hantavirus virus pdf

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  • Feb 22, 2020

Hantavirus Infection | American Society of Nephrology
Hantavirus Infection | American Society of Nephrology

Hantaviruses is rodent-borne virus that causes clinical disease in humans of varying severity. There are several different hantaviruses, with different geographical distribution and the different causes clinical disease. Each hantavirus specific to different rodent hosts. Transmission of the virus to humans occurs through inhalation of infected rodent urine, droppings, or saliva

The three major clinical syndromes can be distinguished after hantavirus infection. Hemorrhagic fever with renal syndrome (HFRS), mainly caused by Seoul, Puumala and Dobrava virus; nephropathia epidemica, a mild form of HFRS caused by Puumala virus; and hantavirus cardiopulmonary syndrome, which may be caused by the Andes virus, Sin Nombre virus, and several others. There is no curative treatment for hantavirus infection, and eliminate or minimize contact with rodents is the best way to prevent infection

Hantavirus refers to a genus that includes several dozen species or global genotype .; six so far in Europe, differ in their virulence to humans. Each hantavirus has a specific species of rodent hosts, or groups of closely related host species. Hantaviruses expand in Europe :. They are found in new areas and the incidence has increased in some endemic areas established

European hantavirus disease most commonly caused by the Puumala hantavirus, carried by rats bank (Myodes glareolus). The virus is widespread in much of the continent, except the UK, the coastal areas of the Mediterranean and northern regions.

Dobrava hantavirus, carried by rats yellow-necked (Apodemus flavicollis), only found in Europe south-east, as far as the Czech Republic and southern Germany in the north, although the species of the carrier has a wider distribution in western and northern Europe ,
Other hantaviruses in Europe, but with a less public health importance, including Saaremaa hantavirus, carried by the striped field mouse (Apodemus agrarius) and are found in eastern and central Europe and the Baltic countries; Seoul hantavirus, carried by rats (Rattus norvegicus, R. rattus); Tula hantavirus, carried by rats Microtus; and Seewis hantavirus, common in the Rat (Sorex Araneus), and only recently discovered in Europe.

the results of clinical disease hemorrhagic fever with renal syndrome (also called “nephropatia epidemica”) and the cause of less than 0.5% of deaths.

Overall, the three syndromes caused by hantaviruses:
(1) Hemorrhagic fever with renal syndrome (HFRS), especially in Europe and Asia;
(2) Nephropathia epidemica (NE), a mild form of HFRS, caused by the Puumala hantavirus, and in Europe;
(3) hantavirus cardiopulmonary syndrome (HCP), in the United States.

The clinical presentation of patients with hantavirus disease are quite variable, from asymptomatic to severe. The incubation period is relatively long, mostly 2-3 weeks, but may be up to six weeks. Hantavirus infection in endemic areas should be suspected if an acute fever accompanied by thrombocytopenia, headache, pain is often very severe, and abdominal and back without apparent respiratory symptoms.

The case of death due to Puumala virus infection ranges from less than 0.1 and 0.4%. Recovery usually begins in the second week of illness and accompanied by an increase in urine output resulting in polyuria. Full recovery may, however, take weeks. long-lasting complications are rare, and include glomerulonephritis, Guillain-Barré syndrome, hypopituitarism, and hypertension.

The clinical picture Dobrava virus infection are very similar, but more severe symptoms, with a higher case fatality rate.

3.1. Reservoir

Rodents such as mice and rats yellow-necked bank is a reservoir for hantaviruses. In the northern parts of Europe, a human outbreak occurs during peak cyclic populations of host species. In temperate Europe, on the other hand, human epidemic associated with the (irregular) the mast year, ie with heavy seed crop of oak and beech led to an abundance of rodent species of seed-eating including A. flavicollis. carrier mice often attack human settlements in the autumn so as to increase the risk. During the peak years of rodents, a high proportion of mice can be seropositive. Once infected, the mice Bank began to shed virus after 5-6 days, and excretion continues for about two months.

3.2. transmission mode

mice secrete hantaviruses in the urine, feces and saliva, and human infection occurs mostly through inhalation of aerosolised virus contaminated with rodent droppings. Therefore rodent infested dusty places are risk sites. There is no transmission from human to human is known hantaviruses Europe. There is no known arthropod vectors for hantaviruses.

3.3. risk group

Works such as forestry workers and farmers have an increased risk of exposure

Avoid the virus-contaminated dust during work or leisure time is crucial .; for people with underlying disease, face masks can be used. The creation of airborne dust should be avoided when the area containing rodent droppings are cleaned, and wet cleaning with disinfectant is recommended. wild rat was taken home as pets or to laboratories for research purposes has caused the infection.

Since the Puumala virus remains infective outside the host for long periods of unpredictable length (for two weeks at room temperature), the risk of infection may persist after the mice had been removed.

The diagnosis of hantavirus disease mainly relies on the detection of antibodies, through immuno-fluorescent test (IFA) or enzyme Immuno Assay (EIA). In the acute phase of hantavirus infection, antibodies are not specific. low avidity IgG antibodies and fluorescence granular at IFA from acute sera can be used to separate the old from the new infection. In recent years, immuno-chromatographic test IgM as a test point-of-care with an optical reader, have been developed. RT-PCR of the patient’s blood comes into use.

hantavirus disease treatment, especially symptoms. Maintaining fluid balance, while avoiding over-hydration in patients potentially oliguri is very important. In the case of renal insufficiency, dialysis may be necessary. Because the European hantaviruses not spread from human to human, there is no isolation is required.

Ribavirin is the only drug that is used in a severe hantavirus infection in Europe. There is currently no vaccine available in Europe

Hantavirus disease is under-diagnosed in many regions of Europe .; local guidelines adapted to raise awareness is necessary. The respective roles of different rodent species in the transmission of RBD needs to be studied further. Rodent vector control strategies need to be further developed and fine-tuned.

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Kallio ERK, Klingström J, Gustafsson E, Manni T, Vaheri A, Henttonen H et al. Puumala hantavirus prolonged survival outside the host: evidence for indirect transmission through the environment. J Gen Virol 2006a; 87 :. 2127-2134

Kanerva M, Mustonen J, Vaheri A. Pathogenesis Puumala hantavirus infections and others. Rev Med Virol 1998; 8 :. 67-86

Klingström J, Heyman P, Escutenaire S, Brus Sjolander K, Dejaegere F, Henttonen H et al. rodent host specificity of European hantaviruses: characterization of interspecific spillover. J Med Virol 2002; 68 :. 581-588

Lee HW, YK Chu, YD Woo et al. The vaccine against dengue fever with renal syndrome. In: Saluzzo JF, Dodet B (eds). Factors in the emergence and control of rodent-borne diseases (hantaviral and arenaviral disease). Amsterdam: Elsevier; 1999, pp. 147-156.

Mustonen J, Partanen J, Kanerva M et al. Genetic susceptibility to severe course nephropathia epidemica caused by Puumala hantavirus. Kidney Int 1996; 49: 217-221.
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