1
|
Wang W, Wang Z, Chen Z, Liang M, Zhang A, Sheng H, Ni M, Yang J. Construction of an early differentiation diagnosis model for patients with severe fever with thrombocytopenia syndrome and hemorrhagic fever with renal syndrome. J Med Virol 2024; 96:e29626. [PMID: 38654664 DOI: 10.1002/jmv.29626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with a high mortality rate. Differentiating between SFTS and hemorrhagic fever with renal syndrome (HFRS) is difficult and inefficient. Retrospective analysis of the medical records of individuals with SFTS and HFRS was performed. Clinical and laboratory data were compared, and a diagnostic model was developed based on multivariate logistic regression analyzes. Receiver operating characteristic curve analysis was used to evaluate the diagnostic model. Among the 189 patients, 113 with SFTS and 76 with HFRS were enrolled. Univariate analysis revealed that more than 20 variables were significantly associated with SFTS. Multivariate logistic regression analysis revealed that gender, especially female gender (odds ratio [OR]: 4.299; 95% confidence interval [CI]: 1.163-15.887; p = 0.029), age ≥65 years (OR: 16.386; 95% CI: 3.043-88.245; p = 0.001), neurological symptoms (OR: 12.312; 95% CI: 1.638-92.530; p = 0.015), leukopenia (<4.0 × 109/L) (OR: 17.355; 95% CI: 3.920-76.839; p < 0.001), and normal Cr (OR: 97.678; 95% CI: 15.483-616.226; p < 0.001) were significantly associated with SFTS but not with HFRS. The area under the curve of the differential diagnostic model was 0.960 (95% CI: 0.936-0.984), which was significantly better than that of each single factor. In addition, the model exhibited very excellent sensitivity and specificity (92.9% and 85.5%, respectively). In cases where HFRS and SFTS are endemic, a diagnostic model based on five parameters, such as gender, age ≥65 years, neurological symptoms, leukopenia and normal Cr, will facilitate the differential diagnosis of SFTS and HFRS in medical institutions, especially in primary care settings.
Collapse
Affiliation(s)
- Wenjie Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Zijian Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Zumin Chen
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Manman Liang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Aiping Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Haoyu Sheng
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Mingyue Ni
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Jianghua Yang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| |
Collapse
|
2
|
Zhou Y, Yang J, Hai H, Dong J, Wen Y. Hantavirus infection-related acute inflammatory demyelinative polyradiculoneuropathy: A case report and literature review. Medicine (Baltimore) 2024; 103:e37332. [PMID: 38457548 PMCID: PMC10919522 DOI: 10.1097/md.0000000000037332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/01/2024] [Indexed: 03/10/2024] Open
Abstract
RATIONALE Hemorrhagic fever with renal syndrome (HFRS) is a common infectious disease in China. As a complication of post-Hantavirus infection, Guillain-Barre syndrome (GBS) was rarely previously reported. Here, we described a case of acute inflammatory demyelinative polyradiculoneuropathy secondary to Hantavirus infection in spring of 2023. We also made a summary of the clinical features from previous reported cases. PATIENT CONCERNS A young male patient complained a fever with headache, who was subsequently diagnosed with HFRS with positive serum Hantavirus antibody IgM. Two weeks later, he presented sustained back pain, obvious numbness located in 4 extremities, chest and abdomen, facial dyskinesia and 4 extremities muscle weakness. DIAGNOSIS, INTERVENTIONS, AND OUTCOMES He was rapidly diagnosed with GBS by typical cerebrospinal fluid change and the electromyography examination presentation, which was verified associated with hantavirus infection. He was treated with intravenous immunoglobulin infusion followed by rehabilitation treatment. He got a complete recovery within 4 months after disease onset. LESSONS GBS was an uncommon manifestation of Hantavirus infection. GBS should be considered when acute limb weakness happens in cases with HFRS. A multidisciplinary team could make a rapid diagnosis and optimal treatment when nervous system disorders occurred.
Collapse
Affiliation(s)
- Ying Zhou
- Department of Infectious Diseases II, Shenyang Natural Focal Diseases Clinical Medical Research Center, The First Affiliated Hospital of China Medical University. No. 155, Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China
| | - Jun Yang
- Department of neurology, The First Affiliated Hospital of China Medical University. No. 155, Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China
| | - Hong Hai
- Department of rehabilitation, The First Affiliated Hospital of China Medical University, No. 155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China
| | - Jun Dong
- Department of Infectious Diseases Ⅲ, Fushun Infectious Disease Hospital, No. 25 Shenfu North Line, Shuncheng District, Fushun City, Liaoning Province, China
| | - Ying Wen
- Department of Infectious Diseases II, Shenyang Natural Focal Diseases Clinical Medical Research Center, The First Affiliated Hospital of China Medical University. No. 155, Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China
| |
Collapse
|
3
|
Hu H, Zhan J, Chen W, Yang Y, Jiang H, Zheng X, Li J, Hu F, Yu D, Li J, Yang X, Zhang Y, Wang X, Bi Z, Liang Y, Shen H, Du H, Lian J. Development and validation of a novel death risk stratification scale in patients with hemorrhagic fever with renal syndrome: a 14-year ambispective cohort study. Clin Microbiol Infect 2024; 30:387-394. [PMID: 37952580 DOI: 10.1016/j.cmi.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES To develop and validate a simple and effective death risk stratification scale for hemorrhagic fever with renal syndrome (HFRS). METHODS In this ambispective cohort study, we investigated the epidemiological and clinical data of 2245 patients with HFRS (1873 enrolled retrospectively and constituting the training cohort, 372 prospectively recruited as the validation cohort) from September 2008 to December 2021, and identified independent risk factors for 30-day death of HFRS. Using logistic regression analysis, a nomogram prediction model was established and was further simplified into a novel scoring scale. Calibration plot, receiver operating characteristic curve, net reclassification index, integrated discrimination index, and decision curve analysis were used to assess the calibration, discrimination, precision, and clinical utility in both training and validation cohorts. RESULTS Of 2245 patients with HFRS, 132 (5.9%) died during hospitalization. The nomogram prediction model and scoring scale were developed using six predictors: comorbid hypertension, hypotensive shock, hypoxemia, neutrophils, aspartate aminotransferase, and activated partial thromboplastin time. Both the scale and nomogram were well calibrated (near-diagonal calibration curves) and demonstrated significant predictive values (areas under receiver operating characteristic curves >0.9, sensitivity and specificity >90% in the training cohort and >84% in the validation cohort). The simplified scoring scale demonstrated equivalent discriminative ability to the nomogram, with net reclassification index and integrated discrimination index of 0.022 and 0.007 in the training cohort, 0.126 and 0.022 in the validation cohort. Decision curve analysis graphically represented significant clinical utility and comparable net benefits of the nomogram and scoring scale across a range of threshold probabilities. DISCUSSION This evidence-based, factor-weighted, accurate score could help clinicians swiftly stratify HFRS mortality risk and facilitate the implementation of patient triage and tiered medical services during epidemic peaks.
Collapse
Affiliation(s)
- Haifeng Hu
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Jiayi Zhan
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Wenjing Chen
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China; Department of Infectious Diseases, Affiliated Hospital of Yan'an University, Yan'an, China
| | - Yali Yang
- Department of Inpatient Ultrasound, Second Affiliated Hospital of Xi'an Medical University, Xi'an, China
| | - Hong Jiang
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Xuyang Zheng
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Jiayu Li
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Fei Hu
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China; Department of Infectious Diseases, 985th Hospital of Chinese People's Liberation Army, Taiyuan, China
| | - Denghui Yu
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China; Department of Intensive Care Unit, General Hospital of Southern Theater Command, Guangzhou, China
| | - Jing Li
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Xiaofei Yang
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Ye Zhang
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Xiaoyan Wang
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Zhanhu Bi
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Yan Liang
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China; College of Life Sciences, Northwest University, Xi'an, China
| | - Huanjun Shen
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Hong Du
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Jianqi Lian
- Center for Infectious Diseases, Second Affiliated Hospital of Air Force Medical University, Xi'an, China.
| |
Collapse
|
4
|
Shakirova V, Markelova M, Davidyuk Y, Stott-Marshall RJ, Foster TL, Khaiboullina S, Rizvanov A, Martynova E. Rosuvastatin as a Supplemental Treatment for the Clinical Symptoms of Nephropathia Epidemica: A Pilot Clinical Study. Viruses 2024; 16:306. [PMID: 38400081 PMCID: PMC10892398 DOI: 10.3390/v16020306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
Nephropathis epidemica (NE), a mild form of hemorrhagic fever with renal syndrome (HFRS), is an acute zoonotic disease endemic in the Republic of Tatarstan. This study aimed to assess the impact of rosuvastatin on the clinical and laboratory results of NE. A total of 61 NE patients and 30 controls were included in this study; 22 NE patients and 7 controls received a daily dose of rosuvastatin (10 mg) for ten consecutive days. Serum samples were collected on days 1, 5, and 10 after admission to the hospital. These samples were analyzed to determine the levels of lipids, cytokines, and kidney toxicity markers. Our findings indicate that rosuvastatin reduced the duration of the second wave of fever and alleviated back pain and headache symptoms. Additionally, low-density lipoprotein cholesterol (LDL-C) serum levels were significantly decreased on days 5 and 10 upon rosuvastatin treatment. Furthermore, rosuvastatin decreased the levels of cytokines in the serum, particularly proinflammatory cytokines IL-1β and IL-8. NE patients had significantly altered levels of the kidney toxicity markers albumin and osteopontin. The data from our study provide evidence supporting the therapeutic potential of rosuvastatin in NE cases.
Collapse
Affiliation(s)
- Venera Shakirova
- Department of Infection Diseases, Kazan State Medical Academy, Kazan 420012, Russia;
| | - Maria Markelova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia; (M.M.); (Y.D.); (S.K.); (A.R.)
| | - Yuriy Davidyuk
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia; (M.M.); (Y.D.); (S.K.); (A.R.)
| | - Robert J. Stott-Marshall
- Faculty of Medicine and Health Sciences, School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK; (R.J.S.-M.); (T.L.F.)
| | - Toshana L. Foster
- Faculty of Medicine and Health Sciences, School of Veterinary Medicine and Science, The University of Nottingham, Sutton Bonington Campus, Loughborough LE12 5RD, UK; (R.J.S.-M.); (T.L.F.)
| | - Svetlana Khaiboullina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia; (M.M.); (Y.D.); (S.K.); (A.R.)
| | - Albert Rizvanov
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia; (M.M.); (Y.D.); (S.K.); (A.R.)
| | - Ekaterina Martynova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia; (M.M.); (Y.D.); (S.K.); (A.R.)
| |
Collapse
|
5
|
Chen K, Zhao T, Sun H, Geng Y, Xu Y, Shan C, Chen Y. Comparison of Three Detection Methods for Seoul Virus Causing Hemorrhagic Fever with Renal Syndrome. Clin Lab 2024; 70. [PMID: 38345985 DOI: 10.7754/clin.lab.2023.230821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
BACKGROUND Seoul virus (SEOV) is a significant causative pathogen of hemorrhagic fever with renal syndrome (HFRS). Accurate discrimination of SEOV infection from other viral or bacterial infections holds vital clinical importance. METHODS Our study utilized quantitative real-time PCR (qRT-PCR), metagenomic next-generation sequencing (mNGS), and immunological assays to identify the pathogen causing HFRS. RESULTS For the case, mNGS identified SEOV and suspected host or environmental microorganisms at 5 days from symptom onset. qRT-PCR detected SEOV between 5 to 8 days from symptom onset. Anti-hantavirus IgM antibodies reached positive criteria at 7 days and IgG antibodies at 9 days from symptom onset. CONCLUSIONS qRT-PCR, mNGS, and immunological assays each have merits and drawbacks. Optimal selection depends on laboratory conditions and clinical requirements.
