Clinical and virological characteristics of hantavirus infections in a 2014 Croatian outbreak

Vilibić-Čavlek, Tatjana; Furic, Alena; Barbić, Ljubo; Tabain, Irena; Stevanović, Vladimir; Mlinarić‐Galinović, Gordana

doi:10.3855/jidc.7987

Cited by 14 publications

(14 citation statements)

References 23 publications

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“…Consistent with previous research 29 , 30 , middle-aged male HFRS cases predominated, and farmers accounted for the highest proportion of all occupations. To our knowledge, the hantavirus is most likely transmitted to humans through the inhalation of aerosolized excreta from infected rodents 1 .…”

Section: Discussionsupporting

confidence: 91%

Spatial-temporal characteristics and the epidemiology of haemorrhagic fever with renal syndrome from 2007 to 2016 in Zhejiang Province, China

Wang

Xue

et al. 2018

Sci Rep

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Zhejiang Province is one of the six provinces in China that has the highest incidence of haemorrhagic fever with renal syndrome (HFRS). Data on HFRS cases in Zhejiang Province from January 2007 to July 2017 were obtained from the China Information Network System of Disease Prevention and Control. Joinpoint regression analysis was used to observe the trend of the incidence rate of HFRS. The monthly incidence rate was predicted by autoregressive integrated moving average(ARIMA) models. Spatial autocorrelation analysis was performed to detect geographic clusters. A multivariate time series model was employed to analyze heterogeneous transmission of HFRS. There were a total of 4,836 HFRS cases, with 15 fatal cases reported in Zhejiang Province, China in the last decade. Results show that the mean absolute percentage error (MAPE) of the modelling performance and the forecasting performance of the ARIMA model were 27.53% and 16.29%, respectively. Male farmers and middle-aged patients account for the majority of the patient population. There were 54 high-high clusters and 1 high-low cluster identified at the county level. The random effect variance of the autoregressive component is 0.33; the spatio-temporal component is 1.30; and the endemic component is 2.45. According to the results, there was obvious spatial heterogeneity in the endemic component and spatio-temporal component but little spatial heterogeneity in the autoregressive component. A significant decreasing trend in the incidence rate was identified, and obvious clusters were discovered. Spatial heterogeneity in the factors driving HFRS transmission was discovered, which suggested that a targeted preventive effort should be considered in different districts based on their own main factors that contribute to the epidemics.

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Section: Discussionsupporting

confidence: 91%

Spatial-temporal characteristics and the epidemiology of haemorrhagic fever with renal syndrome from 2007 to 2016 in Zhejiang Province, China

Wang

Xue

et al. 2018

Sci Rep

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“…The distribution of our cases by age and sex show a higher incidence among males compared with females and a peak incidence among those aged 30–59 years, confirming prior findings from Germany and other European countries [35,36]. Apart from sex-specific differences in the exposure to pathogens, women and men also differ in their physiological responses to infections [37].…”

Section: Discussionsupporting

confidence: 88%

Molecular and epidemiological characteristics of human Puumala and Dobrava-Belgrade hantavirus infections, Germany, 2001 to 2017

et al. 2019

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Introduction Two hantavirus species, Puumala (PUUV) and Dobrava-Belgrade (DOBV) virus (genotype Kurkino), are endemic in Germany. Recent PUUV outbreaks raised questions concerning increasing frequency of outbreaks and expansion of PUUV endemic areas. Aims To describe the epidemiology of human PUUV and DOBV infections in Germany. Methods We conducted an observational retrospective study analysing national hantavirus surveillance data notified to the national public health institute and hantavirus nucleotide sequences from patients collected at the national consultation laboratory between 2001 and 2017. Matching molecular sequences with surveillance data, we conducted epidemiological, phylogenetic and phylogeographic analyses. Results In total, 12,148 cases of symptomatic hantavirus infection were notified 2001–17 (mean annual incidence: 0.87/100,000; range: 0.09–3.51). PUUV infections showed a highly variable space-time disease incidence pattern, causing large outbreaks every 2–3 years with peaks in early summer and up to 3,000 annually reported cases. Sex-specific differences in disease presentation were observed. Of 202 PUUV nucleotide sequences obtained from cases, 189 (93.6%) fall into well-supported phylogenetic clusters corresponding to different endemic areas in Germany. DOBV infections caused few, mostly sporadic cases in autumn and winter in the north and east of Germany. Conclusions The frequency of PUUV outbreaks increased between 2001 and 2017 but our data does not support the suggested expansion of endemic areas. The epidemiology of PUUV and DOBV-Kurkino infections differs in several aspects. Moreover, the latter are relatively rare and combining efforts and data of several countries to identify risk factors and develop specific recommendations for prevention could be worthwhile.

