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Wang Y, Zhang C, Gao J, Chen Z, Liu Z, Huang J, Chen Y, Li Z, Chang N, Tao Y, Tang H, Gao X, Xu Y, Wang C, Li D, Liu X, Pan J, Cai W, Gong P, Luo Y, Liang W, Liu Q, Stenseth NC, Yang R, Xu L. Spatiotemporal trends of hemorrhagic fever with renal syndrome (HFRS) in China under climate variation. Proc Natl Acad Sci U S A 2024; 121:e2312556121. [PMID: 38227655 PMCID: PMC10823223 DOI: 10.1073/pnas.2312556121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 12/05/2023] [Indexed: 01/18/2024] Open
Abstract
Hemorrhagic fever with renal syndrome (HFRS) is a zoonotic disease caused by the rodent-transmitted orthohantaviruses (HVs), with China possessing the most cases globally. The virus hosts in China are Apodemus agrarius and Rattus norvegicus, and the disease spread is strongly influenced by global climate dynamics. To assess and predict the spatiotemporal trends of HFRS from 2005 to 2098, we collected historical HFRS data in mainland China (2005-2020), historical and projected climate and population data (2005-2098), and spatial variables including biotic, environmental, topographical, and socioeconomic. Spatiotemporal predictions and mapping were conducted under 27 scenarios incorporating multiple integrated representative concentration pathway models and population scenarios. We identify the type of magistral HVs host species as the best spatial division, including four region categories. Seven extreme climate indices associated with temperature and precipitation have been pinpointed as key factors affecting the trends of HFRS. Our predictions indicate that annual HFRS cases will increase significantly in 62 of 356 cities in mainland China. Rattus regions are predicted to be the most active, surpassing Apodemus and Mixed regions. Eighty cities are identified as at severe risk level for HFRS, each with over 50 reported cases annually, including 22 new cities primarily located in East China and Rattus regions after 2020, while 6 others develop new risk. Our results suggest that the risk of HFRS will remain high through the end of this century, with Rattus norvegicus being the most active host, and that extreme climate indices are significant risk factors. Our findings can inform evidence-based policymaking regarding future risk of HFRS.
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Affiliation(s)
- Yuchen Wang
- Vanke School of Public Health, Tsinghua University, Beijing100084, China
- Institute for Healthy China, Tsinghua University, Beijing100084, China
| | - Chutian Zhang
- Vanke School of Public Health, Tsinghua University, Beijing100084, China
- Institute for Healthy China, Tsinghua University, Beijing100084, China
- College of Natural Resources and Environment, Northwest A&F University, Yangling712100, China
| | - Jing Gao
- Vanke School of Public Health, Tsinghua University, Beijing100084, China
- Institute for Healthy China, Tsinghua University, Beijing100084, China
- Respiratory Medicine Unit, Department of Medicine & Centre for Molecular Medicine, Karolinska Institute, Stockholm171 77, Sweden
- Heart and Lung Centre, Department of Pulmonary Medicine, University of Helsinki and Helsinki University Hospital, Helsinki00290, Finland
| | - Ziqi Chen
- Vanke School of Public Health, Tsinghua University, Beijing100084, China
- Institute for Healthy China, Tsinghua University, Beijing100084, China
| | - Zhao Liu
- School of Linkong Economics and Management, Beijing Institute of Economics and Management, Beijing100102, China
| | - Jianbin Huang
- Beijing Yanshan Earth Critical Zone National Research Station, University of Chinese Academy of Sciences, Beijing101408, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing100190, China
| | - Yidan Chen
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, 100084, China
| | - Zhichao Li
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing100101, China
| | - Nan Chang
- School of Public Health, Nanjing Medical University, Nanjing210000, China
| | - Yuxin Tao
- Center for Statistical Science, Department of Industrial Engineering, Tsinghua University, Beijing100084, China
| | - Hui Tang
- Department of Geosciences, Natural History Museum, University of Oslo, Blindern, Oslo0316, Norway
- Natural History Museum, University of Oslo, Blindern, Oslo0316, Norway
- Department of Geosciences and Geography, University of Helsinki, Helsinki00014, Finland
| | - Xuejie Gao
- Climate Change Research Centre, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing100029, China
- College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing100049, China
| | - Ying Xu
- National Climate Centre, China Meteorological Administration, Beijing100081, China
| | - Can Wang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, 100084, China
| | - Dong Li
- Center for Statistical Science, Department of Industrial Engineering, Tsinghua University, Beijing100084, China
| | - Xiaobo Liu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing102206, China
| | - Jingxiang Pan
- Joan & Sanford I. Weill Medical College, Cornell University, Ithaca, New York10065
| | - Wenjia Cai
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modelling, Institute for Global Change Studies, Tsinghua University, Beijing100084, China
| | - Peng Gong
