Occupational Hantavirus Infections in Agricultural and Forestry Workers: A Systematic Review and Metanalysis

Abstract

Hantaviruses are zoonotic pathogens that can cause serious human disorders, including hemorrhagic fever with renal syndrome and hantavirus cardiopulmonary syndrome. As the main risk factor for human infections is the interaction with rodents, occupational groups such as farmers and forestry workers are reportedly at high risk, but no summary evidence has been collected to date. Therefore, we searched two different databases (PubMed and EMBASE), focusing on studies reporting the prevalence of hantaviruses in farmers and forestry workers. Data were extracted using a standardized assessment form, and results of such analyses were systematically reported, summarized and compared. We identified a total of 42 articles, including a total of 28 estimates on farmers, and 22 on forestry workers, with a total workforce of 15,043 cases (821 positive cases, 5.5%). A pooled seroprevalence of 3.7% (95% confidence interval [95% CI] 2.2–6.2) was identified in farmers, compared to 3.8% (95% CI 2.6–5.7) in forestry workers. Compared to the reference population, an increased occurrence was reported for both occupational groups (odds ratio [OR] 1.875, 95% CI 1.438–2.445 and OR 2.892, 95% CI 2.079–4.023 for farmers and forestry workers, respectively). In summary, our analyses stress the actual occurrence of hantaviruses in selected occupational groups. Improved understanding of appropriate preventive measures, as well as further studies on hantavirus infection rates in reservoir host species (rodents, shrews, and bats) and virus transmission to humans, is needed to prevent future outbreaks.

Seroprevalence of Hantavirus in Forestry Workers, Northern France, 2019–2020

“…Our primary aim was to estimate the overall and regional seroprevalence of the hantavirus among forestry workers in northern France. In our study, the overall seroprevalence for hantavirus was estimated at 3.3% (95% CI: 2.5–4.3), which aligns with a previous meta-analysis by Riccò and colleagues [ 19 ] that indicated a seroprevalence of 4.1% (95% CI: 2.7–6.1) among European forestry workers. Nevertheless, results may not be directly comparable to ours, because this metanalysis included data from various European countries (west, south, and east European countries) with heterogeneous hantavirus incidences, and a variety of laboratory methodologies.…”

“…There is little information on the presence of PUUV in French regions that are considered non-endemic. Given that forestry workers are at higher risk than the rest of the population due to potential exposure to rodents, particularly the bank vole, host of PUUV, and their excreta [ 19 ], conducting a study targeting forestry workers can help us document the distribution of hantavirus. Our primary aim was to estimate the overall and regional prevalence of antibodies against PUUV antigens among forestry workers in northern France.…”

Seroprevalence of Coxiella burnetii in Occupational Settings: A Meta-Analysis of Italian Studies

“…In other words, the actual representativity of the assessed occupational groups, even in the targeted areas, remains unclear. On the other hand, as previously stressed for other infectious diseases affecting agricultural workers [46,47,51], the job description could fail to appreciate other exposures, possibly associated with residential and environmental factors, as agricultural settings hardly dichotomize occupational and residential environments [46,47,52,53]. Moreover, the studies were also quite heterogenous in geographical terms, sample size, and sampling strategy [13,18,25,37].…”

“…As a consequence, the status of QF in Italian agricultural and forestry workers would be quite similar to other zoonotic pathogens of occupational interest, e.g., Hantaviruses, Tickborne Encephalitis virus, and Borrelia burgdoferi (the causal agent of Lyme disease) [46][47][48][49][50]. More precisely, our analyses stress the strong association of seroprevalence for C. burnetii with the meat industry (more precisely, for abattoir personnel) and farm tasks that cause the interaction between men and animals, i.e., animal breeders, but also with veterinarians [1,14,23].…”

The role of glomerular lesions in the prognosis of patients with acute kidney injury during hemorrhagic fever with renal syndrome

“…Humans are not the natural host of Hantavirus, and infection occurs in most cases due to accidental inhalation of virus-containing aerosols in rodent feces. Living or working in an environment with rodents has a high risk of infection [ 18 ]. In our study, the patients’ main occupation was farmer or worker, and most of them had experience working outdoors before the onset of HFRS.…”