Collapse
|
6
|
Schrottmaier WC, Schmuckenschlager A, Thunberg T, Wigren-Byström J, Fors-Connolly AM, Assinger A, Ahlm C, Forsell MNE. Direct and indirect effects of Puumala hantavirus on platelet function. Thromb Res 2024; 233:41-54. [PMID: 38006765 DOI: 10.1016/j.thromres.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/27/2023] [Accepted: 11/15/2023] [Indexed: 11/27/2023]
Abstract
Thrombocytopenia is a cardinal symptom of hantavirus-induced diseases including Puumala virus (PUUV)-induced hemorrhagic fever with renal syndrome (HFRS), which is associated with impaired platelet function, bleeding manifestations and augmented thrombotic risk. However, the underlying mechanisms causing thrombocytopenia and platelet hypo-responsiveness are unknown. Thus, we investigated the direct and indirect impact of PUUV on platelet production, function and degradation. Analysis of PUUV-HFRS patient blood revealed that platelet hypo-responsiveness in PUUV infection was cell-intrinsic and accompanied by reduced platelet-leukocyte aggregates (PLAs) and upregulation of monocyte tissue factor (TF), whereas platelet vasodilator-stimulated phosphoprotein (VASP) phosphorylation was comparable to healthy controls. Plasma CXCL4 levels followed platelet count dynamics throughout disease course. PUUV activated both neutrophils and monocytes in vitro, but platelet desialylation, degranulation and GPIIb/IIIa activation as well as PLA formation and endothelial adhesion under flow remained unaltered in the presence of PUUV. Further, MEG-01 megakaryocytes infected with PUUV displayed unaltered polyploidization, expression of surface receptors and platelet production. However, infection of endothelial cells with PUUV significantly increased platelet sequestration. Our data thus demonstrate that although platelet production, activation or degradation are not directly modulated, PUUV indirectly fosters thrombocytopenia by sequestration of platelets to infected endothelium. Upregulation of immunothrombotic processes in PUUV-HFRS may further contribute to platelet dysfunction and consumption. Given the pathophysiologic similarities of hantavirus infections, our findings thus provide important insights into the mechanisms underlying thrombocytopenia and highlight immune-mediated coagulopathy as potential therapeutic target.
Collapse
Affiliation(s)
- Waltraud C Schrottmaier
- Institute of Vascular Biology and Thrombosis Research, Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria; Department of Clinical Microbiology, Umeå University, Umeå, Sweden.
| | - Anna Schmuckenschlager
- Institute of Vascular Biology and Thrombosis Research, Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Therese Thunberg
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | | | | | - Alice Assinger
- Institute of Vascular Biology and Thrombosis Research, Center of Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Clas Ahlm
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | | |
Collapse
|
7
|
Xiao W, Tang Y, Chen L, Jia Z, Mei T. Case Report: Hemorrhagic Fever with Renal Syndrome Complicated by Bilateral Subdural Hematoma. Am J Trop Med Hyg 2023; 109:1339-1343. [PMID: 37931317 DOI: 10.4269/ajtmh.23-0248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/13/2023] [Indexed: 11/08/2023] Open
Abstract
Hemorrhagic fever with renal syndrome (HFRS) is an acute, natural focal disease worldwide. Bilateral subdural hematoma (BSH) is a rare occurrence in patients with HFRS. A 51-year-old man was admitted with fever, headache, lower back pain, and reduced urine volume. The patient was diagnosed with HFRS accompanied by BSH, as evidenced by IgM and IgG antibodies for hantavirus that were positive, and abnormal blood test results and computed tomographic head scan. He recovered and was discharged after symptomatic treatment. Hemorrhagic fever with renal syndrome might present rare clinical manifestations with BSH. The early identification of this condition is crucial to an improved prognosis.
Collapse
Affiliation(s)
- Wei Xiao
- Department of Neurosurgical Care Unit, The First People's Hospital of Changde City, Changde, China
| | - Yanli Tang
- Department of Neurosurgical Care Unit, The First People's Hospital of Changde City, Changde, China
| | - Lie Chen
- Department of Neurosurgical Care Unit, The First People's Hospital of Changde City, Changde, China
| | - Zheyong Jia
- Department of Neurosurgical Care Unit, The First People's Hospital of Changde City, Changde, China
| | - Tao Mei
- Department of Neurosurgical Care Unit, The First People's Hospital of Changde City, Changde, China
| |
Collapse
|
8
|
Zhao HD, Sun JJ, Liu HL. Potential clinical biomarkers in monitoring the severity of Hantaan virus infection. Cytokine 2023; 170:156340. [PMID: 37607412 DOI: 10.1016/j.cyto.2023.156340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/13/2023] [Accepted: 08/17/2023] [Indexed: 08/24/2023]
Abstract
Hantavirus, which causes hemorrhagic fever with renal syndrome (HFRS) is almost prevalent worldwide. While Hantaan virus (HTNV) causes the most severe form of HFRS with typical clinical manifestations of thrombocytopenia, increased vascular permeability, and acute kidney injury. Although the knowledge of the pathogenesis of HFRS is still limited, immune dysfunction and pathological damage caused by disorders of immune regulation are proposed to play a vital role in the development of the disorder, and the endothelium is considered to be the primary target of hantaviruses. Here, we reviewed the production and function of multiple molecules, mainly focusing on their role in immune response, endothelium, vascular permeability regulation, and platelet and coagulation activation which are closely related to the pathogenesis of HTNV infection. meanwhile, the relationship between these molecules and characteristics of HTNV infection including the hospital duration, immune dysfunction, thrombocytopenia, leukocytosis, and acute kidney injury are also presented, to provide a novel insight into the potential role of these molecules as monitoring markers for HTNV infection.
Collapse
Affiliation(s)
- Han-Dong Zhao
- Central Laboratory of Virology, Shaanxi Provincial Hospital of Infectious Diseases, The Eighth Hospital Affiliated to Medical College of Xi'an Jiaotong University, Xi'an 710061, China
| | - Ju-Jun Sun
- Clinical Laboratory Center, XD Group Hospital, Xi'an 710077, China
| | - Hong-Li Liu
- Clinical Laboratory Center, Xi'an People's Hospital (Xi'an Fourth Hospital) Guang-Ren Hospital Affiliated to Xi'an Jiaotong University Health Science Center, Xi'an 710004, China.
| |
Collapse
|
9
|
He S, Han Q, Wang X, Zhang X, Li N, Liu Z. Aspartate aminotransferase to platelet ratio at admission can predict the prognosis of patients with hemorrhagic fever with renal syndrome. J Med Virol 2023; 95:e29126. [PMID: 37786231 DOI: 10.1002/jmv.29126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/30/2023] [Accepted: 09/05/2023] [Indexed: 10/04/2023]
Abstract
Early indicators are needed to predict the prognosis of patients with hemorrhagic fever with renal syndrome (HFRS). Aspartate aminotransferase to platelet ratio index (APRI) has been shown to be related to mortality risk of patients with various diseases. This study evaluated the prognostic value of APRI and other inflammatory scores in HFRS patients. Data of hospitalized HFRS patients from a tertiary hospital in northwest China were collected and the inflammatory scores such as APRI and neutrophil to lymphocyte count ratio (NLR) were calculated at the day of patient admission. Independent factors related to the survival of patients were determined by multivariate logistic regression. Receiver operating characteristic curve was used to analyze the predictive value, and area under the curve (AUC) and 95% confidence interval (CI) were calculated for quantification. Of the 317 HFRS patients included in study, 15 patients died. Age (OR: 1.10, 95% CI: 1.04-1.16, p = 0.001), NLR (OR: 1.11, 95% CI: 1.02-1.19, p = 0.01), and APRI (OR: 1.06, 95% CI: 1.03-1.10, p = 0.001) were quantitative objective factors independently associated with the survival of patients. APRI had an AUC of 0.95 (95% CI: 0.91-1.00, p < 0.001) for predicting the prognosis of patients, with a sensitivity of 93.3% and a specificity of 86.8%. The performance of APRI was better than that of age or NLR. Patients with an APRI ≥ 6.15 had significantly decreased survival compared with those with an APRI < 6.15. In conclusion, this simple index APRI calculated at admission can serve as a biomarker to identify HFRS patients at risk of poor prognosis.
Collapse
Affiliation(s)
- Shan He
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Postgraduate Department, Xi'an Medical University, Xi'an, Shaanxi, China
| | - Qunying Han
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaoyun Wang
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaoge Zhang
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Na Li
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zhengwen Liu
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| |
Collapse
|
10
|
Huang H, Kong Y, Yin H, Yang Z, Ren T, Zhang Y. A case of pulmonary tuberculosis patient complicated with hemorrhagic fever with renal syndrome and scrub typhus in Yunnan, China: a case report. BMC Infect Dis 2023; 23:631. [PMID: 37752443 PMCID: PMC10523743 DOI: 10.1186/s12879-023-08416-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 06/21/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Hemorrhagic fever with renal syndrome (HFRS) caused by Orthohantavirus (OHV) and scrub typhus (ST) caused by Orientia tsutsugamushi (OT) are two infectious diseases prevalent in southwest China. Rodents are the natural host and the main source of the two diseases. OT infection to humans is usually resulted from bite of an infective chigger mite on rodents, and OHV is transmitted through contact or inhalation of aerosols and secretions from infected rodent. The use of antibiotics and hormones is crucial for infectious diseases, although the clinical manifestations are not obvious and a definitive diagnosis becomes more difficult in the presence of these drugs. Clinically, fever is the first symptom of these two diseases, and most of them are accompanied by common symptoms such as chills and headaches. The clinical symptoms of these two diseases are very similar and therefore it is not easy to make a differential diagnosis. CASE PRESENTATION In this case, a 44-year-old male famer with pulmonary tuberculosis and a history of working in coal transportation was admitted to the hospital because of respiratory symptoms accompanied by fever, headache, and skin rashes on his body. Biochemical and urinalysis revealed the hepatic and renal injury. The subsequent molecular testing confirmed he suffered from HFRS and scrub typhus simultaneously that the serological and clinical diagnosis could not identify the cause of infection before. Such case has not been reported in Yunnan Province before. CONCLUSION The clinical diagnosis should be combined with serological and nucleic acid testing approaches for differential diagnosis in areas where HFRS and ST are endemic.
Collapse
Affiliation(s)
- Hao Huang
- Institute of Preventive Medicine, School of Public Health, Dali University, Dali, 67100, Yunnan, China
- Yunnan Key Laboratory of Screening and Research On Anti-Pathogenic Plant Resources From Western Yunnan, Dali, 67100, Yunnan, China
- Yunnan University Key Laboratory of Zoonotic Disease Cross-Border Prevention and Quarantine, Dali, 67100, Yunnan, China
| | - Yichen Kong
- Institute of Preventive Medicine, School of Public Health, Dali University, Dali, 67100, Yunnan, China
- Yunnan Key Laboratory of Screening and Research On Anti-Pathogenic Plant Resources From Western Yunnan, Dali, 67100, Yunnan, China
- Yunnan University Key Laboratory of Zoonotic Disease Cross-Border Prevention and Quarantine, Dali, 67100, Yunnan, China
| | - Hongmin Yin
- Institute of Preventive Medicine, School of Public Health, Dali University, Dali, 67100, Yunnan, China
- Yunnan Key Laboratory of Screening and Research On Anti-Pathogenic Plant Resources From Western Yunnan, Dali, 67100, Yunnan, China
- Yunnan University Key Laboratory of Zoonotic Disease Cross-Border Prevention and Quarantine, Dali, 67100, Yunnan, China
| | - Zi Yang
- Institute of Preventive Medicine, School of Public Health, Dali University, Dali, 67100, Yunnan, China
- Yunnan Key Laboratory of Screening and Research On Anti-Pathogenic Plant Resources From Western Yunnan, Dali, 67100, Yunnan, China
- Yunnan University Key Laboratory of Zoonotic Disease Cross-Border Prevention and Quarantine, Dali, 67100, Yunnan, China
| | - Tilian Ren
- Xiangyun County People's Hospital, Xiangyun, 672100, Yunnan, China.
| | - Yunzhi Zhang
- Institute of Preventive Medicine, School of Public Health, Dali University, Dali, 67100, Yunnan, China.
- Yunnan Key Laboratory of Screening and Research On Anti-Pathogenic Plant Resources From Western Yunnan, Dali, 67100, Yunnan, China.