- Department of Earth Sciences and Geography, University of Hong Kong, Hong Kong Special Administrative Region999077, China
| | - Yong Luo
- Department of Earth System Science, Ministry of Education Key Laboratory for Earth System Modelling, Institute for Global Change Studies, Tsinghua University, Beijing100084, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing100084, China
- Institute for Healthy China, Tsinghua University, Beijing100084, China
| | - Qiyong Liu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing102206, China
| | - Nils Chr. Stenseth
- Vanke School of Public Health, Tsinghua University, Beijing100084, China
- Centre for Pandemics and One-Health Research, Faculty of Medicine, University of Oslo, OsloN-0316, Norway
- Centre for Ecological and Evolutionary Synthesis, Department of Biosciences, Faculty of Mathematics and Natural Sciences, University of Oslo, OsloN-0315, Norway
| | - Ruifu Yang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing100071, China
| | - Lei Xu
- Vanke School of Public Health, Tsinghua University, Beijing100084, China
- Institute for Healthy China, Tsinghua University, Beijing100084, China
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2
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Jacob AT, Ziegler BM, Farha SM, Vivian LR, Zilinski CA, Armstrong AR, Burdette AJ, Beachboard DC, Stobart CC. Sin Nombre Virus and the Emergence of Other Hantaviruses: A Review of the Biology, Ecology, and Disease of a Zoonotic Pathogen. BIOLOGY 2023; 12:1413. [PMID: 37998012 PMCID: PMC10669331 DOI: 10.3390/biology12111413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023]
Abstract
Sin Nombre virus (SNV) is an emerging virus that was first discovered in the Four Corners region of the United States in 1993. The virus causes a disease known as Hantavirus Pulmonary Syndrome (HPS), sometimes called Hantavirus Cardiopulmonary Syndrome (HCPS), a life-threatening illness named for the predominance of infection of pulmonary endothelial cells. SNV is one of several rodent-borne hantaviruses found in the western hemisphere with the capability of causing this disease. The primary reservoir of SNV is the deer mouse (Peromyscus maniculatus), and the virus is transmitted primarily through aerosolized rodent excreta and secreta. Here, we review the history of SNV emergence and its virus biology and relationship to other New World hantaviruses, disease, treatment, and prevention options.
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Affiliation(s)
- Andrew T. Jacob
- Department of Biological Sciences, Butler University, Indianapolis, IN 46208, USA
| | | | - Stefania M. Farha
- Department of Biological Sciences, Butler University, Indianapolis, IN 46208, USA
| | - Lyla R. Vivian
- Department of Biological Sciences, Butler University, Indianapolis, IN 46208, USA
| | - Cora A. Zilinski
- Department of Biology, DeSales University, Center Valley, PA 18034, USA
| | | | - Andrew J. Burdette
- Department of Biological Sciences, Butler University, Indianapolis, IN 46208, USA
| | - Dia C. Beachboard
- Department of Biology, DeSales University, Center Valley, PA 18034, USA
| | - Christopher C. Stobart
- Department of Biological Sciences, Butler University, Indianapolis, IN 46208, USA
- Interdisciplinary Program in Public Health, Butler University, Indianapolis, IN 46208, USA
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3
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Moirano G, Botta A, Yang M, Mangeruga M, Murray K, Vineis P. Land-cover, land-use and human hantavirus infection risk: a systematic review. Pathog Glob Health 2023:1-15. [PMID: 37876214 DOI: 10.1080/20477724.2023.2272097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
Previous studies suggest that the risk of human infection by hantavirus, a family of rodent-borne viruses, might be affected by different environmental determinants such as land cover, land use and land use change. This study examined the association between land-cover, land-use, land use change, and human hantavirus infection risk. PubMed and Scopus databases were interrogated using terms relative to land use (change) and human hantavirus disease. Screening and selection of the articles were completed by three independent reviewers. Classes of land use assessed by the different studies were categorized into three macro-categories of exposure ('Agriculture', 'Forest Cover', 'Urban Areas') to qualitatively synthesize the direction of the association between exposure variables and hantavirus infection risk in humans. A total of 25 articles were included, with 14 studies (56%) conducted in China, 4 studies (16%) conducted in South America and 7 studies (28%) conducted in Europe. Most of the studies (88%) evaluated land cover or land use, while 3 studies (12%) evaluated land use change, all in relation to hantavirus infection risk. We observed that land cover and land-use categories could affect hantavirus infection incidence. Overall, agricultural land use was positively associated with increased human hantavirus infection risk, particularly in China and Brazil. In Europe, a positive association between forest cover and hantavirus infection incidence was observed. Studies that assessed the relationship between built-up areas and hantavirus infection risk were more variable, with studies reporting positive, negative or no associations.
