1
|
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.
Collapse
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
| |
Collapse
|
2
|
Wang Y, Wei X, Jia R, Peng X, Zhang X, Yang M, Li Z, Guo J, Chen Y, Yin W, Zhang W, Wang Y. The Spatiotemporal Pattern and Its Determinants of Hemorrhagic Fever With Renal Syndrome in Northeastern China: Spatiotemporal Analysis. JMIR Public Health Surveill 2023; 9:e42673. [PMID: 37200083 DOI: 10.2196/42673] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/29/2023] [Accepted: 04/11/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Hemorrhagic fever with renal syndrome (HFRS) is a significant zoonotic disease mainly transmitted by rodents. However, the determinants of its spatiotemporal patterns in Northeast China remain unclear. OBJECTIVE This study aimed to investigate the spatiotemporal dynamics and epidemiological characteristics of HFRS and detect the meteorological effect of the HFRS epidemic in Northeastern China. METHODS The HFRS cases of Northeastern China were collected from the Chinese Center for Disease Control and Prevention, and meteorological data were collected from the National Basic Geographic Information Center. Times series analyses, wavelet analysis, Geodetector model, and SARIMA model were performed to identify the epidemiological characteristics, periodical fluctuation, and meteorological effect of HFRS in Northeastern China. RESULTS A total of 52,655 HFRS cases were reported in Northeastern China from 2006 to 2020, and most patients with HFRS (n=36,558, 69.43%) were aged between 30-59 years. HFRS occurred most frequently in June and November and had a significant 4- to 6-month periodicity. The explanatory power of the meteorological factors to HFRS varies from 0.15 ≤ q ≤ 0.01. In Heilongjiang province, mean temperature with a 4-month lag, mean ground temperature with a 4-month lag, and mean pressure with a 5-month lag had the most explanatory power on HFRS. In Liaoning province, mean temperature with a 1-month lag, mean ground temperature with a 1-month lag, and mean wind speed with a 4-month lag were found to have an effect on HFRS, but in Jilin province, the most important meteorological factors for HFRS were precipitation with a 6-month lag and maximum evaporation with a 5-month lag. The interaction analysis of meteorological factors mostly showed nonlinear enhancement. The SARIMA model predicted that 8,343 cases of HFRS are expected to occur in Northeastern China. CONCLUSIONS HFRS showed significant inequality in epidemic and meteorological effects in Northeastern China, and eastern prefecture-level cities presented a high risk of epidemic. This study quantifies the hysteresis effects of different meteorological factors and prompts us to focus on the influence of ground temperature and precipitation on HFRS transmission in future studies, which could assist local health authorities in developing HFRS-climate surveillance, prevention, and control strategies targeting high-risk populations in China.
Collapse
Affiliation(s)
- Yanding Wang
- School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Xianyu Wei
- School of Public Health, Anhui Medical University, Hefei, China
| | - Ruizhong Jia
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - XingYu Peng
- School of Public Health, China Medical University, Shenyang, China
| | - Xiushan Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Meitao Yang
- School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Zhiqiang Li
- School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Jinpeng Guo
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Yong Chen
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Wenwu Yin
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenyi Zhang
- School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- School of Public Health, Anhui Medical University, Hefei, China
| | - Yong Wang
- School of Public Health, China Medical University, Shenyang, China
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- School of Public Health, Anhui Medical University, Hefei, China
| |
Collapse
|
3
|
Lv CL, Tian Y, Qiu Y, Xu Q, Chen JJ, Jiang BG, Li ZJ, Wang LP, Hay SI, Liu W, Fang LQ. Dual seasonal pattern for hemorrhagic fever with renal syndrome and its potential determinants in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 859:160339. [PMID: 36427712 DOI: 10.1016/j.scitotenv.2022.160339] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Hemorrhagic fever with renal syndrome (HFRS) continued to affect human health across Eurasia, which complicated by climate change has posed a challenge for the disease prevention measures. Nation-wide surveillance data of HFRS cases were collected during 2008-2020.The seasonality and epidemiological features were presented by combining the HFRS incidence and the endemic types data. Factors potentially involved in affecting incidence and shaping disease seasonality were investigated by generalized additive mixed model, distributed lag nonlinear model and multivariate