- Yunnan University Key Laboratory of Zoonotic Disease Cross-Border Prevention and Quarantine, Dali, 67100, Yunnan, China.
| |
Collapse
|
11
|
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. Lancet Infect Dis 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] [What about the content of this article? (0)] [Affiliation(s)] [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
|
12
|
Reynes JM, Schaeffer L, Papadopoulos P, Ait-Ahmed M, Siby-Diakite D, Ripaux-Lefèvre M, Buivan TP, Lechat S, Vray M, Galempoix JM. Molecular Detection of Orthohantavirus puumalaense in Plasma and Urine Samples from Hospitalized Patients Presenting with a Serologically Confirmed Acute Hantavirus Infection in France. J Clin Microbiol 2023; 61:e0037223. [PMID: 37486218 PMCID: PMC10446862 DOI: 10.1128/jcm.00372-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/05/2023] [Indexed: 07/25/2023] Open
Abstract
Molecular detection of Orthohantavirus puumalaense (PUUV) RNA during the course of the disease has been studied in blood of patients in Sweden and Slovenia. The use of urine has been poorly investigated. The aims of this work were to study PUUV RNA detection in plasma from a cohort of patients in France where a different PUUV lineage circulates and to assess the use of urine instead of plasma. Matched plasma and urine samples were collected daily from hospitalized patients presenting with fever, pain, and thrombocytopenia within the last 8 days and testing positive for IgM and IgG against PUUV in serum collected at inclusion and/or approximately 1 month after release. RNA was extracted from samples, and PUUV RNA was detected using real-time reverse transcription-PCR for plasma and urine samples. Sixty-seven patients presented a serologically confirmed acute hantavirus infection. At inclusion, PUUV RNA was detected in plasma from 55 of 62 patients (88.7%) sampled within the first week after disease onset, whereas it was detected in 15 of 60 (25.0%) of matched urine samples. It was then detected from 33 (71.7%) and 2 (4.4%) of 46 patients discharged from the hospital during the second week after disease onset, in plasma and urine, respectively. When PUUV RNA was detected in urine it was also detected in plasma, and not vice versa. Detection of PUUV RNA in plasma from hospitalized patients in France is similar to that observed in Sweden and Slovenia. Urine is not an appropriate sample for this detection.
Collapse
Affiliation(s)
- Jean-Marc Reynes
- Institut Pasteur, Université Paris Cité, Unité Environnement et Risques Infectieux, Centre National de Référence Hantavirus, Paris, France
| | - Laura Schaeffer
- Institut Pasteur, Université Paris Cité, Unité Epidémiologie des Maladies Emergentes, Paris, France
| | - Pavlos Papadopoulos
- Institut Pasteur, Université Paris Cité, Unité Environnement et Risques Infectieux, Centre National de Référence Hantavirus, Paris, France
| | - Mohand Ait-Ahmed
- Institut Pasteur, Université Paris Cité, Centre de Recherche Translationnelle, Paris, France
| | - Dieyenaba Siby-Diakite
- Institut Pasteur, Université Paris Cité, Unité Environnement et Risques Infectieux, Centre National de Référence Hantavirus, Paris, France
| | - Maryline Ripaux-Lefèvre
- Institut Pasteur, Université Paris Cité, Unité Environnement et Risques Infectieux, Centre National de Référence Hantavirus, Paris, France
| | - Tan-Phuc Buivan
- Institut Pasteur, Université Paris Cité, Centre de Recherche Translationnelle, Paris, France
| | - Sylvie Lechat
- Centre Hospitalier Intercommunal nord Ardennes, Laboratoire de Biologie Médicale, Charleville- Mézières, France
| | - Muriel Vray
- Institut Pasteur, Université Paris Cité, Unité Epidémiologie des Maladies Emergentes, Paris, France
| | - Jean-Marc Galempoix
- Centre Hospitalier Intercommunal nord Ardennes, Service de Médecine Interne et Maladies Infectieuses, Charleville- Mézières, France
| | - for The HANTADIAG Study Group
- Institut Pasteur, Université Paris Cité, Unité Environnement et Risques Infectieux, Centre National de Référence Hantavirus, Paris, France
- Institut Pasteur, Université Paris Cité, Unité Epidémiologie des Maladies Emergentes, Paris, France
- Institut Pasteur, Université Paris Cité, Centre de Recherche Translationnelle, Paris, France
- Centre Hospitalier Intercommunal nord Ardennes, Laboratoire de Biologie Médicale, Charleville- Mézières, France
- Centre Hospitalier Intercommunal nord Ardennes, Service de Médecine Interne et Maladies Infectieuses, Charleville- Mézières, France
| |
Collapse
|
13
|
Liu SW, Li JX, Zou L, Liu XQ, Xu G, Xiong Y, Long ZE. Orthohantavirus infections in humans and rodents in the Yichun region, China, from 2016 to 2021. PLoS Negl Trop Dis 2023; 17:e0011540. [PMID: 37552670 PMCID: PMC10437993 DOI: 10.1371/journal.pntd.0011540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 08/18/2023] [Accepted: 07/18/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Rodents are the predominant natural hosts of orthohantavirus and the source of human infection, hemorrhagic fever with renal syndrome (HFRS) caused by orthohantavirus is a severe public health problem in the Yichun region, Jiangxi Province, China. However, little information is known about the infection of orthohantavirus in humans and rodents, and the genetic characteristics of the epidemic orthohantavirus in the region. METHODS The clinical data of HFRS cases in 2016-2021 was analyzed. Virus infection in rodents was analyzed by orthohantavirus antigen detection using immunofluorescent assay, and the species of orthohantaviruses in rodents and patients were identified by real-time RT-PCR and gene sequencing. The S and M segments of orthohantaviruses from rodents and patients were recovered and analyzed. RESULTS A total of 1,573 HFRS cases were reported in the Yichun region from 2016 to 2021, including 11 death cases. HFRS cases peaked twice each year: in winter from November to January and early summer from May to June. Farmers constituted the predominant population suffering from HFRS. The orthohantavirus antigen was identified in five species of rodents: Apodemus agrarius (A. agrarius), Rattus norvegicus (R. norvegicus), Sorex araneus, Rattus losea (R. losea), and Niviventer confucianus (N. confucianus). The real-time RT-PCR test and genetic analysis results showed that Hantaan orthohantavirus (HTNV), Seoul orthohantavirus (SEOV), and Dabieshan orthohantavirus (DBSV) were circulated in the rodents. HTNV, SEOV, and DBSV from the rodents were distantly related to other known orthohantaviruses and belonged to novel genetic lineages. SEOV and HTNV were found in HFRS patients, but 97.8% (90/92) of the infections were caused by HTNV. Winter and early summer peaks were both caused by HTNV. The HTNV sequences recovered from HFRS cases were closely related to those from A. agrarius. CONCLUSIONS In the Yichun region, the orthohantaviruses transmitted in rodents include HTNV, SEOV, and DBSV, which have obvious genetic characteristics and high genetic diversity. At the same time, this region is an HFRS mixed epidemic area dominated by HTNV, with two peaks every year, which deserves our high attention.
Collapse
Affiliation(s)
- Shi-Wen Liu
- College of Life Sciences, Nanchang Key Laboratory of Microbial Resources Exploitation & Utilization from Poyang Lake Wetland, Jiangxi Normal University, Nanchang, Jiangxi, China
- Laboratory of Viral Infectious Disease, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, China
| | - Jian-Xiong Li
- Laboratory of Viral Infectious Disease, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, China
| | - Long Zou
- College of Life Sciences, Nanchang Key Laboratory of Microbial Resources Exploitation & Utilization from Poyang Lake Wetland, Jiangxi Normal University, Nanchang, Jiangxi, China
| | - Xiao-Qing Liu
- Laboratory of Viral Infectious Disease, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, China
| | - Gang Xu
- Laboratory of Viral Infectious Disease, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, China
| | - Ying Xiong
- Laboratory of Viral Infectious Disease, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, China
| | - Zhong-Er Long
- College of Life Sciences, Nanchang Key Laboratory of Microbial Resources Exploitation & Utilization from Poyang Lake Wetland, Jiangxi Normal University, Nanchang, Jiangxi, China
| |
Collapse
|
14
|
Sehgal A, Mehta S, Sahay K, Martynova E, Rizvanov A, Baranwal M, Chandy S, Khaiboullina S, Kabwe E, Davidyuk Y. Hemorrhagic Fever with Renal Syndrome in Asia: History, Pathogenesis, Diagnosis, Treatment, and Prevention. Viruses 2023; 15:v15020561. [PMID: 36851775 PMCID: PMC9966805 DOI: 10.3390/v15020561] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/30/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Hemorrhagic Fever with Renal Syndrome (HFRS) is the most frequently diagnosed zoonosis in Asia. This zoonotic infection is the result of exposure to the virus-contaminated aerosols. Orthohantavirus infection may cause Hemorrhagic Fever with Renal Syndrome (HRFS), a disease that is characterized by acute kidney injury and increased vascular permeability. Several species of orthohantaviruses were identified as causing infection, where Hantaan, Puumala, and Seoul viruses are most common. Orthohantaviruses are endemic to several Asian countries, such as China, South Korea, and Japan. Along with those countries, HFRS tops the list of zoonotic infections in the Far Eastern Federal District of Russia. Recently, orthohantavirus circulation was demonstrated in small mammals in Thailand and India, where orthohantavirus was not believed to be endemic. In this review, we summarized the current data on orthohantaviruses in Asia. We gave the synopsis of the history and diversity of orthohantaviruses in Asia. We also described the clinical presentation and current understanding of the pathogenesis of orthohantavirus infection. Additionally, conventional and novel approaches for preventing and treating orthohantavirus infection are discussed.
Collapse
Affiliation(s)
- Ayushi Sehgal
- Department of Biotechnology, Thapar Institute of Engineering and Technology, Patiala 147004, India
| | - Sanya Mehta
- Department of Biotechnology, Thapar Institute of Engineering and Technology, Patiala 147004, India
| | - Kritika Sahay
- Department of Biotechnology, Thapar Institute of Engineering and Technology, Patiala 147004, India
| | - Ekaterina Martynova
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Albert Rizvanov
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Manoj Baranwal
- Department of Biotechnology, Thapar Institute of Engineering and Technology, Patiala 147004, India
| | - Sara Chandy
- Childs Trust Medical Research Foundation, Kanchi Kamakoti Childs Trust Hospital, Chennai 600034, India
| | - Svetlana Khaiboullina
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Emmanuel Kabwe
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
- Kazan Research Institute of Epidemiology and Microbiology, Kazan 420012, Russia
| | - Yuriy Davidyuk
- OpenLab “Gene and Cell Technologies”, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
- Correspondence:
| |
Collapse
|
15
|
Brügger B, Chuard C. [Hantavirus infections]. Rev Med Suisse 2022; 18:1900-1903. [PMID: 36226452 DOI: 10.53738/revmed.2022.18.799.1900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Hantaviruses are enveloped zoonotic RNA viruses hosted by rodents and responsible in the Americas for hantavirus pulmonary syndrome. In Europe, they cause hemorrhagic fever with renal syndrome and its milder form, nephropathia epidemica. The disease begins abruptly with high fever, chills, headache, back pain and abdominal pain associated with nausea and vomiting. Diagnosis is primarily made by serology. There is currently no specific medication or preventive available in Europe. Treatment is symptomatic.
Collapse
Affiliation(s)
- Baptiste Brügger
- Service de médecine interne générale, Hôpital fribourgeois (HFR), 1700 Fribourg
| | - Christian Chuard
- Unité d'infectiologie, Service de médecine interne générale, Hôpital fribourgeois (HFR), 1700 Fribourg
| |
Collapse
|
16
|
Kolben Y, Azmanov H, Ishay Y, Orenbuch-Harroch E, Milgrom Y. Hemorrhagic Fever with Renal Syndrome Caused by Hantavirus Infection: First Reported Case in Israel. Isr Med Assoc J 2022; 24:621-622. [PMID: 36168171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Yotam Kolben
- Departments of Medicine, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Henny Azmanov
- Departments of Medicine, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Yuval Ishay
- Departments of Medicine, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Efrat Orenbuch-Harroch
- Departments of Microbiolog, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Yael Milgrom
- Departments of Gastroenterology and Liver Diseases, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| |
Collapse
|
17
|
Tietäväinen J, Laine O, Mäkelä S, Huhtala H, Pörsti I, Vaheri A, Mustonen J. ABO and Rhesus Blood Groups in Acute Puumala Hantavirus Infection. Viruses 2021; 13:v13112271. [PMID: 34835077 PMCID: PMC8621274 DOI: 10.3390/v13112271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 12/01/2022] Open
Abstract
Puumala hantavirus (PUUV) causes hemorrhagic fever with renal syndrome. We aimed to evaluate whether ABO and rhesus blood groups associate with the susceptibility or the severity of PUUV infection. We analyzed blood groups in 289 adult patients treated in Tampere University hospital due to PUUV infection during the years 1982–2017. Patients’ blood group distribution was compared to that of healthy, voluntary blood donors living in the Tampere University Hospital responsibility area (n = 21,833). The severity of PUUV infection, as judged by the severity of acute kidney injury (AKI), thrombocytopenia, inflammation, capillary leakage, and the length of hospital care, was analyzed across the groups. The ABO and rhesus blood group distributions did not differ between the patients and blood donors. Patients with non-O blood groups had lower systolic blood pressure compared to patients with blood group O, but there was no difference in other markers of capillary leakage or in the severity of AKI. Minor deviations in the number of platelets and leukocytes were detected between the O and non-O blood groups. To conclude, patients with blood group O may be less susceptible to hypotension, but otherwise blood groups have no major influences on disease susceptibility or severity during acute PUUV infection.