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Affiliation(s)
- Giovenale Moirano
- Department of Medical Sciences, University of Turin, Turin, Italy
- Postgraduate School of Biostatistics, Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - Annarita Botta
- Department of Infectious Disease and Infectious Emergencies, AORN Monaldi-Cotugno-CTO, Naples, Italy
| | - Mingyou Yang
- Hypertension Unit, Division of Internal Medicine, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Martina Mangeruga
- Environmental Technology, Centre for Environmental Policy, Imperial College, London, UK
| | - Kris Murray
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Paolo Vineis
- School of Public Health, Imperial College, Medical Research Council (MRC) Centre for Environment and Health, London, UK
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Vial PA, Ferrés M, Vial C, Klingström J, Ahlm C, López R, Le Corre N, Mertz GJ. Hantavirus in humans: a review of clinical aspects and management. THE LANCET. INFECTIOUS DISEASES 2023; 23:e371-e382. [PMID: 37105214 DOI: 10.1016/s1473-3099(23)00128-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 04/29/2023]
Abstract
Hantavirus infections are part of the broad group of viral haemorrhagic fevers. They are also recognised as a distinct model of an emergent zoonotic infection with a global distribution. Many factors influence their epidemiology and transmission, such as climate, environment, social development, ecology of rodent hosts, and human behaviour in endemic regions. Transmission to humans occurs by exposure to infected rodents in endemic areas; however, Andes hantavirus is unique in that it can be transmitted from person to person. As hantaviruses target endothelial cells, they can affect diverse organ systems; increased vascular permeability is central to pathogenesis. The main clinical syndromes associated with hantaviruses are haemorrhagic fever with renal syndrome (HFRS), which is endemic in Europe and Asia, and hantavirus cardiopulmonary syndrome (HCPS), which is endemic in the Americas. HCPS and HFRS are separate clinical entities, but they share several features and have many overlapping symptoms, signs, and pathogenic alterations. For HCPS in particular, clinical outcomes are highly associated with early clinical suspicion, access to rapid diagnostic testing or algorithms for presumptive diagnosis, and prompt transfer to a facility with critical care units. No specific effective antiviral treatment is available.
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Affiliation(s)
- Pablo A Vial
- Programa Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Departamento de Pediatría Clínica Alemana de Santiago, Santiago, Chile.
| | - Marcela Ferrés
- Department of Pediatric Infectious Disease and Immunology, Infectious Disease and Molecular Virology Laboratory, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cecilia Vial
- Programa Hantavirus y Zoonosis, Instituto de Ciencias e Innovación en Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Jonas Klingström
- Division of Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Clas Ahlm
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - René López
- Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Departamento de Paciente Crítico Clínica Alemana, Santiago, Chile
| | - Nicole Le Corre
- Department of Pediatric Infectious Disease and Immunology, Infectious Disease and Molecular Virology Laboratory, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gregory J Mertz
- Department of Internal Medicine, UNM Health Sciences Center, University of New Mexico, Albuquerque, NM, USA
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5
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Marie V, Gordon ML. The (Re-)Emergence and Spread of Viral Zoonotic Disease: A Perfect Storm of Human Ingenuity and Stupidity. Viruses 2023; 15:1638. [PMID: 37631981 PMCID: PMC10458268 DOI: 10.3390/v15081638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
Diseases that are transmitted from vertebrate animals to humans are referred to as zoonotic diseases. Although microbial agents such as bacteria and parasites are linked to zoonotic events, viruses account for a high percentage of zoonotic diseases that have emerged. Worryingly, the 21st century has seen a drastic increase in the emergence and re-emergence of viral zoonotic disease. Even though humans and animals have coexisted for millennia, anthropogenic factors have severely increased interactions between the two populations, thereby increasing the risk of disease spill-over. While drivers such as climate shifts, land exploitation and wildlife trade can directly affect the (re-)emergence of viral zoonotic disease, globalisation, geopolitics and social perceptions can directly facilitate the spread of these (re-)emerging diseases. This opinion paper discusses the "intelligent" nature of viruses and their exploitation of the anthropogenic factors driving the (re-)emergence and spread of viral zoonotic disease in a modernised and connected world.
