hantavirus cases europe

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  • Feb 18, 2020

Prevention measures and communication strategies for hantavirus ...
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Paul Heyman; Antti Vaheri; Åke Lundkvist; Avsic-Zupanc Tatjana

Expert Rev Anti Infect Ther. 2009; 7 (2): 205-217.

Reliable diagnostic tool for the diagnosis of hantavirus infection only became available in the 1990s, and hantavirus infection which may be severe under-diagnosed well into the last decade of the 20th century. Diagnostic hantavirus infection has begun before 1990 in six European countries: Finland (1979), Belgium (1981), Sweden (1984), Slovenia (1985), France (1987) and Russia (1980). In other countries, the attention is only given to hantavirus infection after 1990 ().

A survey conducted by Heyman and Vaheri, on behalf of the European Network for Diagnostics Imported Viral Diseases (ENIVD), accounted for total of 35 424 confirmed cases, 33 587 (94.8%) than were detected between 1990 and 2006. [] of the total cases in the European Union 24 672 (69.6%) were reported by Finland and no cases of hantavirus were reported from Spain, Italy, Cyprus or Denmark. In the Russian Federation, Europe accounted for 95% of the total number of the cases. From 1996 to 2006, 89 162 cases were detected, mostly due to infection PUUV. In the Asian region of the Russian Federation, fewer cases are recorded, with DOBV, SAAV, SEOV, HTNV and AMRV as causal agents (Platonov A, Pers. Comm.). It should, however, be remembered that, given the clinical picture is unclear and clinical symptoms of benign or nonexisting in the majority of patients, at least some cases escaped from a variety of surveillance systems. It is estimated that only 30% of infections PUUV cause disease by serological confirmation. [] Hantavirus disease notifiable (by law disease that must be reported to public health authorities, usually within 48 hours after the laboratory diagnosis) in most countries of the European Union; should not be reported in Austria, Cyprus, France, Portugal, Romania and Spain.

In most European countries, between 10 and 20 species of rodent endemic to the present average. [] Active surveillance and circulation of mice carrying pathogenic hantaviruses rarely or not maintained regularly in most countries. As an active surveillance involves field work (rodent snap and / or live-traps, sampling and subsequent testing) is expensive and time consuming, often without the direct result for the public health authorities. Active surveillance is often initiated at the national level as a response to past or ongoing epidemic, which, by definition, is too little, too late.

Tula virus, PUUV, DOBV, SAAV and SEOV hantaviruses have been reported as outstanding in Europe. Of these, PUUV and DOBV has caused the majority of human cases in Europe, with the exception of Switzerland where the only cases associated with virus Tula. [] More recently, SAAV also found to be responsible for human cases in Eastern Europe. [] There are no confirmed cases of infection SEOV have so far been reported in Europe, although the cases are not published, confirmed by a focus reduction neutralization test, the case in France (Lundkvist A, Pers. Comm.). [] Imported cases of hantavirus caused by DOBV in Sweden and Austria, HTNV in Austria and Sin Nombre virus [] in France, have been rare.

The Western and Northern Europe (Fennoscandia), only PUUV infection have been reported. From the North to the Western and Eastern Europe, the ratio PUUV infection / DOBV varies from 3.6% in Southern Germany, more than 50% in Slovenia and up to 100% in Greece.

The number of human cases is increasing in almost all European countries, and record numbers of cases were recorded in Finland (2603 cases in 2002 and 2526 cases in 2005 []), Sweden (459 cases in 2004 and 2195 cases in 2007 []), Germany (> 1400 was reported in September 2007 []) and Belgium (372 cases in 2005) over the last 5 years (). [] Mild winters and more frequent and productive pole events allows more mice to survive during the winter. mild winters, primarily, responsible for the early start to the breeding season and, therefore, for the rodent population is greater. []

Increased activity of hantavirus epidemic occurred in geographical and temporal nonsynchrony in the EU and neighboring countries. In Western Europe, especially in Belgium, 3-year epidemic cycles occur until 1999 (1990, 1993, 1996 and 1999). Between 1999 and 2005 cycles of 2 years was observed (1999, 2001, 2003 and 2005); 2006 was, once again, an epidemic year, such as 2007 withmore than 260 cases, and 2008, with more than 270 cases detected in the first 11 months, emerged as an epidemic in the fourth row. Because this part of Europe lies in the temperate deciduous broad biome leaves of trees, the cycle of rodents is regulated by the harvest (ie, food available from mainly oak and beech trigger density of the rodent population is higher) and a simultaneous increase of virus circulation in the population. The key factor, however, is the change in the pattern in 1999, which has so far described, but the abiotic factors, such as climatic conditions, may play their role. [,]

Norway, Sweden and Finland, with the 1084, 3516 and 24 672 cases were reported, respectively, explain most cases of hantavirus in Europe. Located in the boreal forest biome, the cycle of the rodent population density depends mainly on the mechanism of predator-prey. a high incidence of HFRS similar to Finland occurred in parts of European Russia (for example, Bashkiria and Udmurtia regions) and the northern part of Sweden.

The pattern of epidemiology in Finland seems to be changing. [] In Eastern Europe, the co-circulation of two or three hantaviruses, PUUV, DOBV and SAAV, can be noted. Austria is an interesting mix of patterns: in low altitude areas (Western Europe) pole-year Prevails pattern, while at higher altitudes (Northern Europe) cyclic pattern observed (Aberle S, Press Comm [] ..). The number of cases in Bosnia-Herzegovina peaked in 1995 with 354 cases [] during the conflict in the region. Epidemiology and epidemic cycle pattern is less clear than in Western or Northern Europe.

Expert Rev Anti Infect Ther. 2009; 7 (2): 205-217. © 2009

serotypes that cause human disease indicated by the symbol * and. ‡ * hantavirus species are currently recognized by the International Committee on Taxonomy of Viruses. ‡ Because of the pathology. HCP: Hantavirus cardiopulmonary syndrome; HFRS: Dengue fever with renal syndrome; NE: Nephropathia epidemica

HFRS :. Hemorrhagic fever with renal syndrome; NE: .. Nephropathia epidemica

Data from []

Paul Heyman † Research Laboratory for Vector-borne Diseases, National Reference Laboratory for hantavirus infections, Queen Astrid Military Hospital Bruynstraat 1, B-1120 Brussels, Belgium Tel.: +32 2264 4044 Fax: +32 2 264 4078 Antti Vaheri Department of Virology, Haartman Institute, University of Helsinki, POB 21, FI-ooo14 Helsinki, Finland Åke Lundkvist Swedish Institute for Infectious Disease Control and Karolinska Institutet, 171 82 Solna, Sweden Avsic-Zupanc Tatjana Institute of Microbiology and Immunology, Faculty of Medicine, Zaloska 4, 1000 Ljubljana, Slovenia

in the last decade both the amplitude and magnitude of hantavirus outbreaks has increased.

Although an understanding and recognition of hantavirus infection have greatly increased worldwide over the past few decades, Puumala and Dobrava pathogenesis of hemorrhagic fever with renal syndrome remains poorly understood.

Currently, no vaccine is available against Puumala and / or Dobrava virus.

More sophisticated serological tests make the diagnosis of hantavirus infection easier, more reliable and more within reach of laboratories in different countries.

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