Collapse
Affiliation(s)
- Johanna Tietäväinen
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (O.L.); (S.M.); (I.P.); (J.M.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland
- Correspondence:
| | - Outi Laine
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (O.L.); (S.M.); (I.P.); (J.M.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland
| | - Satu Mäkelä
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (O.L.); (S.M.); (I.P.); (J.M.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, 33250 Tampere, Finland;
| | - Ilkka Pörsti
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (O.L.); (S.M.); (I.P.); (J.M.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland
| | - Antti Vaheri
- Department of Virology, Medicum, University of Helsinki, 00290 Helsinki, Finland;
| | - Jukka Mustonen
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (O.L.); (S.M.); (I.P.); (J.M.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland
| |
Collapse
|
18
|
Lim SC, Lee YM, Kim CM, Yun NR, Kim DM. Acute Appendicitis Associated with Hantaan Virus Infection. Am J Trop Med Hyg 2021; 105:801-806. [PMID: 34228635 DOI: 10.4269/ajtmh.20-1468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/22/2021] [Indexed: 02/05/2023] Open
Abstract
Hantaviruses are Bunyaviridae viruses that cause hemorrhagic fever with renal syndrome. Appendicitis caused by Hantaan virus has not been reported previously. An 81-year-old man who underwent laparoscopic appendectomy for suspected appendicitis based on abdominal pain, fever, hypotension, and computed tomography findings. Based on a suspicion of hemorrhagic fever with renal syndrome, the patient's plasma was simultaneously analyzed using an indirect immunofluorescent antibody assay and nested reverse transcription-polymerase chain reaction (RT-PCR). The appendix tissue was also analyzed using nested RT-PCR and immunohistochemical (IHC) staining to identify the presence of Hantaan virus. Nested RT-PCR detected the presence of Hantaan virus, and indirect immunofluorescent antibody assay results revealed the presence of elevated antibody levels. Furthermore, IHC staining of the appendix tissue confirmed Hantaan virus antigens in the peripheral nerve bundle. Based on these findings, we confirmed the nerve tropism of the Hantaan virus. Hantaan virus in plasma and appendix tissue samples was confirmed using PCR and phylogenetic tree analysis. Moreover, we detected hypertrophy of the submucosa and periappendiceal adipose tissue nerve bundle along with Hantaan virus antigens in peripheral nerve bundles using IHC staining. Hence, we report that Hantaan virus infection may be accompanied by appendicitis.
Collapse
Affiliation(s)
- Sung-Chul Lim
- 1Department of Pathology, Chosun University College of Medicine, Dong-gu, Gwangju, South Korea
| | - Young Min Lee
- 2Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- 3Premedical Science, College of Medicine, Chosun University, Gwangju, South Korea
| | - Na Ra Yun
- 2Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- 2Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| |
Collapse
|
19
|
Vetter P, L'Huillier AG, Montalbano MF, Pigny F, Eckerle I, Torriani G, Rothenberger S, Laubscher F, Cordey S, Kaiser L, Schibler M. Puumala Virus Infection in Family, Switzerland. Emerg Infect Dis 2021; 27:658-660. [PMID: 33496646 PMCID: PMC7853570 DOI: 10.3201/eid2702.203770] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report 3 cases of Puumala virus infection in a family in Switzerland in January 2019. Clinical manifestations of the infection ranged from mild influenza-like illness to fatal disease. This cluster illustrates the wide range of clinical manifestations of Old World hantavirus infections and the challenge of diagnosing travel-related hemorrhagic fevers.
Collapse
|
20
|
Hofmann J, Heuser E, Weiss S, Tenner B, Schoppmeyer K, Esser J, Klier C, Drewes S, Ulrich RG, Kruger DH. Autochthonous Ratborne Seoul Virus Infection in Woman with Acute Kidney Injury. Emerg Infect Dis 2021; 26:3096-3099. [PMID: 33219808 PMCID: PMC7706977 DOI: 10.3201/eid2612.200708] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Outside Asia, Seoul virus (SEOV) is an underestimated pathogen. In Germany, autochthonous SEOV-associated hantavirus disease has not been unequivocally diagnosed. We found clinical and molecular evidence for SEOV infection in a young woman; her pet rat was the source of infection.
Collapse
|
21
|
Gu XL, Qi R, Li WQ, Jiao YJ, Yu H, Yu XJ. Misdiagnosis of scrub typhus as hemorrhagic fever with renal syndrome and potential co-infection of both diseases in patients in Shandong Province, China, 2013-2014. PLoS Negl Trop Dis 2021; 15:e0009270. [PMID: 33784301 PMCID: PMC8009391 DOI: 10.1371/journal.pntd.0009270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 02/23/2021] [Indexed: 01/27/2023] Open
Abstract
Background Scrub typhus, caused by Orientia tsutsugamushi, an obligate intracellular gram-negative bacterium, along with hemorrhagic fever with renal syndrome (HFRS), caused by hantaviruses, are natural-focus infectious diseases prevalent in Shandong Province, China. Both diseases have similar clinical manifestations in certain disease stages and similar epidemic seasons, which has caused difficulties for physicians in distinguishing them. The aim of this study was to investigate whether misdiagnosis of scrub typhus as HFRS occurred in patients in Shandong Province. Methods Serum samples (N = 112) of clinically suspected HFRS patients from 2013 to 2014 in Shandong Province were analyzed with enzyme-linked immunosorbent assay (ELISA) for antibodies to both hantavirus and Orientia tsutsugamushi. Results ELISA showed that 56.3% (63/112) and 8.0% (9/112) of clinically suspected HFRS patients were IgM antibody positive to hantavirus and O. tsutsugamushi, respectively. Among the hantavirus IgM antibody positive patients, 7.9% (5/63) were also IgM antibody positive to O. tsutsugamushi. Among the hantavirus IgM antibody negative sera, 8.2% (4/49) of sera were positive to O. tsutsugamushi. Conclusions We concluded that some scrub typhus patients were misdiagnosed as HFRS and co-infection of scrub typhus and HFRS might exist in China. Due to the different treatments for scrub typhus and HFRS, physicians should carefully differentiate between scrub typhus and HFRS and consider administering anti-rickettsia antibiotics if treatment for HFRS alone does not work. Scrub typhus is caused by O. tsutsugamushi and hemorrhagic fever with renal syndrome (HFRS) is caused by hantavirus. Both diseases have similar manifestations and have their peak epidemic season in the fall, which makes their clinical differentiation difficult to be differentiated from each other clinically. In this study, we found that scrub typhus was indeed misdiagnosed as HFRS and co-infection of O. tsutsugamushi and hantaviruses might exist in China. Owing to different treatments of HFRS and scrub typhus, physicians need pay attention to differentiate them; identify co-infection of HFRS and scrub typhus; and consider administering antibiotics if antiviral treatment alone does not work.
Collapse
Affiliation(s)
- Xiao-lan Gu
- State Key Laboratory of Virology, School of Health Sciences, Wuhan University, Wuhan, China
| | - Rui Qi
- State Key Laboratory of Virology, School of Health Sciences, Wuhan University, Wuhan, China
| | - Wen-qian Li
- State Key Laboratory of Virology, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yong-jun Jiao
- Institute of Pathogenic Microbiology, Jiangsu Provincial Center for Disease Prevention and Control, Key Laboratory of Enteric Pathogenic Microbiology, Ministry Health, Nanjing, China
| | - Hao Yu
- State Key Laboratory of Virology, School of Health Sciences, Wuhan University, Wuhan, China
| | - Xue-jie Yu
- State Key Laboratory of Virology, School of Health Sciences, Wuhan University, Wuhan, China
- * E-mail:
| |
Collapse
|
22
|
Kang C, Kim JI, Lee J, Bae S, Kim MJ, Song KJ, Song JW, Kim SH, Park MS. Human infection with Seoul orthohantavirus in Korea, 2019. PLoS Negl Trop Dis 2021; 15:e0009168. [PMID: 33617577 PMCID: PMC7932522 DOI: 10.1371/journal.pntd.0009168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 03/04/2021] [Accepted: 01/22/2021] [Indexed: 11/18/2022] Open
Abstract
Of various rodent-borne hantaviruses, Seoul orthohantavirus (SEOV) causes haemorrhagic fever with renal syndrome (HFRS), as does Hantaan orthohantavirus (HTNV). Given global-scale of cases of human infection with SEOV, it is of great clinical importance to distinguish SEOV from other HFRS-causing hantaviruses. In May 2019, a middle-aged patient who had lived in a suburban area of Chungcheong Province, Republic of Korea and enjoyed outdoor activities was transferred to Asan Medical Center in Seoul, Republic of Korea with HFRS; his symptoms included high fever and generalized myalgia. The rapid diagnostic test performed immediately after his transfer detected HTNV-specific antibodies, and the patient was treated accordingly. However, two consecutive IFAs performed at ten-day intervals showed no HTNV-specific immunoglobulin (Ig) G. During continuous supportive care, next-generation sequencing successfully identified viral genomic sequences in the patient’s serum, which were SEOV and not HTNV. Phylogenetic analysis grouped the L, M, and S genes of this SEOV strain together with those of rat- or human-isolated Korean strains reported previously. Given global outbreaks and public health threats of zoonotic hantaviruses, a causative pathogen of hantavirus HFRS should be identified correctly at the time of diagnosis and by point-of-care testing. Rodent-borne Seoul orthohantavirus (SEOV) has provoked human cases from Asia to the Americas and Europe whereas most orthohantaviruses cause regional cases. Despite this, SEOV gets less attention than other orthohantaviruses. In Korea, 2019, a middle-aged man was initially diagnosed with Hantaan orthohantavirus (HTNV) and treated accordingly. However, next-generation sequencing identified SEOV, not HTNV, in the patient’s serum. Given its global outbreaks and public health threats, zoonotic SEOV should be diagnosed correctly on point of care to reduce unnecessary medical costs.
Collapse
Affiliation(s)
- Changmin Kang
- Department of Microbiology, the Institute for Viral Diseases, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jin Il Kim
- Department of Microbiology, the Institute for Viral Diseases, Korea University College of Medicine, Seoul, Republic of Korea
- Biosafety Center, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jungmin Lee
- Department of Microbiology, the Institute for Viral Diseases, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seongman Bae
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Jae Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ki-Joon Song
- Department of Microbiology, the Institute for Viral Diseases, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jin-Won Song
- Department of Microbiology, the Institute for Viral Diseases, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- * E-mail: (S-HK); (M-SP)
| | - Man-Seong Park
- Department of Microbiology, the Institute for Viral Diseases, Korea University College of Medicine, Seoul, Republic of Korea
- Biosafety Center, Korea University College of Medicine, Seoul, Republic of Korea
- * E-mail: (S-HK); (M-SP)
| |
Collapse
|
23
|
Ystrøm IK, Kristensen LH, Jensen TG, Randers E. [Outbreak of nephropathiaepidemica in Jutland, Denmark]. Ugeskr Laeger 2021; 183:V10200760. [PMID: 33491638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In Denmark, most cases of nephropathia epidemica (NE) occur on the island of Funen and are caused by the transmission of Puumala hantavirus to humans from the bank vole. This is a case report comprising four cases of NE occurring in close vicinity to Silkeborg, Jutland, where the disease is not usually seen. NE is characterised by increased vascular permeability, and patients present with flu-like symptoms progressing to acute kidney injury. When NE occurs in areas where it has not traditionally been endemic, awareness of the disease is important to ensure proper diagnosis.