meta-analysis. A total of 76 cities that reported totally 111,054 cases were analyzed. Three endemic types were determined, among them the Type I cities (Hantaan virus-dominant) were related to higher incidence level, showing one spike every year in Autumn-Winter season; Type II (Seoul virus-dominant) cities were related to lower incidence, showing one spike in Spring, while Type III (Hantaan/Seoul-mixed type) showed dual peaks with incidence lying between. Persistently heavy rainfall had significantly negative influence on HFRS incidence in Hantaan virus-dominant endemic area, while a significantly opposite effect was identified when continuously heavy rainfall induced floods, where temperature and relative humidity affected HFRS incidence via an approximately parabolic or linear manner, however few or no such effects was shown in Seoul virus-dominant endemic areas, which was more vulnerable to temperature variation. Dual seasonal pattern of HFRS was depended on the dominant genotypes of hantavirus, and impact of climate on HFRS was greater in Hantaan virus-dominant endemic areas, than in Seoul virus-dominant areas.
Collapse
Affiliation(s)
- Chen-Long Lv
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Yao Tian
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Yan Qiu
- Beijing Haidian District Center for Disease Control and Prevention, Beijing, China
| | - Qiang Xu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Jin-Jin Chen
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Bao-Gui Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Zhong-Jie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li-Ping Wang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, USA.
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.
| |
Collapse
|
4
|
A long-term retrospective analysis of the haemorrhagic fever with renal syndrome epidemic from 2005 to 2021 in Jiangxi Province, China. Sci Rep 2023; 13:2268. [PMID: 36755085 PMCID: PMC9907874 DOI: 10.1038/s41598-023-29330-4] [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: 10/23/2022] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
Jiangxi is one of the provinces in China most seriously affected by the haemorrhagic fever with renal syndrome (HFRS) epidemic. The aim of this paper was to systematically explore the HFRS epidemic in Jiangxi from the perspective of Hantavirus (HV) prevalence in rodents and humans and virus molecular characteristics. Individual information on all HFRS cases in Jiangxi from 2005 to 2021 was extracted from the China Information System for Disease Control and Prevention. All S and M fragment sequences of the Seoul virus and Hantan virus strains uploaded by Jiangxi and its neighbouring provinces and some representative sequences from provinces in China or some countries of Southeast Asia with the highest HV prevalence were retrieved and downloaded from NCBI GenBank. Periodogram and spatial autocorrelation were adopted for temporal periodicity and spatial clustering analysis of the HFRS epidemic. Joinpoint regression was utilized to explore the changing morbidity trend patterns of HFRS. Multiple sequence alignment and amino acid variation analysis were used to explore the homology and variation of strain prevalence in Jiangxi. Based on monthly morbidity time series, the periodogram analysis showed that the prevalence of HFRS had periodicities of 6 months and 12 months. Spatial autocorrelation analysis showed that HFRS distributed in Jiangxi was not random, with a "High-High" clustering area around Gaoan County. HFRS morbidity among the 0 ~ 15-year-old and ~ 61-year-old or older populations in Jiangxi increased significantly during the period of 2008-2015. Generally, HFRS morbidity was significantly positively correlated with the index of rat with virus (IRV) (r = 0.742) in the counties surrounding Gaoan from 2005 to 2019. HTNV strains in Jiangxi were in one independent branch, while the SEOV strains in Jiangxi were relatively more diverse. Both the YW89-15 and GAW30/2021 strains shared approximately 85% nucleotide homology and approximately 97% amino acid homology with their corresponding standard strains and vaccine strains. GAW30/2021 and YW89-15 had some amino acid site variations in nucleoprotein, glycoprotein precursor and RNA-dependent polymerase with their corresponding vaccine strains Z10 (HTNV) and Z37 (SEOV). The HFRS epidemic in Jiangxi has obvious temporal periodicity and spatial clustering, and the significant increase in the non-Immunization Expanded Program (EPI) targeted population (children and elderly) suggests that HFRS vaccination in this population needs to be considered. Although applying the EPI played a certain role in curbing the incidence of HFRS in Jiangxi from the perspective of ecological epidemiology, HTNV and SEOV strains prevalent in Jiangxi have some amino acid site variations compared to their corresponding vaccine strains, suggesting that HV variation needs to be continuously monitored in the future to observe vaccine protective efficiency.
