Epidemiological Characteristics and Military Implications of Hemorrhagic Fever with Renal Syndrome in Croatia

Mulić, Rosanda; Ropac, Darko

doi:10.1017/s1049023x00057952

Cited by 8 publications

(10 citation statements)

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“…An epidemic with more than 2,000 severe cases was reported in the Federal Republic of Yugoslavia from 1995 to 1996 [61]. In Croatia, 235 HFRS cases, of which 62.6% were soldiers, were reported from 1987 to 2001 [62], whereas 317 HFRS cases were diagnosed during an epidemic in 2002 [63]. In Serbia and Montenegro, a large epidemic with 128 laboratory-confirmed cases occurred in 2002, and since then, more than 30 cases have been serologically confirmed each year [64].…”

Section: Europementioning

confidence: 99%

Hantavirus Infection: a review and global update

Formenty

Roth

2008

J Infect Dev Ctries

200

215

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Hantaviruses have the potential to cause two different types of diseases in human: hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). HFRS, initially described clinically at the turn of the 20 th century, occurs endemically in the Asian and European continents, while HPS, recognized as a clinical entity since 1993, represents the prototype of emerging diseases occurring in the Western hemisphere. Approximately 150,000 to 200,000 cases of HFRS are hospitalized each year world wide, with most of the cases occurring in the developing countries. The case fatality rate of HFRS varies from <1% to 12% depending on the viruses. Although HPS is much smaller in number than HFRS, with approximately 200 HPS cases per year in the Americas, the average case fatality rate is 40%. The reported cases of hantaviral infection is increasing in many countries and new hantavirus strains have been increasingly identified worldwide, which constitutes a public health problem of increasing global concern. Hantaviral infection might be underestimated due to its asymptomatic and nonspecific mild infection, and the lack of simple standardized laboratory diagnostics in hospitals, especially in the developing countries. This review summarizes the current knowledge on virology, epidemiology, clinical manifestation, laboratory diagnostics, treatment and prevention of hantaviruses and hantaviral infections.

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Section: Europementioning

confidence: 99%

Hantavirus Infection: a review and global update

Formenty

Roth

2008

J Infect Dev Ctries

200

215

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“…The whole Croatian inland area is considered to be endemic for HFRS [4–6]. Both viruses are known to exist in Croatia.…”

Section: Discussionmentioning

confidence: 99%

“…The first four cases of haemorrhagic fever with renal syndrome (HFRS) were described in Croatia and south‐eastern Europe in 1954 [1]. In the following years, the disease occurred mainly sporadically; however, a few outbreaks were recorded as well [2–7], the largest of which was in 2002, with >400 cases [8–10].…”

Section: Introductionmentioning

confidence: 99%

Clinical and laboratory findings in patients with oliguric and non-oliguric Hantavirus haemorrhagic fever with renal syndrome: an analysis of 128 patients

Turčinov¹,

Puljiz²,

Markotić³

et al. 2013

Clinical Microbiology and Infection

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Patients with haemorrhagic fever with renal syndrome (HFRS) may present without significant oliguria. We compared different initial clinical symptoms and laboratory findings in patients who developed oliguric acute renal failure (ARF) with those in patients who did not develop oliguric ARF. Overall, 128 patients with serologically confirmed HFRS were hospitalized at the University Hospital for Infectious Disease, Zagreb, Croatia between January 1999 and December 2010. Clinical signs and laboratory findings were extracted from medical charts, and were assessed for their relationship to the development of oliguric ARF. Puumala virus infection was diagnosed in 101 (79%) patients, and Dobrava-Belgrade virus infection in 27 (21%). Oliguria or anuria developed in 30% of patients. We identified the following risk factors for the development of oliguria and anuria on multivariable analysis: conjunctival hyperaemia or bleeding (relative risk (RR) 1.84, 95% CI 1.09-3.10; p 0.023), diarrhoea (RR 1.45, 95% CI 1.07-1.97; p 0.017), serum sodium of ≤133 mM (RR 2.21, 95% CI 1.34-3.64; p 0.002), and dipstick protein value of >1.5 g/L (RR 1.59, 95% CI 1.09-2.33; p 0.016), as well as hiking in the forest (RR 1.92, 95% CI 1.13-3.26; p 0.016). Our findings may help physicians in the earlier identification of patients with a more severe form of HFRS caused by Puumala and Dobrava-Belgrade viruses. Particular attention should be given to findings such as conjunctival hyperaemia or bleeding, diarrhoea, a low serum sodium level, and proteinuria.

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“…91 Puumala virus (also affecting sheep and transmitted by Clethrinomys glareolus) predominates in northern Sweden, 97 in Scandinavia, 94 and in Balkans. 93 Dobrava and Puumala spread especially in Croatia, Serbia, Bosnia, Herzegovina, and Montenegro 98,99 as well as in Slovakia, 100 and, in general, in eastern and central Europe. 101 In addition, in Germany, about 600 cases of Hantavirus disease, caused mainly by Puumala, and also by Dobrava viruses, were found during the period 2001-2003, mainly in the Baden-Wurttemberg regions.…”

Section: Respiratory Infectionsmentioning

confidence: 99%

Emerging and re‐emerging viral infections in Europe

Pugliese

Beltramo

Torre³

2006

Cell Biochemistry & Function

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Emerging viral infections are becoming a serious problem in Europe in the recent years. This is particularly true for severe acute respiratory syndrome (SARS), West Nile virus (WNV) disease, Toscana virus (TOSV) disease, and potentially for avian influenza virus (H5N1). In contrast, emergence or re-emergence of severe viral infections, including tick borne encephalitis virus, and viral haemorrhagic fever caused by Hantavirus and dengue virus have been frequently reported in several European countries. Laboratory diagnosis of these viral infections based on viral isolation or detection by immune electron microscopy, immunoassay and polymerase chain reaction (PCR) has dramatically improved in the recent years, and SARS represents a good example of a diagnostic approach to emerging viral infections. Finally, old and new promising agents are in the pipeline of pharmaceutical companies to treat emerging viral infections. However only prevention based on large epidemiological studies, and research and development of new vaccines may be able to control and eventually eradicate these deadly viral infections.

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Epidemiological Characteristics and Military Implications of Hemorrhagic Fever with Renal Syndrome in Croatia

Cited by 8 publications

References 0 publications

Hantavirus Infection: a review and global update

Hantavirus Infection: a review and global update

Clinical and laboratory findings in patients with oliguric and non-oliguric Hantavirus haemorrhagic fever with renal syndrome: an analysis of 128 patients

Emerging and re‐emerging viral infections in Europe

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