreb, Croatia
| | - Ivan-Christian Kurolt
- University Hospital for Infectious Diseases “Dr. Fran Mihaljević”, Research Department, Zagreb, Croatia
| | - Stephanie Speck
- Bundeswehr Institute of Microbiology, Department of Virology & Rickettsiology, Munich, Germany
| | - Josipa Habuš
- University of Zagreb, Faculty of Veterinary Medicine, Department of Microbiology and Infectious Diseases with Clinic, Zagreb, Croatia
| | - Marko Vucelja
- University of Zagreb, Faculty of Forestry, Department of Forest Protection and Wildlife Management, Zagreb, Croatia
| | - Lidija Cvetko Krajinović
- University Hospital for Infectious Diseases “Dr. Fran Mihaljević”, Research Department, Zagreb, Croatia
| | - Ante Tadin
- University Hospital for Infectious Diseases “Dr. Fran Mihaljević”, Research Department, Zagreb, Croatia
| | - Josip Margaletić
- University of Zagreb, Faculty of Forestry, Department of Forest Protection and Wildlife Management, Zagreb, Croatia
| | - Sandra Essbauer
- Bundeswehr Institute of Microbiology, Department of Virology & Rickettsiology, Munich, Germany
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Latus J, Tenner-Racz K, Racz P, Kitterer D, Cadar D, Ott G, Alscher MD, Schmidt-Chanasit J, Braun N. Detection of Puumala hantavirus antigen in human intestine during acute hantavirus infection. PLoS One 2014; 9:e98397. [PMID: 24857988 PMCID: PMC4032337 DOI: 10.1371/journal.pone.0098397] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 05/02/2014] [Indexed: 11/24/2022] Open
Abstract
Background Puumala virus (PUUV) is the most important hantavirus species in Central Europe. Nephropathia epidemica (NE), caused by PUUV, is characterized by acute renal injury (AKI) with thrombocytopenia and frequently gastrointestinal symptoms. Methods 456 patients with serologically and clinically confirmed NE were investigated at time of follow-up in a single clinic. The course of the NE was investigated using medical reports. We identified patients who had endoscopy with intestinal biopsy during acute phase of NE. Histopathological, immunohistochemical and molecular analyses of the biopsies were performed. Results Thirteen patients underwent colonoscopy or gastroscopy for abdominal pain, diarrhea, nausea and vomiting during acute phase of NE. Immunohistochemistry (IHC) revealed PUUV nucleocapsid antigen in 11 biopsies from 8 patients; 14 biopsies from 5 patients were negative for PUUV nucleocapsid antigen. IHC localized PUUV nucleocapsid antigen in endothelial cells of capillaries or larger vessels in the lamina propria. Rate of AKI was not higher and severity of AKI was not different in the PUUV-positive compared to the PUUV-negative group. All IHC positive biopsies were positive for PUUV RNA using RT-PCR. Phylogenetic reconstruction revealed clustering of all PUUV strains from this study with viruses previously detected from the South-West of Germany. Long-term outcome was favorable in both groups. Conclusions In patients with NE, PUUV nucleocapsid antigen and PUUV RNA was detected frequently in the intestine. This finding could explain frequent GI-symptoms in NE patients, thus demonstration of a more generalized PUUV infection. The RT-PCR was an effective and sensitive method to detect PUUV RNA in FFPE tissues. Therefore, it can be used as a diagnostic and phylogenetic approach also for archival materials. AKI was not more often present in patients with PUUV-positive IHC. This last finding should be investigated in larger numbers of patients with PUUV infection.