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“…Abnormal laboratory test results returned to normal within approximately 3-5 days, with a range of 1-13 days. These findings seem to be similar to those of other reported patients infected with PUUV (Christova et al, 2017;Golovljova et al, 2007;Latus et al, 2015;Skarphedinsson, Thiesson, Shakar, & Tepel, 2015;Vilibic-Cavlek et al, 2017).…”

Section: çElebisupporting

confidence: 92%

Dynamics of Puumala hantavirus outbreak in Black Sea Region, Turkey

Çelebi

Öztoprak

Öktem

et al. 2019

Zoonoses and Public Health

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Background Some of the hantavirus species in Euro‐Asia cause haemorrhagic fever with renal syndrome (HFRS) in humans. The first documented human hantavirus infection in Turkey was diagnosed in 2009. This report describes the dynamics of the first hantavirus outbreak that emerged in humans in the Western Black Sea Region of Turkey. Methods All the suspected cases of hantavirus infection were admitted to the Infectious Diseases and Clinical Microbiology Department at the Zonguldak Bülent Ecevit University Hospital in Zonguldak, Turkey. The patients were carefully interviewed, examined and evaluated using routine laboratory tests and hantavirus diagnostic tools. Hantavirus‐reactive antibodies (IgM and IgG) in serum samples were detected via enzyme immune assay (EIA) and immunofluorescence assay (IFA) in the acute and convalescence stages of the disease. The presence of hantavirus ribonucleic acid (RNA) was analysed via reverse transcription polymerase chain reaction (RT‐PCR) in serum and urine samples. A focus reduction neutralization test (FRNT) was performed to confirm specific hantavirus serotypes. In addition, a case–control study was conducted to identify possible risk factors for hantavirus transmission in the outbreak area. A control group was composed of asymptomatic individuals who were seronegative for hantavirus IgM and IgG and living in the outbreak area. Results A total of 55 suspected cases of hantavirus infection were admitted to the inpatient clinic between February and June of 2009. Twenty‐four patients were diagnosed with acute HFRS via EIA or IFA. In 22 of the 24 infected patients, Puumala virus (PUUV) was identified as the causative hantavirus type by detecting IgM in the acute stage and an increase in the IgG level in follow‐up serum samples. PUUV was also verified as the infecting agent by FRNT in two of the 24 cases. Among the 24 laboratory‐confirmed HFRS cases, 21 (87.5%) were males and 3 (12.5%) were females, and the mean age was 45.92 years (standard deviation ± 16.90 years). Almost all these individuals were living in villages or rural areas. The 24 HFRS cases were matched with 26 healthy controls for statistical analyses and according to binary logistic regression analysis, and dealing with rodent control activities in gardens or in annexes of their homes (p = 0.021 and Odds ratio [OR] = 17.11) and being male (p = 0.019 and OR = 22.37) were detected as statistically significant risk factors for hantavirus infection. The most commonly observed clinical complaints were fatigue (95.8%), shivering (91.7%), fever (87.1%), headache (70.8%) and nausea (70.8%). Haemodialysis was required for four patients (16.7%). Except for the first case diagnosed with acute hantavirus infection, no patient died. The mean delay time to hospital admission from initiation of symptoms was 5.3 days, the mean duration of febrile days was 2.6 days, and the mean duration of hospital stay was 8.5 days. Conclusion Hantaviruses are circulating in Turkey and causing sporadic or epidemic infection in humans. Addit...

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Clinical and virological characteristics of hantavirus infections in a 2014 Croatian outbreak

Cited by 14 publications

References 23 publications

Spatial-temporal characteristics and the epidemiology of haemorrhagic fever with renal syndrome from 2007 to 2016 in Zhejiang Province, China

Spatial-temporal characteristics and the epidemiology of haemorrhagic fever with renal syndrome from 2007 to 2016 in Zhejiang Province, China

Molecular and epidemiological characteristics of human Puumala and Dobrava-Belgrade hantavirus infections, Germany, 2001 to 2017

Dynamics of Puumala hantavirus outbreak in Black Sea Region, Turkey

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