Collapse
|
24
|
Shepherd JG, Blunsum AE, Carmichael S, Smollett K, Maxwell-Scott H, Farmer ECW, Osborne J, MacLean A, Ashraf S, Shah R, Gunson R, da Silva Filipe A, Aarons EJ, Thomson EC. Seoul Virus Associated with Pet Rats, Scotland, UK, 2019. Emerg Infect Dis 2021; 27:2677-2680. [PMID: 34545785 PMCID: PMC8462346 DOI: 10.3201/eid2710.211298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We describe a case of hemorrhagic fever with renal syndrome caused by Seoul virus in a woman in Scotland, UK. Whole-genome sequencing showed the virus belonged to a lineage characterized by recent international expansion, probably driven by trade in pet rats.
Collapse
|
25
|
Singh H, Kaur H, Medhi B. Novel therapeutic approaches toward Hantaan virus and its clinical features' similarity with COVID-19. Indian J Pharmacol 2020; 52:347-355. [PMID: 33283765 PMCID: PMC8025769 DOI: 10.4103/ijp.ijp_1001_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 10/19/2020] [Accepted: 11/09/2020] [Indexed: 12/12/2022] Open
Abstract
Zoonotic virus spill over in human community has been an intensive area of viral pathogenesis and the outbreak of Hantaan virus and severe acute respiratory syndrome coronavirus 2 (SARS CoV2) after late December 2019 caused a global threat. Hantaan virus is second to the COVID-19 outbreak in China with seven cases positive and one death. Both RNA viruses have opposite sense as in (-) for Hantaan virus and (+) for SARS CoV2 but have similarity in the pathogenesis and relevant clinical features including dry cough, high fever, shortness of breath, and SARS associated with pneumonia and certain reported cases with multiple organ failure. Although COVID-19 has global impact with high death toll, Hantaan virus has varyingly high mortality rate between 1% and 40%. Hence, there is a need to explore novel therapeutic targets in Hantaan virus due to its rapid evolution rate in its genetic makeup which governs virulence and target host cells. This review emphasizes the importance of structural and nonstructural proteins of Hantaan virus with relevant insight from SARS CoV2. The envelope glycoproteins such as Gn, Gc, and nucleocapsid protein (N) direct the viral assembly and replication in host cells. Therapeutic treatment has similarity in using ribavirin and extracorporeal membrane oxygenation but lack of efficacious treatment in both cases of SARAS CoV2 and Hantaan virus. Therefore, potential features regarding therapeutic targets for drug discovery for Hantaan viruses are discussed herewith. The conclusive description highlights that N protein is substantially involved in evoking immune response and induces symptoms and could be precursive target for drug discovery studies.
Collapse
Affiliation(s)
| | | | - Bikash Medhi
- Department of Pharmacology, PGIMER, Chandigarh, India
| |
Collapse
|
26
|
Heo DH, Kang YM, Song KH, Seo JW, Kim JH, Chun JY, Jun KI, Kang CK, Moon SM, Choe PG, Park WB, Bang JH, Kim ES, Kim HB, Park SW, Oh WS, Kim NJ, Oh MD. Clinical Score System to Differentiate Severe Fever with Thrombocytopenia Syndrome Patients from Patients with Scrub Typhus or Hemorrhagic Fever with Renal Syndrome in Korea. J Korean Med Sci 2020; 35:e77. [PMID: 32193903 PMCID: PMC7086083 DOI: 10.3346/jkms.2020.35.e77] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/21/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with high mortality in East Asia. This study aimed to develop, for primary care providers, a prediction score using initial symptoms and basic laboratory blood tests to differentiate between SFTS and other endemic zoonoses in Korea. METHODS Patients aged ≥ 18 years diagnosed with endemic zoonoses during a 3-year period (between January 2015 and December 2017) were retrospectively enrolled from 4 tertiary university hospitals. A prediction score was built based on multivariate logistic regression analyses. RESULTS Of 84 patients, 35 with SFTS and 49 with other endemic zoonoses were enrolled. In multivariate logistic regression analysis, independent predictors of SFTS included neurologic symptoms (odds ratio [OR], 12.915; 95% confidence interval [CI], 2.173-76.747), diarrhea (OR, 10.306; 95% CI, 1.588-66.895), leukopenia (< 4,000/mm³) (OR, 19.400; 95% CI, 3.290-114.408), and normal C-reactive protein (< 0.5 mg/dL) (OR, 24.739; 95% CI, 1.812-337.742). We set up a prediction score by assigning one point to each of these four predictors. A score of ≥ 2 had 82.9% sensitivity (95% CI, 71.7%-87.5%) and 95.9% specificity (95% CI, 88.0%-99.2%). The area under the curve of the clinical prediction score was 0.950 (95% CI, 0.903-0.997). CONCLUSION This study finding suggests a simple and useful scoring system to predict SFTS in patients with endemic zoonoses. We expect this strategic approach to facilitate early differentiation of SFTS from other endemic zoonoses, especially by primary care providers, and to improve the clinical outcomes.
Collapse
Affiliation(s)
- Dae Hyuk Heo
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yu Min Kang
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Kyoung Ho Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
| | - Jun Won Seo
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jeong Han Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - June Young Chun
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kang Il Jun
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Chang Kyung Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Song Mi Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Pyoeng Gyun Choe
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Wan Beom Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ji Hwan Bang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hong Bin Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Won Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Won Sup Oh
- Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Nam Joong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Myoung Don Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|
27
|
Qi R, Sun XF, Qin XR, Wang LJ, Zhao M, Jiang F, Wang L, Lei XY, Liu JW, Yu XJ. Suggestive Serological Evidence of Infection with Shrew-Borne Imjin Virus ( Hantaviridae) in Humans. Viruses 2019; 11:v11121128. [PMID: 31817575 PMCID: PMC6949945 DOI: 10.3390/v11121128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/24/2019] [Accepted: 12/02/2019] [Indexed: 12/19/2022] Open
Abstract
The pathogenicity of the shrew-borne Imjin virus (MJNV) is unknown. The objective of our study was to find serological evidence of MJNV infection in humans. Partial MJNV nucleocapsid protein (NP) was cloned and expressed as an antigen for double-antigen sandwich ELISA, IgM capture ELISA, and dot blot to detect MJNV specific antibodies in hemorrhagic fever with renal syndrome (HFRS) patients’ and healthy persons’ sera from endemic areas in China. The purified recombinant NP reacted with neither the 90 healthy individuals’ sera from non-endemic areas of MJNV nor the 100 antisera to HFRS-causing virus, indicating that the MJNV NP had no cross-reaction with normal human sera and HFRS-causing viral antibodies. As determined by screening ELISA and dot blot analysis, IgG antibodies against MJNV NP were detected in sera from two of 385 healthy individuals from MJNV-endemic areas, suggesting infection with MJNV or MJNV-like thottimvirus. Based on the suggestive evidence, healthcare workers should be alert to febrile diseases occurring among individuals with exposure to shrew-infested habitats.
Collapse
Affiliation(s)
- Rui Qi
- State Key Laboratory of Virology, School of Health Sciences, Wuhan University, Wuhan 430071, China (J.-W.L.)
| | - Xi-Feng Sun
- School of Public Health, Shandong University, Jinan 250012, China
| | - Xiang-Rong Qin
- State Key Laboratory of Virology, School of Health Sciences, Wuhan University, Wuhan 430071, China (J.-W.L.)
| | - Li-Jun Wang
- State Key Laboratory of Virology, School of Health Sciences, Wuhan University, Wuhan 430071, China (J.-W.L.)
| | - Min Zhao
- State Key Laboratory of Virology, School of Health Sciences, Wuhan University, Wuhan 430071, China (J.-W.L.)
| | - Fachun Jiang
- Qingdao Center for Disease Control and Prevention, Qingdao 266033, China
| | - Ling Wang
- Zibo Center for Disease Control and Prevention, Zibo 255026, China
| | - Xiao-Ying Lei
- School of Public Health, Shandong University, Jinan 250012, China
| | - Jian-Wei Liu
- State Key Laboratory of Virology, School of Health Sciences, Wuhan University, Wuhan 430071, China (J.-W.L.)
| | - Xue-Jie Yu
- State Key Laboratory of Virology, School of Health Sciences, Wuhan University, Wuhan 430071, China (J.-W.L.)
- Correspondence: or ; Tel.: +86-27-6875-8782
| |
Collapse
|
28
|
Abstract
Although Seoul orthohantavirus is the only globally spread hantavirus pathogen, few confirmed human infections with this virus have been reported in Western countries, suggesting lower medical awareness of the milder, transient, and often chameleon-like symptoms of this zoonosis. We describe lesser known clinical and laboratory characteristics to help improve underreporting of this virus.
Collapse
|
29
|
Kletenkov K, Martynova E, Davidyuk Y, Kabwe E, Shamsutdinov A, Garanina E, Shakirova V, Khaertynova I, Anokhin V, Tarlinton R, Rizvanov A, Khaiboullina S, Morzunov S. Δ ccr5 Genotype Is Associated with Mild Form of Nephropathia Epidemica. Viruses 2019; 11:v11070675. [PMID: 31340562 PMCID: PMC6669606 DOI: 10.3390/v11070675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/22/2019] [Accepted: 07/17/2019] [Indexed: 01/03/2023] Open
Abstract
Nephropathia Epidemica (NE), a mild form of hemorrhagic fever with renal syndrome (HFRS) and linked to hantavirus infection, is endemic in the Republic of Tatarstan. Several genetic markers of HFRS severity have been identified previously, including human leukocyte antigen (HLA) complexes and nucleotide polymorphism in the tumor necrosis factor alpha (TNFα) gene. Still, our understanding of the genetic markers of NE severity remains incomplete. The frequency of the C-C chemokine receptor type 5 (CCR5) gene wild type and gene with 32-base-pair deletion (Δ32CCR5) genotypes in 98 NE samples and 592 controls was analyzed using PCR. Along with the serum levels of 94 analytes, a lack of differences in the CCR5 genotype distribution between NE cases and the general population suggests that the CCR5 genotype does not affect susceptibility to hantavirus infection. However, in NE cases, significant variation in the serum levels of the host matrix metalloproteases between functional CCR5 homozygous and Δ32CCR5 heterozygous patients was detected. Also, the oliguric phase was longer, while thrombocyte counts were lower in functional CCR5 homozygous as compared to heterozygous NE cases. Our data, for the first time, presents the potential role of the CCR5 receptor genotype in NE pathogenesis. Our data suggests that NE pathogenesis in functional CCR5 homozygous and heterozygous NE patients differs, where homozygous cases may have more disintegration of the extracellular matrix and potentially more severe disease.