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Affiliation(s)
- Veronna Marie
- Microbiology Laboratory, Department of Analytical Services, Rand Water, Vereeniging 1939, South Africa
| | - Michelle L. Gordon
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban 4001, South Africa;
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López WR, Altamiranda-Saavedra M, Kehl SD, Ferro I, Bellomo C, Martínez VP, Simoy MI, Gil JF. Modeling potential risk areas of Orthohantavirus transmission in Northwestern Argentina using an ecological niche approach. BMC Public Health 2023; 23:1236. [PMID: 37365559 DOI: 10.1186/s12889-023-16071-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Hantavirus Pulmonary Syndrome (HPS) is a rodent-borne zoonosis in the Americas, with up to 50% mortality rates. In Argentina, the Northwestern endemic area presents half of the annually notified HPS cases in the country, transmitted by at least three rodent species recognized as reservoirs of Orthohantavirus. The potential distribution of reservoir species based on ecological niche models (ENM) can be a useful tool to establish risk areas for zoonotic diseases. Our main aim was to generate an Orthohantavirus risk transmission map based on ENM of the reservoir species in northwest Argentina (NWA), to compare this map with the distribution of HPS cases; and to explore the possible effect of climatic and environmental variables on the spatial variation of the infection risk. METHODS Using the reservoir geographic occurrence data, climatic/environmental variables, and the maximum entropy method, we created models of potential geographic distribution for each reservoir in NWA. We explored the overlap of the HPS cases with the reservoir-based risk map and a deforestation map. Then, we calculated the human population at risk using a census radius layer and a comparison of the environmental variables' latitudinal variation with the distribution of HPS risk. RESULTS We obtained a single best model for each reservoir. The temperature, rainfall, and vegetation cover contributed the most to the models. In total, 945 HPS cases were recorded, of which 97,85% were in the highest risk areas. We estimated that 18% of the NWA population was at risk and 78% of the cases occurred less than 10 km from deforestation. The highest niche overlap was between Calomys fecundus and Oligoryzomys chacoensis. CONCLUSIONS This study identifies potential risk areas for HPS transmission based on climatic and environmental factors that determine the distribution of the reservoirs and Orthohantavirus transmission in NWA. This can be used by public health authorities as a tool to generate preventive and control measures for HPS in NWA.
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Affiliation(s)
- Walter R López
- Instituto de Investigaciones de Enfermedades Tropicales (IIET), Universidad Nacional de Salta (UNSa), Sede Regional Orán, A4400, Salta, Argentina
| | - Mariano Altamiranda-Saavedra
- Grupo de Investigación Bioforense, Facultad de Derecho Y Ciencias Forenses, Tecnológico de Antioquia Institución Universitaria, Antioquia, Colombia
| | - Sebastián D Kehl
- Instituto Nacional de Enfermedades Infecciosas (INEI), Administración Nacional de Laboratorios E Institutos de Salud (ANLIS) "Dr. C. G. Malbrán", Buenos Aires, Argentina
| | - Ignacio Ferro
- Instituto de Ecorregiones Andinas (INECOA), Consejo Nacional de Investigaciones Científicas Y Técnicas (CONICET), Universidad Nacional de Jujuy (UNJu), San Salvador de Jujuy, Argentina
| | - Carla Bellomo
- Instituto Nacional de Enfermedades Infecciosas (INEI), Administración Nacional de Laboratorios E Institutos de Salud (ANLIS) "Dr. C. G. Malbrán", Buenos Aires, Argentina
| | - Valeria P Martínez
- Instituto Nacional de Enfermedades Infecciosas (INEI), Administración Nacional de Laboratorios E Institutos de Salud (ANLIS) "Dr. C. G. Malbrán", Buenos Aires, Argentina
| | - Mario I Simoy
- Instituto de Investigaciones en Energía No Convencional (INENCO), Consejo Nacional de Investigaciones Científicas Y Técnicas (CONICET), Universidad Nacional de Salta (UNSa), A4400, Salta, Argentina
- Instituto Multidisciplinario Sobre Ecosistemas Y Desarrollo Sustentable (UNCPBA - CICPBA), Tandil, Argentina
| | - José F Gil
- Instituto de Investigaciones de Enfermedades Tropicales (IIET), Universidad Nacional de Salta (UNSa), Sede Regional Orán, A4400, Salta, Argentina.
