Hantaviruses are a likely threat to NATO forces in Bosnia and Herzegovina and Croatia

Markotić, Alemka; LeDuc, James W.; Hlača, D. M.; Rabatić, Sabina; Sarcevic, A.; Dašić, Gorana; Gagro, Alenka; Kuzman, Ilija; Barac, V.; Avšič–Županc, Tatjana; Beus, I; Dekaris, Dragan

doi:10.1038/nm0396-269

Cited by 30 publications

(22 citation statements)

References 10 publications

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“…All of Croatia except for the coastal region and the islands is endemic for hantaviruses (Markotić et al 1996;. Puumala virus (PUUV) and Dobrava-Belgrade virus (DOBV) are the main causative viruses of HFRS in Croatia Cvetko et al 2005;Miletić Medved et al 2002), while Tula and Saaremaa viruses were also detected in small rodents (Scharninghausen et al 2002;Plyusnina et al 2010).…”

Section: Introductionmentioning

confidence: 99%

“…Main rodent reservoirs of hantaviruses in Croatia are the yellow-necked mouse (Apodemus flavicollis), the striped field mouse (Apodemus agrarius), and the bank vole (Myodes glareolus) (Cvetko et al 2005;Ledina et al 2002). The two biggest HFRS outbreaks were recorded in Croatia in 1995 (Markotić et al 1996Ledina et al 2002) and (Miletić Medved et al 2002Cvetko et al 2005), with over 150 and 400 HFRS cases, respectively. Sporadic cases are recorded annually.…”

Section: Introductionmentioning

confidence: 99%

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Multiple Co-infections of Rodents with Hantaviruses,Leptospira,andBabesiain Croatia

Tadin

Turk

Korva

et al. 2012

Vector-Borne and Zoonotic Diseases

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Hantaviruses, Leptospira spp., and Babesia spp. are rodent-borne pathogens present worldwide. We studied multiple co-infections of small rodents in Croatia with all three pathogens. Twenty-eight Apodemus flavicollis and 16 Myodes glareolus were tested for the presence of hantavirus RNA by real-time RT-PCR, Leptospira strains by renoculture method and Babesia DNA by PCR. Anti-hantavirus antibodies and anti-Leptospira antibodies were detected by serological methods. Very high infection rates with each pathogen were found in A. flavicollis: 20 of 28 rodents (71%) were infected with Dobrava virus, 13 rodents (46%) were infected with Leptospira, and 5 rodents (18%) were infected with Babesia. Multiple co-infections with all three pathogens were found in 3 of 28 (11%) A. flavicollis animals, suggesting that the same rodent host can be infected with several pathogens at the same time. Dual infections with both hantaviruses and Leptospira were found in 7 of 44 rodents (16%), with hantaviruses and Babesia in 2 rodents (5%), and double infection with both Leptospira and Babesia were found in 1 rodent (2%). Since hantaviruses, Leptospira, and Babesia have similar geographical distributions, it is to be expected that in other parts of the world multiple co-infections, representing a serious threat to public health, can be found.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multiple Co-infections of Rodents with Hantaviruses,Leptospira,andBabesiain Croatia

Tadin

Turk

Korva

et al. 2012

Vector-Borne and Zoonotic Diseases

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“…Since the discovery of hantavirus during the Korean con¯ict [LeDuc et al, 1990], reports on HFRS cases among soldiers involved in ®eld training or wartime con¯icts in the HFRS endemic regions have been reported [Markotic Â et al, 1996]. A broad spectrum of clinical conditions have been recognized in HFRS, ranging from inapparent or mild illness to a fulminant hemorrhagic process with severe renal failure and death [Schmaljohn and Hjelle, 1997].…”