Collapse
Affiliation(s)
- Konstantin Kletenkov
- Openlab "Gene and Cell Technologies", Institute of Fundamental Medicine and Biology Kazan Federal University, Kazan 420008, Republic of Tatarstan, Russian
| | - Ekaterina Martynova
- Openlab "Gene and Cell Technologies", Institute of Fundamental Medicine and Biology Kazan Federal University, Kazan 420008, Republic of Tatarstan, Russian
| | - Yuriy Davidyuk
- Openlab "Gene and Cell Technologies", Institute of Fundamental Medicine and Biology Kazan Federal University, Kazan 420008, Republic of Tatarstan, Russian
| | - Emmanuel Kabwe
- Openlab "Gene and Cell Technologies", Institute of Fundamental Medicine and Biology Kazan Federal University, Kazan 420008, Republic of Tatarstan, Russian
| | - Anton Shamsutdinov
- Openlab "Gene and Cell Technologies", Institute of Fundamental Medicine and Biology Kazan Federal University, Kazan 420008, Republic of Tatarstan, Russian
| | - Ekaterina Garanina
- Openlab "Gene and Cell Technologies", Institute of Fundamental Medicine and Biology Kazan Federal University, Kazan 420008, Republic of Tatarstan, Russian
| | - Venera Shakirova
- Department of Infectious Diseases, Kazan State Medical Academy, Kazan 420012, the Republic of Tatarstan, Russian
| | - Ilsiyar Khaertynova
- Department of Infectious Diseases, Kazan State Medical Academy, Kazan 420012, the Republic of Tatarstan, Russian
| | - Vladimir Anokhin
- Department of Pediatric Infectious Diseases, Kazan State Medical University, Kazan 420012, Republic of Tatarstan, Russian
| | - Rachael Tarlinton
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough LE12 5RD, UK
| | - Albert Rizvanov
- Openlab "Gene and Cell Technologies", Institute of Fundamental Medicine and Biology Kazan Federal University, Kazan 420008, Republic of Tatarstan, Russian
| | - Svetlana Khaiboullina
- Openlab "Gene and Cell Technologies", Institute of Fundamental Medicine and Biology Kazan Federal University, Kazan 420008, Republic of Tatarstan, Russian
- Department of Microbiology and Immunology, University of Nevada, Reno, NV 89557, USA
| | - Sergey Morzunov
- Department of Pathology, University of Nevada, Reno, NV 89557, USA.
| |
Collapse
|
30
|
Niskanen S, Jääskeläinen A, Vapalahti O, Sironen T. Evaluation of Real-Time RT-PCR for Diagnostic Use in Detection of Puumala Virus. Viruses 2019; 11:v11070661. [PMID: 31330941 PMCID: PMC6669532 DOI: 10.3390/v11070661] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/04/2019] [Accepted: 07/12/2019] [Indexed: 12/14/2022] Open
Abstract
Puumala virus (PUUV) is the most common cause of hantavirus infection in Europe, with thousands of cases occurring particularly in Northern, Central and Eastern Europe and Russia. It causes a mild form of hemorrhagic fever with renal syndrome also known as nephropathia epidemica (NE) with clinical picture ranging from mild to severe. Currently, the laboratory diagnosis of NE is mainly based on serology. Here, we evaluated a real-time one-step qRT-PCR (PUUV-qRT-PCR) for detection of PUUV with 238 consecutive diagnostic serum samples from patients with suspected PUUV infection. The PUUV-qRT-PCR was both specific and sensitive for PUUV RNA. The analytical sensitivity (limit of detection) was estimated to be four copies of PUUV per reaction. Altogether 28 out of 30 (93%) PUUV IgM positive samples were positive also for PUUV RNA. No false positives were detected and the specificity was thus 100%. Interestingly, one sample was found positive in PUUV-qRT-PCR prior to subsequent IgM and IgG seroconversion. PUUV-qRT-PCR could be used for diagnostics in the early phase of NE infection and might be helpful especially in the rare severe cases when the patient’s condition may deteriorate rapidly.
Collapse
Affiliation(s)
- Silja Niskanen
- Department of Virology, University of Helsinki, 00290 Helsinki, Finland
| | - Anne Jääskeläinen
- Department of Virology, University of Helsinki, 00290 Helsinki, Finland
- Department of Virology and Immunology, Helsinki University Hospital Laboratory (HUSLAB), 00290 Helsinki, Finland
| | - Olli Vapalahti
- Department of Virology, University of Helsinki, 00290 Helsinki, Finland
- Department of Virology and Immunology, Helsinki University Hospital Laboratory (HUSLAB), 00290 Helsinki, Finland
- Department of Veterinary Microbiology and Epidemiology, Faculty of Veterinary Medicine, University of Helsinki, 00290 Helsinki, Finland
| | - Tarja Sironen
- Department of Virology, University of Helsinki, 00290 Helsinki, Finland.
- Department of Veterinary Microbiology and Epidemiology, Faculty of Veterinary Medicine, University of Helsinki, 00290 Helsinki, Finland.
| |
Collapse
|
31
|
Maas M, van Heteren M, de Vries A, Kuiken T, Hoornweg T, Veldhuis Kroeze E, Rockx B. Seoul Virus Tropism and Pathology in Naturally Infected Feeder Rats. Viruses 2019; 11:v11060531. [PMID: 31181690 PMCID: PMC6630879 DOI: 10.3390/v11060531] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/24/2019] [Accepted: 06/05/2019] [Indexed: 01/02/2023] Open
Abstract
Seoul virus (SEOV) is a zoonotic orthohantavirus carried by black and brown rats, and can cause hemorrhagic fever with renal syndrome in humans. Human cases of SEOV virus infection have most recently been reported in the USA, United Kingdom, France and the Netherlands and were primarily associated with contact with pet rats and feeder rats. Infection of rats results in an asymptomatic but persistent infection. Little is known about the cell tropism of SEOV in its reservoir and most available data is based on experimental infection studies in which rats were inoculated via a route which does not recapitulate virus transmission in nature. Here we report the histopathological analysis of SEOV cell tropism in key target organs following natural infection of a cohort of feeder rats, comprising 19 adults and 11 juveniles. All adult rats in this study were positive for SEOV specific antibodies and viral RNA in their tissues. One juvenile rat was seropositive, but negative in the rRT-PCR. Of the 19 adult rats of which subsequently additional organs were tested, SEOV RNA was detected in all lungs, followed by kidney (79%) and liver (74%). Histopathologic changes associated with SEOV infection were primarily found in the liver, consistent with a pathological diagnosis of a mild hepatitis. In conclusion, natural SEOV infection results in mild inflammation of the liver in the absence of clinical disease.
Collapse
Affiliation(s)
- Miriam Maas
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA, Bilthoven, The Netherlands.
| | - Melanie van Heteren
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.
| | - Ankje de Vries
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA, Bilthoven, The Netherlands.
| | - Thijs Kuiken
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.
| | - Tabitha Hoornweg
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, 3720 BA, Bilthoven, The Netherlands.
| | - Edwin Veldhuis Kroeze
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.
| | - Barry Rockx
- Department of Viroscience, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.
| |
Collapse
|
32
|
Bhoelan S, Langerak T, Noack D, van Schinkel L, van Nood E, van Gorp ECM, Rockx B, Goeijenbier M. Hypopituitarism after Orthohantavirus Infection: What is Currently Known? Viruses 2019; 11:v11040340. [PMID: 30974852 PMCID: PMC6521286 DOI: 10.3390/v11040340] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 04/03/2019] [Accepted: 04/06/2019] [Indexed: 12/16/2022] Open
Abstract
Several case reports have described hypopituitarism following orthohantavirus infection, mostly following Puumala virus. The pathogenesis of this seemingly rare complication of orthohantavirus infection remains unknown. This review explores the possible pathophysiological mechanisms of pituitary damage due to orthohantavirus infection. In only three out of the 28 reported cases, hypopituitarism was detected during active infection. In the remaining cases, detection of pituitary damage was delayed, varying from two months up to thirteen months post-infection. In these cases, hypopituitarism remained undetected during the acute phase of infection or only occurred weeks to months post infection. Both ischemic and hemorrhagic damage of the pituitary gland have been detected in radiographic imaging and post-mortem studies in the studied case reports series. Ischemic damage could be caused by hypotension and/or vasospasms during the acute phase of hemorrhagic fever with renal syndrome (HFRS) while hemorrhage could be caused by thrombocytopenia, thrombopathy, and other known causes of coagulation disorders during orthohantavirus infection. Also, hypophysitis due to the presence of auto-antibodies have been suggested in the literature. In conclusion, a significant number of case reports and series describe hypopituitarism after orthohantavirus infection. In most cases hypopituitarism was diagnosed with a delay and therefore could very well be underreported. Clinicians should be aware of this potential endocrine complication, with substantial morbidity, and if unrecognized, significant mortality.
Collapse
Affiliation(s)
- Soerajja Bhoelan
- Department of Viroscience, Erasmus MC, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
| | - Thomas Langerak
- Department of Viroscience, Erasmus MC, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
| | - Danny Noack
- Department of Viroscience, Erasmus MC, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
| | - Linda van Schinkel
- Department of Internal Medicine, Erasmus MC, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
| | - Els van Nood
- Department of Internal Medicine, Erasmus MC, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
| | - Eric C M van Gorp
- Department of Viroscience, Erasmus MC, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
| | - Barry Rockx
- Department of Viroscience, Erasmus MC, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
| | - Marco Goeijenbier
- Department of Viroscience, Erasmus MC, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
- Department of Internal Medicine, Erasmus MC, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
| |
Collapse
|
33
|
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.
Collapse
|
34
|
Qi R, Qin XR, Wang L, Han HJ, Cui F, Yu H, Liu JW, Yu XJ. Severe fever with thrombocytopenia syndrome can masquerade as hemorrhagic fever with renal syndrome. PLoS Negl Trop Dis 2019; 13:e0007308. [PMID: 30925154 PMCID: PMC6457554 DOI: 10.1371/journal.pntd.0007308] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/10/2019] [Accepted: 03/15/2019] [Indexed: 12/23/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever with a high fatality rate and high frequency of person-to-person transmission and is caused by SFTSV, a tick-borne Phlebovirus. Because SFTS has similar clinical manifestations and epidemic characters (such as spatial and temporal distributions) with hemorrhagic fever with renal syndrome (HFRS) in China, we reason that SFTS patients might be misdiagnosed as HFRS. Methodology/principal findings Acute-phase sera of 128 clinically diagnosed HFRS patients were retrospectively analyzed for Hantavirus IgM antibodies with ELISA. Hantavirus-negative patients’ sera were further analyzed for SFTSV IgM antibodies with ELISA. ELISA showed that 73 of 128 (57.0%) of clinically diagnosed HFRS patients were IgM antibody positive to Hantaviruses. Among the 55 Hantavirus-IgM negative patients, four (7.3%) were IgM antibody positive to SFTSV. The results indicated that the four SFTS patients were misdiagnosed as HFRS. The misdiagnosed SFTS patients had clinical manifestations common to HFRS and were unable to be differentiated from HFRS clinically. Conclusions Our study showed that SFTS patients could be clinically misdiagnosed as HFRS. The misdiagnosis of SFTS as HFRS causes particular concern because it may increase the risk of death of SFTS patients and person-to-person transmission of SFTSV without proper care for and isolation of SFTS patients. SFTS were clinically misdiagnosed as HFRS. It could cause particular concern in China. Physicians could not rely heavily on the exposure history. Both SFTS and HFRS patients are treated based on the clinical diagnosis in China. Laboratory confirmation of both diseases is not performed in clinical hospitals and the patients’ blood was usually submitted to a local or provincial center for disease control and prevention. In most cases the confirmation diagnosis is to provide retrospective information rather than to guide clinical therapy. Therefore, physicians need to carefully differentiate SFTS and HFRS patients because the fatality of SFTS is much higher than HFRS and SFTS is easily spread from person to person by contacting infected blood or even through aerosol.
Collapse
Affiliation(s)
- Rui Qi
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
| | - Xiang-rong Qin
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
| | - Ling Wang
- Zibo Center for Disease Control and Prevention, Zibo City, China
| | - Hui-ju Han
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
| | - Feng Cui
- Zibo Center for Disease Control and Prevention, Zibo City, China
| | - Hao Yu
- Fudan University School of Medicine, Shanghai, China
| | - Jian-wei Liu
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
| | - Xue-jie Yu
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
- * E-mail: ,
| |
Collapse
|
35
|
Heo DH, Hwang JH, Choi SH, Jeon M, Lee JH, Lee JH, Hwang SD, Lee KA, Lee SH, Lee CS. Recent Increase of Human Granulocytic Anaplasmosis and Co-Infection with Scrub Typhus or Korean Hemorrhagic Fever with Renal Syndrome in Korea. J Korean Med Sci 2019; 34:e87. [PMID: 30914905 PMCID: PMC6427050 DOI: 10.3346/jkms.2019.34.e87] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/24/2019] [Indexed: 11/20/2022] Open
Abstract
We report 17 patients with human granulocytic anaplasmosis between January 2015 and September 2018 at two tertiary university hospitals in Korea. Monthly incidence peaked in May and June. Among these patients, we identified three who were co-infected with scrub typhus, and one patient with hemorrhagic fever with renal syndrome.
