Analysis of an Outbreak of Hemorrhagic Fever with Renal Syndrome in College Students in Xi’an, China

Abstract

The aim of the present study was to analyze an outbreak of hemorrhagic fever with renal syndrome (HFRS), caused by a Hantavirus, in college students in the northern urban area of Xi’an in 2012. The outbreak affected six students and included two deaths. The epidemiological survey revealed that both of the deceased cases were misdiagnosed initially, and treatment was delayed. Furthermore, a higher rodent population density and lower HFRS vaccine coverage were observed in the affected area, which indicates a possible role in the outbreak. Rattus norvegicus (Rn) and Mus musculus (Mm) were the predominant host populations in the area. Genotyping revealed that all HVs from patients and rodents were Hantaan virus (HTNV). Sequence analysis of the S segments revealed that the HTNVs reported in this study had high similarity with strains reported in 2011 and 1985, but these viruses diverged from a strain isolated in 1984 and the HTNV prototype strain 76-118. Detection of anti-HV IgG and amplification of the S segment of HTNV from a non-natural HTNV reservoir indicates that further investigations by increased rodent trapping are necessary.

Spatiotemporal Transmission Dynamics of Hemorrhagic Fever with Renal Syndrome in China, 2005–2012

“…Our study showed the remarkable variation in the spatiotemporal distribution of HFRS cases in China, with most high-risk counties located in the provinces of Heilongjiang, Jilin, Liaoning, Shaanxi and Shandong, where nearly half of all cases were located, indicating that HFRS still remains an important public health problem in China. Our findings helped policy-makers, public health practitioners and health authorities by identifying both the persisting, established focus in northeastern China and the reemerged newly identified foci which began in Shaanxi province in 2008 [9] , [34] , [35] . Our study also identified that the primary cluster of HFRS shifted to the center of Shaanxi province since 2008.…”

“…Our study also identified that the primary cluster of HFRS shifted to the center of Shaanxi province since 2008. Some studies have shown that the higher prevalence of infection and wider distribution of rodent hosts could drive the outbreak or reemergence of HFRS [9] , [10] . The incidence of HFRS has been increasing in some big cities, such as Shenyang and Beijing [14] , [15] , [17] .…”

“…However, HFRS still remains a serious public health problem with 20,000–50,000 cases reported annually [3] , [7] , [8] . With rapid economic development, urbanization and human population migration, together with the effects of climate change, new foci of infection have continuously emerged in recent years, and the endemic areas have extended from rural to urban areas and even into city centers [9] – [12] . The distribution of HFRS has varied geographically, and changed year by year.…”

Using a distributed lag non-linear model to identify impact of temperature variables on haemorrhagic fever with renal syndrome in Shandong Province

“…We performed sensitivity analyses by changing different stratified methods, season (spring, summer, autumn and winter) and month (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12) and changing the df for meteorological variables from 3 to 5. All statistical analyses were performed by using R software (version 3.3.1) with the 'dlnm' package to fit the models.…”

Structure and Function of HLA-A*02-Restricted Hantaan Virus Cytotoxic T-Cell Epitope That Mediates Effective Protective Responses in HLA-A2.1/Kb Transgenic Mice

“…An epidemiological survey revealed the feasibility, safety, and immunogenicity of the inactive vaccine. However, the efficacy of the vaccine should be improved to further reduce the risk of infection (32). The peptides in vivo may mimic the epitopes that are presented and restricted the MHC to target cells, thus inducing relevant immune responses.…”