Section: Introductionmentioning

confidence: 99%

“…In 1989, there was an outbreak among soldiers near Velika Gorica, with 14 HFRS cases con®rmed [Anonymous, 1993]; in 1991, another outbreak occurred, in Novska County, a newly recognized HFRS endemic area [Borc Ïic Â et al, 1996]. In 1995, we recorded the largest HFRS epidemic in Croatia to date [Markotic Â et al, 1996;Kuzman et al, 1997]. Since that time, about 10±20 sporadic HFRS cases have been recorded per year (A.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of puumala and Dobrava infections in Croatia*

Markotić

St²,

Kuzman

et al. 2002

Journal of Medical Virology

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In this study, two different hantaviruses, Puumala virus (PUUV) and Dobrava virus (DOBV), were demonstrated for the first time to coexist and cause hemorrhagic fever with renal syndrome (HFRS) in Croatia. Phylogenetic analysis showed some differences among the nucleotide sequences of PUUV originating from Dinara mountain, which was more closely related to Austrian PUUV than other Croatian PUUV from Mala Kapela mountain. More consistency was found among the Croatian DOBV. HFRS was verified in 85 of 201 suspected cases recorded in 1995 during the largest HFRS outbreak in Croatia. Most of these cases were soldiers. With the exception of the coastal region and islands, all of Croatia was found to be an area endemic for HFRS. A statistically significantly higher proportion of DOBV-infected patients had acute renal failure, visual disturbance, severe thrombocytopenia, and elevated levels of nonsegmented leukocytes, creatine, and total bilirubin. The prevalence of gastrointestinal and electrocardiography disorders also was greater in DOBV-infected patients. Interestingly, significantly more PUUV-infected patients had elevated systolic blood pressure on admission to the hospital. Further prospective studies are necessary to shed more light on differences in HFRS severity associated with PUU and DOB viruses.

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“…Several HFRS outbreaks in B&H have been reported up to the present time (5,6,7,8). During the war in B&H (1995), more than 300 patients, mostly soldiers from northeast Bosnia, were hospitalized with acute hantavirus disease due either to PUUV or DOBV as first documented by IgG and IgM ELISA (9) and later confirmed by focus reduction neutralization tests (10).…”

Section: Introductionmentioning

confidence: 99%

Pathogenicity and virulence of the present hantaviruses in Bosnia and Herzegovina: the impact on renal function

Hukić

Valjevac

Tulumović

et al. 2010

Eur J Clin Microbiol Infect Dis

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SummaryDobrava (DOBV) and Puumala (PUUV) viruses are endemic throughout the Balkans and cause high fever with renal syndrome (HFRS). The aim was to assess impact of two different HTV on renal function in HFRS patients during acute stage of illness. We also aimed to assess DOBV and PUUV distribution between symptomatic, HFRS patients and asymptomatic hantavirus antibody positive subjects. The study included 264 symptomatic, HFRS patients and 63 asymptomatic hantavirus antibody positive healthy subjects. In our study, 131 (49,6%) HFRS patients were regarded as PUUV and 69 (26,1%) as DOBV-infected patients, while in 64 (24,2%) of HFRS patients that showed all clinical and biochemical signs of HFRS, the causal hantavirus could not be determined with commercially available tests. DOBV-infected patients were associated with more requirements for haemodialysis treatment, lower diuresis and higher serum creatinine and urea values compared to PUUV-infected patients. PUUV was significantly predominant in asymptomatic hantavirus antibody positive subjects (69,8%) compared to HFRS patients. DOBV was present in 17,5% of asymptomatic subjects and interestingly, the preferential hantavirus serotype could not be determined in 12,7% of the asymptomatic antibody-positive subjects.

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Hantaviruses are a likely threat to NATO forces in Bosnia and Herzegovina and Croatia

Cited by 30 publications

References 10 publications

Multiple Co-infections of Rodents with Hantaviruses,Leptospira,andBabesiain Croatia

Multiple Co-infections of Rodents with Hantaviruses,Leptospira,andBabesiain Croatia

Characteristics of puumala and Dobrava infections in Croatia*

Pathogenicity and virulence of the present hantaviruses in Bosnia and Herzegovina: the impact on renal function

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