Collapse
Affiliation(s)
- Dae-Hyuk Heo
- Department of Internal Medicine, Design Hospital, Jeonju, Korea
| | - Joo-Hee Hwang
- Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
- Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Seung Hee Choi
- Department of Industrial Design, Chonbuk National University, Jeonju, Korea
| | - Mir Jeon
- Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
| | - Ju-Hyung Lee
- Department of Preventive Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Jae-Hoon Lee
- Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University College of Medicine, Iksan, Korea
| | - Seon-Do Hwang
- Division of Zoonoses, Center for Immunology and Pathology, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
- Division of Bacterial Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Kyeong-Ah Lee
- Division of Bacterial Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Seung-Hun Lee
- Division of Zoonoses, Center for Immunology and Pathology, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
- Yeosu National Quarantine Office, Korea Centers for Disease Control and Prevention, Yeosu, Korea
| | - Chang-Seop Lee
- Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
- Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| |
Collapse
|
36
|
Economou Lundeberg E, Frisk J. [First case of nephropathia epidemica in southern Sweden]. Lakartidningen 2019; 116:FFLR. [PMID: 30694519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Nephropathia epidemica (NE) is the European version of hemorrhagic fever with renal syndrome. NE is caused by the Puumala type of Hantavirus with the bank vole (Clethrionomys glareolus) as the natural reservoir. Endemic regions include northern Sweden with an incidence of 53 to 569 cases per year, depending on the cyclic variation of rodent populations. In southern Sweden, south of the Mälardalen region, no cases of NE have been described without a historical account of travel to endemic areas in the weeks beforehand. This case report describes the course of disease of a patient diagnosed with NE, who had only stayed in the southernmost region of Sweden: Skåne. This may indicate the spread of NE to more southern regions of Sweden. NE should consequently be considered as a differential diagnosis at emergency and infectious disease departments throughout Sweden.
Collapse
Affiliation(s)
- Elin Economou Lundeberg
- Centralsjukhuset Kristianstad - Infektionskliniken Kristianstad, Sweden Centralsjukhuset Kristianstad - Infektionskliniken Kristianstad, Sweden
| | - Josefin Frisk
- Centralsjukhuset Kristianstad - Infektionskliniken Kristianstad, Sweden Centralsjukhuset Kristianstad - Infektionskliniken Kristianstad, Sweden
| |
Collapse
|
37
|
Swanink C, Reimerink J, Gisolf J, de Vries A, Claassen M, Martens L, Waegemaekers T, Rozendaal H, Valkenburgh S, Hoornweg T, Maas M. Autochthonous Human Case of Seoul Virus Infection, the Netherlands. Emerg Infect Dis 2018; 24:2158-2163. [PMID: 30067176 PMCID: PMC6256391 DOI: 10.3201/eid2412.180229] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Orthohantaviruses are a group of rodentborne viruses with a worldwide distribution. The orthohantavirus Seoul virus (SEOV) can cause hemorrhagic fever with renal syndrome in humans and is distributed worldwide, like its reservoir host, the rat. Cases of SEOV in wild and pet rats have been described in several countries, and human cases have been reported in the United Kingdom, France, Canada, and the United States. In the Netherlands, SEOV has previously been found in wild brown rats. We describe an autochthonous human case of SEOV infection in the Netherlands. This patient had nonspecific clinical symptoms of an orthohantavirus infection (gastrointestinal symptoms and distinct elevation of liver enzymes). Subsequent source investigation revealed 2 potential sources, the patient’s feeder rats and a feeder rat farm. At both sources, a high prevalence of SEOV was found in the rats. The virus closely resembled the Cherwell and Turckheim SEOV strains that were previously found in Europe.
Collapse
|
38
|
Pastissier A, Humbert S, Naudion P, Meaux-Ruault N, Badoz M, Magy-Bertrand N. Severe Sinus Bradycardia in Puumala virus infection. Int J Infect Dis 2018; 79:75-76. [PMID: 30503652 DOI: 10.1016/j.ijid.2018.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/25/2018] [Accepted: 11/26/2018] [Indexed: 11/19/2022] Open
Abstract
Puumala orthohantavirus (PUUV) is the most prevalent of the four species of zoonotic hantaviruses found in Europe, causing nephropathia epidemica, a mild form of hemorrhagic fever with acute kidney injury that presents with elevated serum creatinine level, proteinuria and hematuria. The febrile phase of the infection begins with flu-like syndrome and visual disturbance. Laboratory results can show thrombocytopenia. The oliguric phase with elevated serum creatinine level then occurs. Cardiac involvement is sometimes observed, especially ECG abnormality: transient T-waves inversion, generally in the lateral or inferior leads. Marked bradycardia has been exceptionally described. We report the case of a 36-year-old woman with acute PUUV infection. Two days after admission, the patient presented a sinus bradycardia at 25/min. The bradycardia was asymptomatic, persisted one week and resolved spontaneously. Cardiac involvement in Puumala virus infection seems not to be associated with a bad prognosis. Bradycardia in the course of an influenza-like illness in endemic areas should suggest several pathogens such as legionella, Q fever or PUUV virus infection.
Collapse
Affiliation(s)
| | | | - Pauline Naudion
- Service de Médecine Interne, CHRU de Besançon, Besançon, France.
| | | | - Marc Badoz
- Service de Cardiologie, CHRU de Besançon, Besançon, France.
| | | |
Collapse
|
39
|
Mantula PS, Outinen TK, Jaatinen P, Hämäläinen M, Huhtala H, Pörsti IH, Vaheri A, Mustonen JT, Mäkelä SM. High plasma resistin associates with severe acute kidney injury in Puumala hantavirus infection. PLoS One 2018; 13:e0208017. [PMID: 30517161 PMCID: PMC6281250 DOI: 10.1371/journal.pone.0208017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 11/09/2018] [Indexed: 11/26/2022] Open
Abstract
Background Puumala hantavirus (PUUV) infected patients typically suffer from acute kidney injury (AKI). Adipokines have inflammation modulating functions in acute diseases including AKI. We examined plasma levels of three adipokines (resistin, leptin, and adiponectin) in acute PUUV infection and their associations with disease severity. Methods This study included 79 patients hospitalized due to acute PUUV infection. Plasma resistin, leptin, adiponectin, as well as IL-6 and CRP, were measured at the acute phase, recovery phase and one year after hospitalization. Results Plasma resistin levels were significantly higher in the acute phase compared to the recovery phase and one year after (median resistin 28 pg/mL (11–107) vs. 17 pg/mL (7–36) vs. 14 pg/mL (7–31), p<0.001). Maximum resistin concentration correlated with maximum plasma creatinine levels (r = 0.63; p<0.001). The higher the amount of albuminuria in the urine dipstick test (0–1+, 2+ or 3+) at admission, the higher the median of maximum resistin (24.7 pg/mL, 25.4 pg/mL and 39.6 pg/mL, respectively, p = 0.002). High resistin was also an independent risk factor for severe AKI (creatinine ≥353.6μmol/L) (OR 1.08, 95% CI 1.02–1.14). Neither plasma leptin nor adiponectin level had any correlation with creatinine concentration or the amount of albuminuria. Conclusions Plasma resistin independently associates with the severity of AKI in acute PUUV infection. The association of resistin with the amount of albuminuria suggests that the level of plasma resistin is not only influenced by renal clearance but could have some role in the pathogenesis of AKI during PUUV infection.
Collapse
Affiliation(s)
- Paula S. Mantula
- Tampere University Hospital, Department of Internal Medicine, Tampere, Finland
- * E-mail:
| | - Tuula K. Outinen
- Tampere University Hospital, Department of Internal Medicine, Tampere, Finland
| | - Pia Jaatinen
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
- Division of Intermal Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Mari Hämäläinen
- The Immunopharmacology Group, Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Ilkka H. Pörsti
- Tampere University Hospital, Department of Internal Medicine, Tampere, Finland
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Antti Vaheri
- Department of Virology, Medicum, University of Helsinki, Helsinki, Finland
| | - Jukka T. Mustonen
- Tampere University Hospital, Department of Internal Medicine, Tampere, Finland
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Satu M. Mäkelä
- Tampere University Hospital, Department of Internal Medicine, Tampere, Finland
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| |
Collapse
|
40
|
Lie KC, Aziz MH, Kosasih H, Neal A, Halim CL, Wulan WN, Karyana M, Hadi U. Case report: two confirmed cases of human Seoul virus infections in Indonesia. BMC Infect Dis 2018; 18:578. [PMID: 30445913 PMCID: PMC6240170 DOI: 10.1186/s12879-018-3482-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/31/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Seoul virus (SEOV) is a member of hantavirus family, which is transmitted to humans by Rattus rattus and Rattus norvegicus. Diagnosing SEOV infection is difficult because the clinical presentations are often undifferentiated with other viral or bacterial infections and assays to test antibodies seroconversion and RNA detection are not available in resource-limited setting like Indonesia. CASE PRESENTATION We report two confirmed cases of SEOV infection from Indonesia. Here, we illustrate the clinical presentations, hematology and biochemistry profiles, and outcomes of the two cases. Phylogenetic analysis revealed that SEOV sequences have highest homology to isolates obtained from rodents in Indonesia. CONCLUSIONS This report highlights the importance of considering SEOV infection in febrile patients with lymphopenia, thrombocytopenia, and elevation of liver enzyme despite the absence of hemorrhagic manifestations and renal syndromes. The public health importance of rodent-borne diseases such as SEOV infection urges an integrated epidemiological surveillance both in humans and rodents in Indonesia.
Collapse
Affiliation(s)
- Khie Chen Lie
- Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Mochamad Helmi Aziz
- INA-RESPOND, NIHRD, Ministry of Health Republic of Indonesia Building 4 (Laboratorium Terpadu), 5th Floor, Jalan Percetakan Negara No. 29, Jakarta, 10560 Indonesia
| | - Herman Kosasih
- INA-RESPOND, NIHRD, Ministry of Health Republic of Indonesia Building 4 (Laboratorium Terpadu), 5th Floor, Jalan Percetakan Negara No. 29, Jakarta, 10560 Indonesia
| | - Aaron Neal
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD USA
| | - Caleb Leonardo Halim
- INA-RESPOND, NIHRD, Ministry of Health Republic of Indonesia Building 4 (Laboratorium Terpadu), 5th Floor, Jalan Percetakan Negara No. 29, Jakarta, 10560 Indonesia
| | - Wahyu Nawang Wulan
- INA-RESPOND, NIHRD, Ministry of Health Republic of Indonesia Building 4 (Laboratorium Terpadu), 5th Floor, Jalan Percetakan Negara No. 29, Jakarta, 10560 Indonesia
| | - Muhammad Karyana
- National Institute of Health Research and Development (NIHRD), Ministry of Health Republic of Indonesia, Jakarta, Indonesia
| | - Usman Hadi
- Universitas Airlangga, Dr. Soetomo Hospital, Surabaya, Indonesia
| |
Collapse
|
41
|
Ma Y, Tang K, Song C, Fan L, Zhang Y, Zhang C, Zhang Y, Jin B, Ma Y. [The reduced level of plasma melatonin in HFRS patients is correlated with disease severity and stage]. Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi 2018; 34:1027-1031. [PMID: 30591112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective To investigate the changes of plasma melatonin (MLT) level in patients with hemorrhagic fever with renal syndrome (HFRS) and the relationships between the MLT level and the disease stage or severity. Methods The plasma samples were collected from 14 HFRS patients at acute stage or convalescent stage and 14 normal controls. After extraction, competitive enzyme-linked immunosorbent assay (CELISA) was used to detect the content of MLT in the plasma. The plasma MTL levels were compared between different severities or stages of HFRS patients and the normal controls. Meanwhile, the relationships between the MLT level and clinical indicators such as white blood cell (WBC) count were analyzed. Results The plasma MLT level of HFRS patients at the acute stage were significantly lower than that of the normal controls, and also significantly lower than that at the convalescence of HFRS. At the acute stage, the plasma MLT level of mild/severe HFRS patients was lower than that of critical patients. Moreover, the level of plasma MLT was negatively correlated with WBC count in HFRS patients at acute or convalescence stages. Conclusion MLT may be involved in the regulation of inflammatory responses in HFRS patients, which may affect the pathogenesis and disease progression of HFRS.