- Instituto de Investigaciones en Energía No Convencional (INENCO), Consejo Nacional de Investigaciones Científicas Y Técnicas (CONICET), Universidad Nacional de Salta (UNSa), A4400, Salta, Argentina.
- Cátedra de Química Biológica Y Biología Molecular de La Facultad de Ciencias Naturales, Universidad Nacional de Salta, A4400, Salta, Argentina.
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Mocanu A, Cajvan AM, Lazaruc TI, Lupu VV, Florescu L, Lupu A, Bogos RA, Ioniuc I, Scurtu G, Dragan F, Starcea IM. Hantavirus Infection in Children-A Pilot Study of Single Regional Center. Viruses 2023; 15:v15040872. [PMID: 37112856 PMCID: PMC10143646 DOI: 10.3390/v15040872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Hantaviruses are infectious etiological agents of a group of rodent-borne hemorrhagic fevers, with two types of clinical manifestations in humans: hantavirus pulmonary syndrome (HPS) and hemorrhagic fever with renal syndrome (HFRS). According to available statistics, the disease occurs mainly in adults, but the lower incidence in the pediatric population might also be related to a lack of diagnosis possibilities or even unsatisfactory knowledge about the disease. MATERIALS AND METHODS The purpose of this study was to evaluate the cases of hemorrhagic fever with renal syndrome diagnosed and treated in the Department of Nephrology at St. Mary's Emergency Hospital for Children in Iasi, Romania, representative of the North-East of Romania. We also reviewed the specialized literature on the topic. RESULTS Between January 2017 and January 2022, eight cases of HFRS, all men, and seven from rural areas, aged 11-18 years old, were referred to our clinic because of an acute kidney injury (AKI). Seven cases were identified as Dobrava serotype while one case was determined by Haantan serotype. CONCLUSIONS HFRS should always be considered as a differential diagnosis when faced with a patient with AKI and thrombocytopenia. Dobrava serotype is the most common hantavirus subtype in the Balkans. For the specific prevention of human infections, mainly in high-risk groups, vaccines are needed. As far as we know, this is the first study on HFRS in Romanian children.
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Affiliation(s)
- Adriana Mocanu
- Pediatrics "Grigore T. Popa", University of Medicine and Pharmacy, 700115 Iasi, Romania
- Nephrology Division, St. Mary's Emergency Hospital for Children, 700309 Iasi, Romania
| | - Ana-Maria Cajvan
- Nephrology Division, St. Mary's Emergency Hospital for Children, 700309 Iasi, Romania
| | - Tudor Ilie Lazaruc
- Pediatrics "Grigore T. Popa", University of Medicine and Pharmacy, 700115 Iasi, Romania
- Nephrology Division, St. Mary's Emergency Hospital for Children, 700309 Iasi, Romania
| | - Vasile Valeriu Lupu
- Pediatrics "Grigore T. Popa", University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Laura Florescu
- Pediatrics "Grigore T. Popa", University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ancuta Lupu
- Pediatrics "Grigore T. Popa", University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Roxana Alexandra Bogos
- Pediatrics "Grigore T. Popa", University of Medicine and Pharmacy, 700115 Iasi, Romania
- Nephrology Division, St. Mary's Emergency Hospital for Children, 700309 Iasi, Romania
| | - Ileana Ioniuc
- Pediatrics "Grigore T. Popa", University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Georgiana Scurtu
- Pediatrics "Grigore T. Popa", University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Felicia Dragan
- Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania
| | - Iuliana Magdalena Starcea
- Pediatrics "Grigore T. Popa", University of Medicine and Pharmacy, 700115 Iasi, Romania
- Nephrology Division, St. Mary's Emergency Hospital for Children, 700309 Iasi, Romania
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8
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Wang Y, Wei X, Xiao X, Yin W, He J, Ren Z, Li Z, Yang M, Tong S, Guo Y, Zhang W, Wang Y. Climate and socio-economic factors drive the spatio-temporal dynamics of HFRS in Northeastern China. One Health 2022; 15:100466. [DOI: 10.1016/j.onehlt.2022.100466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/15/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022] Open
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