Nefropatía epidémica por el virus Puumala: a propósito de un caso / Epidemic nephropathy due to Puumala virus: A case report

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Double trouble: hemorrhagic fever with renal syndrome and leptospirosis.

The clinical picture of hemorrhagic fever with renal syndrome can closely mimic that of unicteric leptospirosis and vice versa. This is the first description of dual infection with Dobrava virus and leptospira and alteration of immune parameters in a Croatian soldier.

[The study on ELISA methods for detection of specific antibodies against hemorrhagic fever with renal syndrome virus in rat sera].

Three ELISA methods were developed to detect specific antibodies against hemorrhagic fever with renal syndrome virus (HFRSV) in rats sera. It was shown that all three kinds of McAb-ELISA were specific, sensitive and simple for the detection of HFRSV antibodies in rat sera.

Antigenic and molecular characterization of hantavirus isolates from China.

Hemorrhagic fever with renal syndrome (HFRS) is caused by certain viruses in the genus Hantavirus, family Bunyaviridae, and is a major public health problem in China. By using molecular and serological tests, we characterized 15 hantaviruses isolated either from patients with HFRS or from rodents captured in endemic areas of China. By cross plaque-reduction neutralization tests performed with rabbit immune sera, we identified two serologically distinct groups of viruses, comprised of those related to Hantaan virus, and those related to Seoul virus. To study the genetic relationships among these viruses, we amplified a 330 base pair region of the medium (M) genome segment of each isolate by reverse transcription and polymerase chain reaction (PCR) and compared the nucleotide sequences to those of other, well-characterized hantaviruses. In addition, we PCR-amplified and analyzed the entire coding region of the small (S) genome segment of each isolate by restriction enzyme digestion with a battery of enzymes. The results of our genetic analyses of both the M and S segments of these isolates confirmed our serological data, indicating that Hantaan and Seoul viruses co-circulate in endemic disease regions of China. We constructed a phylogenetic tree based on multiple alignment of the partial M segment sequences. The resulting dendrogram distinguished three genetic subtypes of Hantaan viruses and one type of Seoul virus.

Isolation of a Puumala-like virus from Mus musculus captured in Yugoslavia and its association with severe hemorrhagic fever with renal syndrome.

An outbreak of severe hemorrhagic fever with renal syndrome (HFRS) occurred in 1988 in Pozarevac, Serbia, Yugoslavia. The disease was diagnosed in 4 children and 1 adult, and 1 of the children died. Rodents were captured from the same area and virus isolation attempted. A hantavirus, POZ-M1, was isolated from lung tissues of hantavirus antigen-positive Mus musculus. Serology and restriction enzyme digestion of polymerase chain reaction-amplified segments from this virus showed that it was a strain of Puumala (PUU) virus, the causative agent of nephropathia epidemica. While Clethrionomys glareolus is the major rodent host for PUU virus, these results suggest that M. musculus may also play an important role in harboring and transmitting PUU-like viruses. The serologic association of this virus with patients with severe HFRS reaffirms that PUU-like viruses may cause severe disease in addition to the generally mild form normally associated with nephropathia epidemica.

Hantavirus: an old bug learns new tricks.

Hantaviruses are a diverse group of RNA arboviruses in the Bunyaviridae family. Although their role as the causative agents of HFRS has been well established, the recent outbreak of a new disease in the Southwest clearly demonstrates the protein clinical manifestations that this pathogen can produce. Furthermore, whereas hantaviruses have been characterized largely as focal agents in the production of geographically delimited diseases, recent trends indicate that endemic areas for the virus are expanding. Outbreaks often occur in clusters as a result of the epizoology of rodent hosts, but isolated cases of hantavirus-related disease also may be observed. Although hantaviruses have proven their pathogenic capability in other areas of the world, it was perceived widely that they were of little consequence to public health in the United States. However, as more is learned about the nature of this truly global infectious agent, its potential danger to mankind becomes increasingly apparent. It is hoped that continued research will elucidate all the facets of hantavirus-induced disease.

[A study on gastric mucosa damage, antigen location, and virus dissociation in patients with epidemic hemorrhagic fever].

Gastric mucosa damage was investigated with techniques of gastroscopy, gastric biopsy, antigen location with immunohistochemical enzyme staining and virus dissociation in 135 patients with epidemic hemorrhagic fever (EHF). We found that the major pathologic finding in gastric mucosa is hemorrhage of squamous shape. EHF virus antigen exists in epithelial cytoplasm of the superficial layer and lamina propria of gastric mucosa and the virus is dissociated from gastric mucosa. The virus is identified as of field-rat serotype with electronmicroscopy and monoclonal antibody techniques. These results suggest that it is necessary to start antivirus therapy early and to give prophylactic measures to prevent gastric mucosa damage and upper digestive tract bleeding.

[Detection of hemorrhagic fever virus-RNA in renal tissue and peripheral blood in patients with hemorrhagic fever with renal syndrome].

Hemorrhagic fever virus (HFV) RNA in renal tissue and blood samples from 21 patients with epidemic hemorrhagic fever with renal syndrome (HFRS) were examined by either in situ or blot hybridization using digoxigenin labelled HFV-cDNA probe. HFV associated antigen and immune complex (IC) in renal tissue were also investigated simultaneously using immunofluorescence (IF) technique. HFV-RNA was detected in the renal specimen particularly renal tubular in 8/21 HFRS patients mostly of severe type illness. However, the deposition of IC in the renal tissue in this group of patients occurred mainly in the mild type apparently in a different manner of HFV-RNA. We conclude that both the HFV-RNA and immune complexes deposition are contributable to the pathogenesis of renal lesion in HFRS.

Belgrade virus, a cause of hemorrhagic fever with renal syndrome in the Balkans, is closely related to Dobrava virus of field mice.

Belgrade virus is a recently described hantavirus that causes severe hemorrhagic fever with renal syndrome (HFRS) in people living in various parts of the Balkan Peninsula. Nucleotide sequencing of the G2-encoding region in the medium (M) segment of the viral genome, reverse transcribed and amplified by the polymerase chain reaction, revealed the Belgrade virus to be substantially different from Hantaan virus and other major serotypes of hantavirus but identical to Dobrava virus, a virus isolated from a field mouse (Apodemus flavicollis) in Slovenia. Belgrade virus may be an important cause of HFRS in the Balkan Peninsula, extending north toward the Alps. It poses a special danger to humans who have close contact with field rodents.