Lymphocytic choriomeningitis, Ljungan and orthopoxvirus seroconversions in patients hospitalized due to acute Puumala hantavirus infection

Abstract

a b s t r a c tBackground: The emergence and re-emergence of zoonotic and vector-borne diseases are increasing in Europe. Prominent rodent-borne zoonotic viruses include Puumala hantavirus (PUUV; the causative agent of nephropathia epidemica, NE), lymphocytic choriomeningitis virus (LCMV), and orthopoxviruses (OPV). In addition, Ljungan virus (LV) is considered a potentially zoonotic virus. Objective: The aim of this study was to compare clinical picture between acute PUUV patients with and without additional rodent-borne viral infections, to investigate if concurrent infections influence disease severity. Study design: We evaluated seroprevalence of and seroconversions to LCMV, LV and OPV in 116 patients hospitalized for NE. Clinical and laboratory variables were closely monitored during hospital care. Results: A total of five LCMV, 15 LV, and one OPV seroconversions occurred. NE patients with LCMV seroconversions were younger, and had lower plasma creatinine concentrations and platelet counts than patients without LCMV seroconversions. No differences occurred in clinical or laboratory findings between patients with and without seroconversions to LV and OPV. We report, for the first time, LCMV seroprevalence in Finland, with 8.5% of NE patients seropositive for this virus. Seroprevalences for LV and OPV were 47.8% and 32.4%, respectively. Conclusion: Cases with LCMV seroconversions were statistically younger, had milder acute kidney injury and more severe thrombocytopenia than patients without LCMV. However, the low number of seroconversion cases precludes firm conclusions. Concurrent LV or OPV infections do not appear to influence clinical picture for NE patients.

Seroprevalence of lymphocytic choriomeningitis virus and Ljungan virus in Finnish patients with suspected neurological infections

“…Data from this study showed that the seroprevalence of LCMV was lower (5.0%, Table ) than in our previous study conducted on 116 patients hospitalized for NE in Finland (8.5%) . Similar results have been reported in earlier serological studies of human LCMV infections in the United States America and Europe.…”

“…More recently, we tested for LV antibodies in 534 serum samples collected from 116 Finnish patients hospitalized for NE with serologically confirmed acute PUUV infection. Seroprevalence to LV in this panel was 47.8%, but we did not encounter any unusual or additional symptoms in patients with LV antibodies, hence it seems unlikely that exposure to LV influences NE severity. Here, LV seroprevalence tended to be higher in younger patients, increasing from 39%, in 5‐10‐year‐old patients, to 52% in 11‐20‐year‐olds (Table ) and then decreasing with age.…”

“…RNA was extracted from CSF samples using QIAamp Viral RNA mini kit (Qiagen, Hilden, Germany). LCMV and LV were screened using the Invitrogen SuperScript ® III One‐Step RT‐PCR System with Platinum ® Taq DNA Polymerase (Invitrogen, Carlsbad, CA), and amplified using reverse transcription PCR (RT‐PCR) targeting L gene of Old World arenaviruses and 5′UTR of parechoviruses, described previously in . The RT‐PCRs for LCMV were tested using RNA controls of Lassa (Josiah strain) and LCMV (Armstrong strain), and for parechoviruses using HPeV1‐6, LV 145SLG, and LV 87‐012G .…”

“…However, the role of LV in human pathologies is controversial, and investigations into its zoonotic potential are ongoing. The first two estimates of LV seroprevalence in humans were reported recently in Finland (36%, 47.8%) . There is still a lack of information on the role of LV in neurological infections.…”

Orthopoxvirus Seroprevalence in Cats and Veterinary Personnel in North-Eastern Italy in 2011

“…Slides for IFA were prepared in the laboratory, using Vero E6 cells infected with VACV. Specific human IgG were detected using standard procedures [36]. In particular, rabbit anti-human IgG conjugated with fluorescein isothiocyanate was used as a secondary antibody (Sigma-Aldrich, Inc.).…”