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Affiliation(s)
- Joerg Latus
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch Hospital, Auerbachstrasse 110, Stuttgart, Germany
| | - Klara Tenner-Racz
- Bernhard Nocht Institute for Tropical Medicine, WHO Collaborating Centre for Arbovirus and Haemmorrhagic Fever Reference and Research, Bernhard-Nocht-Strasse 74, Hamburg, Germany
| | - Paul Racz
- Bernhard Nocht Institute for Tropical Medicine, WHO Collaborating Centre for Arbovirus and Haemmorrhagic Fever Reference and Research, Bernhard-Nocht-Strasse 74, Hamburg, Germany
| | - Daniel Kitterer
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch Hospital, Auerbachstrasse 110, Stuttgart, Germany
- * E-mail:
| | - Daniel Cadar
- Bernhard Nocht Institute for Tropical Medicine, WHO Collaborating Centre for Arbovirus and Haemmorrhagic Fever Reference and Research, Bernhard-Nocht-Strasse 74, Hamburg, Germany
| | - German Ott
- Department of Diagnostic Medicine, Division of Pathology, Robert-Bosch Hospital, Auerbachstrasse 110, Stuttgart, Germany
| | - M. Dominik Alscher
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch Hospital, Auerbachstrasse 110, Stuttgart, Germany
| | - Jonas Schmidt-Chanasit
- Bernhard Nocht Institute for Tropical Medicine, WHO Collaborating Centre for Arbovirus and Haemmorrhagic Fever Reference and Research, Bernhard-Nocht-Strasse 74, Hamburg, Germany
- German Centre for Infection Research (DZIF), partner site Hamburg-Luebeck-Borstel, Hamburg, Germany
| | - Niko Braun
- Department of Internal Medicine, Division of Nephrology, Robert-Bosch Hospital, Auerbachstrasse 110, Stuttgart, Germany
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Kalthoff D, Bock WI, Hühn F, Beer M, Hoffmann B. Fatal Cowpox Virus Infection in Cotton-Top Tamarins (Saguinus oedipus) in Germany. Vector Borne Zoonotic Dis 2014; 14:303-5. [DOI: 10.1089/vbz.2013.1442] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Donata Kalthoff
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut (FLI), Greifswald-Insel Riems, Germany
| | - Wulf-Iwo Bock
- Thuringian State Authority for Consumer Protection (TLV), Bad Langensalza, Germany
| | - Franziska Hühn
- Thuringian State Authority for Consumer Protection (TLV), Bad Langensalza, Germany
| | - Martin Beer
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut (FLI), Greifswald-Insel Riems, Germany
| | - Bernd Hoffmann
- Institute of Diagnostic Virology, Friedrich-Loeffler-Institut (FLI), Greifswald-Insel Riems, Germany
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Eckerle I, Lenk M, Ulrich RG. More novel hantaviruses and diversifying reservoir hosts--time for development of reservoir-derived cell culture models? Viruses 2014; 6:951-67. [PMID: 24576845 PMCID: PMC3970132 DOI: 10.3390/v6030951] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 02/11/2014] [Accepted: 02/15/2014] [Indexed: 12/21/2022] Open
Abstract
Due to novel, improved and high-throughput detection methods, there is a plethora of newly identified viruses within the genus Hantavirus. Furthermore, reservoir host species are increasingly recognized besides representatives of the order Rodentia, now including members of the mammalian orders Soricomorpha/Eulipotyphla and Chiroptera. Despite the great interest created by emerging zoonotic viruses, there is still a gross lack of in vitro models, which reflect the exclusive host adaptation of most zoonotic viruses. The usually narrow host range and genetic diversity of hantaviruses make them an exciting candidate for studying virus-host interactions on a cellular level. To do so, well-characterized reservoir cell lines covering a wide range of bat, insectivore and rodent species are essential. Most currently available cell culture models display a heterologous virus-host relationship and are therefore only of limited value. Here, we review the recently established approaches to generate reservoir-derived cell culture models for the in vitro study of virus-host interactions. These successfully used model systems almost exclusively originate from bats and bat-borne viruses other than hantaviruses. Therefore we propose a parallel approach for research on rodent- and insectivore-borne hantaviruses, taking the generation of novel rodent and insectivore cell lines from wildlife species into account. These cell lines would be also valuable for studies on further rodent-borne viruses, such as orthopox- and arenaviruses.
