Epidemiological Studies of Hemorrhagic Fever with Renal Syndrome: Analysis of Risk Factors and Mode of Transmission

Abstract

During an outbreak of hemorrhagic fever with renal syndrome in the Anhui Province of China, a door-to-door survey was conducted of all of the 10,024 residents of eight village communities. The incidence rates were higher in males than in females and higher in adults than in children. Of all the residents surveyed, however, those who had slept on the ground or had been engaged in heavy farm work were at a significantly higher risk of illness than were those who slept on wooden beds or did light work. Among men who did heavy farm work and who gave a history of sleeping in straw huts on the drained swamp, the attack rate was 2.33 times higher than it was for those sleeping exclusively in their permanent homes. Among both sexes, threshers had a significantly higher attack rate than did nonthreshers. Suspicions that trombiculid mites or gamasoid mites act as vehicles of transmission cannot be accepted as an explanation for the association of the risk of illness with the type of work done and with sleeping arrangements. Circumstantial evidence supports our hypotheses of airborne transmission and transmission by inoculation of infectious materials into skin lesions.

Prevalence of serum IgG antibodies to Puumala virus (haemorrhagic fever with renal syndrome) in Northern Sweden

“…A HFRS virus seroprevalence study of telephone engineers in Korea showed a higher seropositivity rate when compared to the local population [18]. In China higher incidence rates for HFRS infection were reported in those engaged in heavy farm work, and in those with a history of sleeping in straw huts or on the ground [19]. In the present study, health care workers had similar or even lower seroprevalence rates than the whole group, indicating no increased risk of nosocomial PUV transmission.…”

The Hantaviruses, Etiologic Agents of Hemorrhagic Fever with Renal Syndrome: A Possible Cause of Hypertension and Chronic Renal Disease in the United States

“…Investigators now suspect that excreted, infectious virus in urine and feces from infected rodents is the source of virtually all human infections. This also holds true for other hantaviruses discussed below (45, 93,99).…”

Prevalence of antibodies specific to Puumala virus among farmers in Sweden

“…In China, an increased incidence of hemoirhagic fever with renal syn- drome was reported for residents engaged in heavy farm work (17). In Korea, telephone company employees working outdoors were found to be at increased risk (18).…”