Collapse
Affiliation(s)
- Yan Ma
- Fourth Team of Cadets, Air Force Military Medical University, Xi'an 710032, China
| | - Kang Tang
- Department of Immunology, Air Force Military Medical University, Xi'an 710032, China
| | - Chaojun Song
- Department of Immunology, Air Force Military Medical University, Xi'an 710032, China
| | - Li Fan
- Department of Pharmacochemistry and Pharmaceutical Analysis, College of Basic Medicine, Air Force Military Medical University, Xi'an 710032, China
| | - Yusi Zhang
- Department of Immunology, Air Force Military Medical University, Xi'an 710032, China
| | - Chunmei Zhang
- Department of Immunology, Air Force Military Medical University, Xi'an 710032, China
| | - Yun Zhang
- Department of Immunology, Air Force Military Medical University, Xi'an 710032, China
| | - Boquan Jin
- Department of Immunology, Air Force Military Medical University, Xi'an 710032, China
| | - Ying Ma
- Department of Immunology, Air Force Military Medical University, Xi'an 710032, China. *Corresponding author, E-mail:
| |
Collapse
|
42
|
Abstract
A cholecystectomy was carried out on a 45-year-old female patient with fever, myalgia and right upper abdominal pain because of a suspected cholecystitis. Postoperatively acute kidney injury occurred. A comprehensive medical history taken later revealed a presumed occupational contact to rodents. Serological testing detected a recent infection with Dobrava-Belgrade hantavirus. The kidney function normalized with supportive therapeutic measures. Hantavirus infection should be considered in the differential diagnosis of acute kidney injury combined with fever, myalgia and abdominal pain.
Collapse
Affiliation(s)
- M Mahmud
- III. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
| | - C Winkelmann
- Innere Medizin, Krankenhaus Buchholz, Buchholz, Deutschland
| | - S Harendza
- III. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| |
Collapse
|
43
|
Pal E, Korva M, Resman Rus K, Kejžar N, Bogovič P, Kurent A, Avšič-Županc T, Strle F. Sequential assessment of clinical and laboratory parameters in patients with hemorrhagic fever with renal syndrome. PLoS One 2018; 13:e0197661. [PMID: 29791494 PMCID: PMC5965875 DOI: 10.1371/journal.pone.0197661] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 05/07/2018] [Indexed: 01/25/2023] Open
Abstract
Background Information on the sequential appearance, duration, and magnitude of clinical and laboratory parameters in hemorrhagic fever with renal syndrome (HFRS) is limited. Methods Analysis of clinical and laboratory parameters obtained serially in 81 patients with HFRS, of whom 15 were infected with Dobrava virus and 66 with Puumala virus. Results The initial signs/symptoms, appearing on median day 1 of illness, were fever, headache, and myalgia. These were present in 86%, 65%, and 40% of patients and had a median duration of 4, 4, and 5.5 days, respectively. The signs/symptoms were followed by myopia (appearance on day 5), insomnia (day 6), oliguria/anuria (day 6), polyuria (day 9), and sinus bradycardia (day 9.5). These were present in 35%, 30%, 28%, 91%, and 35% of patients; their median duration was 2, 2, 2, 7, and 1 day, respectively. Laboratory abnormalities, including thrombocytopenia, elevated alanine aminotransferase, CRP, procalcitonin, creatinine, diminished glomerular filtration rate, and leukocytosis, were ascertained on admission to hospital or on the following day (day 5 or 6 of illness) and were established in 95%, 87%, 99%, 91%, 94%, 87%, and 55% of patients, and had a median duration of 4, 3, 7, 3, 9, 8, and 2 days, respectively. Comparison of patients infected with Dobrava and Puumala viruses found several differences in the frequency, magnitude, and duration of abnormalities, indicating that Dobrava virus causes the more severe HFRS. Conclusions In the majority of patients, the classic clinical distinction into febrile, hypotonic, oliguric, polyuric, and convalescent phases of illness is unclear.
Collapse
Affiliation(s)
- Emil Pal
- Department of Infectious Diseases, Murska Sobota General Hospital, Rakičan, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Miša Korva
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Katarina Resman Rus
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nataša Kejžar
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Petra Bogovič
- Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Anica Kurent
- Novo Mesto General Hospital, Department of Infectious Diseases, Novo Mesto, Slovenia
| | - Tatjana Avšič-Županc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Franc Strle
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia
- * E-mail:
| |
Collapse
|
44
|
Hentzien M, Mestrallet S, Halin P, Pannet LA, Lebrun D, Dramé M, Bani-Sadr F, Galempoix JM, Strady C, Reynes JM, Penalba C, Servettaz A. Bioclinical Test to Predict Nephropathia Epidemica Severity at Hospital Admission. Emerg Infect Dis 2018; 24:1045-1054. [PMID: 29774835 PMCID: PMC6004848 DOI: 10.3201/eid2406.172160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
We conducted a multicenter, retrospective cohort study of hospitalized patients with serologically proven nephropathia epidemica (NE) living in Ardennes Department, France, during 2000-2014 to develop a bioclinical test predictive of severe disease. Among 205 patients, 45 (22.0%) had severe NE. We found the following factors predictive of severe NE: nephrotoxic drug exposure (p = 0.005, point value 10); visual disorders (p = 0.02, point value 8); microscopic or macroscopic hematuria (p = 0.04, point value 7); leukocyte count >10 × 109 cells/L (p = 0.01, point value 9); and thrombocytopenia <90 × 109/L (p = 0.003, point value 11). When point values for each factor were summed, we found a score of <10 identified low-risk patients (3.3% had severe disease), and a score >20 identified high-risk patients (45.3% had severe disease). If validated in future studies, this test could be used to stratify patients by severity in research studies and in clinical practice.
Collapse
|
45
|
Mukhetdinova GA, Fazlyeva RM, Mavzyutova GA, Valishin DA, Khasanova GM. [The efficiency of modernmethods of laboratory diagnosis in the evaluation of various forms of hemorrhagic fever with renal syndrome caused by the Puumala hantavirus (PUUV).]. Klin Lab Diagn 2018; 63:524-529. [PMID: 30735316 DOI: 10.18821/0869-2084-2018-63-9-524-529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 06/13/2018] [Indexed: 06/09/2023]
Abstract
We've conducted the analysis of both traditional and new methods of laboratory diagnosis to estimate the severity and damage of target organs during Hemorrhagic Fever with Renal Syndrome (HFRS). It was shown that thrombocytopenia corresponds to the severity of the disease and correlates with the severity of renal failure. The level of C-reactive protein reflects the activity of the inflammatory process and correlates with the characteristic laboratory criteria of the disease. Blood serum levels of alveomucine in patients with HFRS more than 45.0 U/ml indicates lung damage. HFRS on the territory of the Bashkortostan Republic is caused by the serotype of Puumala hantavirus; dependence of the form of the disease on the content of antiviral antibodies is not revealed.
Collapse
Affiliation(s)
| | - R M Fazlyeva
- Bashkir State Medical University, 450008, Ufa, Russia
| | | | - D A Valishin
- Bashkir State Medical University, 450008, Ufa, Russia
| | - G M Khasanova
- Bashkir State Medical University, 450008, Ufa, Russia
| |
Collapse
|
46
|
Fill MMA, Mullins H, May AS, Henderson H, Brown SM, Chiang CF, Patel NR, Klena JD, de St. Maurice A, Knust B, Nichol ST, Dunn JR, Schaffner W, Jones TF. Notes from the Field: Multiple Cases of Seoul Virus Infection in a Household with Infected Pet Rats - Tennessee, December 2016-April 2017. MMWR Morb Mortal Wkly Rep 2017; 66:1081-1082. [PMID: 29023435 PMCID: PMC5657933 DOI: 10.15585/mmwr.mm6640a4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
47
|
Clement J, Lee APK, Verpooten GA, Laenen L, Vergote V, De Samblanx H, Berneman ZN, Van Ranst M, Maes P. Acute hantavirus infection presenting as haemolytic-uraemic syndrome (HUS): the importance of early clinical diagnosis. Eur J Clin Microbiol Infect Dis 2017; 37:135-140. [PMID: 28986730 DOI: 10.1007/s10096-017-3113-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 09/11/2017] [Indexed: 01/30/2023]
Abstract
The European prototype of hantavirus, Puumala virus (PUUV), isolated from a common wild rodent, the bank vole (Myodes glareolus), causes nephropathia epidemica (NE). NE can perfectly mimic haemolytic-uraemic syndrome (HUS), progressing from an aspecific flu-like syndrome to acute kidney injury with thrombocytopaenia, and presenting with some signs of haemolytic anaemia and/or coagulopathy. Moreover, both NE and HUS can occur in local outbreaks. We report an isolated case of NE, initially referred for plasmapheresis for suspected HUS, although signs of overt haemolysis were lacking. Early suspicion of hantavirus infection, later confirmed by serology and reverse transcription polymerase chain reaction (RT-PCR), prevented subsequent excessive treatment modalities.
Collapse
Affiliation(s)
- J Clement
- National Reference Laboratory for Hantavirus Infections, University Hospitals Leuven, Leuven, Belgium.
- Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
| | - A P K Lee
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium
| | - G A Verpooten
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium
| | - L Laenen
- National Reference Laboratory for Hantavirus Infections, University Hospitals Leuven, Leuven, Belgium
- Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - V Vergote
- National Reference Laboratory for Hantavirus Infections, University Hospitals Leuven, Leuven, Belgium
- Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - H De Samblanx
- Department of Haematology, Antwerp University Hospital, Edegem, Belgium
| | - Z N Berneman
- Department of Haematology, Antwerp University Hospital, Edegem, Belgium
| | - M Van Ranst
- National Reference Laboratory for Hantavirus Infections, University Hospitals Leuven, Leuven, Belgium
- Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - P Maes
- National Reference Laboratory for Hantavirus Infections, University Hospitals Leuven, Leuven, Belgium
- Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| |
Collapse
|
48
|
Reynes JM, Carli D, Bour JB, Boudjeltia S, Dewilde A, Gerbier G, Nussbaumer T, Jacomo V, Rapt MP, Rollin PE, Septfons A. Seoul Virus Infection in Humans, France, 2014-2016. Emerg Infect Dis 2017; 23:973-977. [PMID: 28368241 PMCID: PMC5443425 DOI: 10.3201/eid2306.160927] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report detection of Seoul virus in 3 patients in France over a 2-year period. These patients accounted for 3 of the 4 Seoul virus infections among 434 hantavirus infections (1.7%) reported during this time. More attention should be given to this virus in Europe where surveillance has been focused mostly on Puumala and Dobrava-Belgrade hantaviruses.
Collapse
|
49
|
Rudakov YV, Shelukhin VA, Shishkin MK, Popov SI, Kann EA, Zhanzharov KV, Mal'tseva OA, Konushkaliev AA. [Clinical and epidemiological characteristics of hemorrhagic fever with renal syndrome in the North-West region of Russia]. Voen Med Zh 2017; 338:37-43. [PMID: 30763478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The data of the literature and our own research of clinical and epidemiological features of hantavirus infection the North-West region of Russia, showing the loss of endemicity of hemorrhagic fever with renal syndrome. It is noted mostly airborne infection in young and middle-aged men, year-round nature of the disease with seasonal peaks. The clinical picture is moderately prevalent the disease with no or minimal systemic manifestation of hemorrhagic syndrome, often marked by thrombocytopenia, moderate dysfunction and kidney damage in half the time without reducing urine output. The introduction of acute kidney damage concept allows significantly improve the diagnostic efficiency and stratification of renal dvsfunction severity in Datients with hantavirus infection.
Collapse
|
50
|
Kilit TP, Kilit C, Erarslan S. A rare cause of acute pancreatitis: Hantavirus infection. Acta Gastroenterol Belg 2017; 80:59-61. [PMID: 29364099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Hantaviruses cause potentially fatal two different systemic infectious diseases in humans named as hemorrhagic fever with renal syndrome (HFRS) and Hantavirus pulmonary syndrome. The clinical features of HFRS are hemorrhage, fever, thrombocytopenia and acute renal insufficiency frequently observed. HFRS shows distinctive clinical manifestations throughout from acute influenza-like febrile illness to shock. Although a large portion of HRFS patients present with a complaint of abdominal pain, acute pancreatitis is a rare complication of HFRS. No specific treatment protocol has been described for HRFS and supportive treatment is the basic approach. The rate of success enhanced with early diagnosis and intensive care support. Clinicians should be alert to the HFRS in patients with acute pancreatitis associated with systemic viral infection. We describe a case with HFRS who has presented with acute kidney injury, thrombocytopenia and acute pancreatitis. The patient was treated by supportive management successfully.
Collapse
|