Collapse
|
5
|
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
|
6
|
Zeng Y, Feng Y, Zhao Y, Zhang X, Yang L, Wang J, Gao Z, Zhang C. An HFman Probe-Based Multiplex Reverse Transcription Loop-Mediated Isothermal Amplification Assay for Simultaneous Detection of Hantaan and Seoul Viruses. Diagnostics (Basel) 2022; 12:diagnostics12081925. [PMID: 36010275 PMCID: PMC9406646 DOI: 10.3390/diagnostics12081925] [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: 07/12/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 11/22/2022] Open
Abstract
Hantaviruses are zoonotic pathogens that are widely distributed worldwide. Hantaan virus (HTNV) and Seoul virus (SEOV) are two most common hantaviruses that infect humans and cause hemorrhagic fever with renal syndrome (HFRS). Rapid and sensitive detection of HTNV and SEOV are crucial for surveillance, clinical treatment and management of HFRS. This study aimed to develop a rapid HFman probe-based mulstiplex reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay to simultaneously detect HTNV and SEOV. A novel multiplex RT-LAMP assay was developed, and 46 serum samples obtained from clinically suspected patients were used for evaluation. The novel RT-LAMP assay can detect as low as 3 copies/reaction of hantaviruses with a detection limit of 41 and 73 copies per reaction for HTNV and SEOV, respectively. A clinical evaluation showed that the consistencies of the multiplex RT-LAMP with RT-qPCR assay were 100% and 97.8% for HTNV and SEOV, respectively. In view of the high prevalence of HTNV and SEOV in rural areas with high rodent density, a colorimetric visual determination method was also developed for point-of-care testing (POCT) for the diagnosis of the two viruses. The novel multiplex RT-LAMP assay is a sensitive, specific, and efficient method for simultaneously detecting HTNV and SEOV.
Collapse
Affiliation(s)
- Yi Zeng
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Yun Feng
- Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - Yongjuan Zhao
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Xiaoling Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - Lifen Yang
- Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - Juan Wang
- Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - Zihou Gao
- Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
- Correspondence: (Z.G.); or (C.Z.)
| | - Chiyu Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
- Correspondence: (Z.G.); or (C.Z.)
| |
Collapse
|
7
|
Wei J, Huang X, Li S, Du S, Yu P, Li J. A Total of 2,657 Reported Cases and 14 Deaths Due to Hemorrhagic Fever with Renal Syndrome - Shaanxi Province, China, January 1-December 19, 2021. China CDC Wkly 2021; 3:1143. [PMID: 35036038 PMCID: PMC8742143 DOI: 10.46234/ccdcw2021.272] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/01/2022] Open
Affiliation(s)
- Jing Wei
- Center for Disease Control and Prevention of Shaanxi Province, Xi'an, Shaanxi, China
| | - Xiaoxia Huang
- Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shen Li
- Center for Disease Control and Prevention of Shaanxi Province, Xi'an, Shaanxi, China
| | - Shanshan Du
- Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Pengbo Yu
- Center for Disease Control and Prevention of Shaanxi Province, Xi'an, Shaanxi, China
| | - Jiandong Li
- Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|