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Affiliation(s)
- Isabella Eckerle
- Institute of Virology, University of Bonn Medical Centre, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany.
| | - Matthias Lenk
- Department of Experimental Animal Facilities and Biorisk Management, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Südufer 10, 17493 Greifswald-Insel Riems, Germany.
| | - Rainer G Ulrich
- Institute for Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Südufer 10, 17493 Greifswald-Insel Riems, Germany.
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Hofmann J, Meier M, Enders M, Führer A, Ettinger J, Klempa B, Schmidt S, Ulrich RG, Kruger DH. Hantavirus disease in Germany due to infection with Dobrava-Belgrade virus genotype Kurkino. Clin Microbiol Infect 2014; 20:O648-55. [PMID: 24438436 DOI: 10.1111/1469-0691.12543] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 12/19/2013] [Accepted: 01/13/2014] [Indexed: 01/10/2023]
Abstract
Members of the Dobrava-Belgrade virus (DOBV) species are hantaviruses carried by different Apodemus mice as reservoir hosts and causing haemorrhagic fever with renal syndrome (HFRS) in humans. In Central Europe, the Kurkino genotype of DOBV, associated with the striped field mouse, Apodemus agrarius, is prevalent. This paper presents the first extensive study of the serological and molecular diagnostics, epidemiology and clinics of DOBV-Kurkino infections in Central Europe. Serum samples from 570 German patients living in the habitat of A. agrarius (north and northeast Germany) and exhibiting febrile disease, were analysed. All samples were tested by ELISA, subsets of samples were also analysed by immunoblot, neutralization assay, and RT-PCR. A group of 86 individuals was confirmed as DOBV-infected. The virus neutralization assay allowed a reliable identification of DOBV antibodies during both acute and convalescent phases of infection. However, differentiation of relevant DOBV genotypes was not possible by neutralization test but required molecular analysis. Whereas DOBV IgM antibodies tend to persist in the infected organism, RNAaemia seems to be short. Nucleotide sequences were amplified from four patients, and their analysis demonstrated infection by DOBV-Kurkino. With respect to the initial results, the high degree of identity of local patient-derived and A. agrarius-derived virus sequences may allow a closer allocation of the geographical place where the human infection occurred. In contrast to moderate/severe HFRS caused by the DOBV genotypes Dobrava or Sochi, all available data showed a mild clinical course of HFRS caused by DOBV-Kurkino infection without lethal outcomes.
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Affiliation(s)
- J Hofmann
- Institute of Medical Virology, Helmut-Ruska-Haus, Charité Medical School, Berlin, Germany; Division of Virology, Labor Berlin Charité-Vivantes GmbH, Berlin, Germany
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First molecular evidence for Puumala hantavirus in Poland. Viruses 2014; 6:340-53. [PMID: 24452006 PMCID: PMC3917447 DOI: 10.3390/v6010340] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 01/10/2014] [Accepted: 01/14/2014] [Indexed: 11/16/2022] Open
Abstract
Puumala virus (PUUV) causes mild to moderate cases of haemorrhagic fever with renal syndrome (HFRS), and is responsible for the majority of hantavirus infections of humans in Fennoscandia, Central and Western Europe. Although there are relatively many PUUV sequences available from different European countries, little is known about the presence of this virus in Poland. During population studies in 2009 a total of 45 bank voles were trapped at three sites in north-eastern Poland, namely islands on Dejguny and Dobskie Lakes and in a forest near Mikołajki. S and M segment-specific RT-PCR assays detected PUUV RNA in three animals from the Mikołajki site. The obtained partial S and M segment sequences demonstrated the highest similarity to the corresponding segments of a PUUV strain from Latvia. Analysis of chest cavity fluid samples by IgG ELISA using a yeast-expressed PUUV nucleocapsid protein resulted in the detection of two seropositive samples, both being also RT-PCR positive. Interestingly, at the trapping site in Mikołajki PUUV-positive bank voles belong to the Carpathian and Eastern genetic lineages within this species. In conclusion, we herein present the first molecular evidence for PUUV in the rodent reservoir from Poland.
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