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Background & objectives: Hantavirus and leptospirosis infections are zoonotic diseases with similar clinical and laboratory findings. The aim of this study is to identify the distinguishing features of these two diseases, for which a definitive diagnosis can take a long time. Methods: Between September 2021 and June 2023, a total of 45 patients who were admitted to our hospital and were diagnosed with hemorrhagic fever with renal syndrome (HFRS) or leptospirosis were retrospectively evaluated. Patients were compared in terms of demographic data, clinical, and laboratory parameters. The role of these variables in predicting HFRS or leptospirosis was investigated. The two diseases were compared with regard to outcomes. Receiver operating characteristics were employed for the calculation of cut-off values, sensitivity, specificity, and positive and negative predictive values for parameters showing significant differences. A statistical significance level of p

Background: The largest documented outbreak of hemorrhagic fever with renal syndrome occurred in Primorje-Gorski Kotar County, Croatia, in 2021, marking the first-time cases of hantavirus infection recorded outside of the known endemic region in the north of the county. Aim: To identify the factors contributing to the spread of the outbreak and to compare risk factors for acquiring hantavirus infection in the endemic and newly affected regions. Methods and Results: A total of 189 cases were confirmed by positive Puumala IgM/IgG antibodies (93.6%), and 13 probable cases were identified by clinical and epidemiological data (6.4%) using a structured questionnaire. Of the 179 cases with available clinical data, 59 (33.0%) were hospitalized. Three cases received hemodialysis, and no deaths were reported. Among 170 cases with information on exposures, 66 (38.8%) reported occupational risk. Cases in the northern part of county were more likely to have been infected in early spring (OR 27.1, 95% CI 2.93–250.7), to report seeing a rodent (OR 6.5; 95%CI 2.3–18.4), and to know someone with hemorrhagic fever with renal syndrome (HFRS) (OR 3.0; 95%CI 1.2–8.0) than cases from the southern part of the county. Data from Croatian Forests Ltd. suggested that an unusually good production of beech seeds in 2020 may have contributed to an increased rodent population in 2021. However, average temperature, rainfall, and humidity data from 2021 did not illustrate a significant difference from previous years (Kruskal–Wallis p = 0.837, p = 0.999, p = 0.108). Conclusion: The 2021 HFRS outbreak was likely fueled by an abundant rodent population and virus transmission in rodent hosts. Human activity, environmental factors, and the ensuing animal–human interactions have spread hantavirus infection from Croatia's mountainous region to a previously nonendemic coastal area with a Mediterranean climate. [ABSTRACT FROM AUTHOR]

Hantavirus infection is a rare zoonotic viral disease characterized by fever, interstitial pneumonia, acute respiratory failure, respiratory distress syndrome, acute heart failure, renal failure and digestive tract disorders. The aim of the work is to acquaint practitioners with the case of hantavirus infection in a child. Materials and methods. The child was treated at Zaporizhzhia City Pediatric Hospital No. 5. He underwent clinical and biochemical blood tests, microbiological, radiological and ultrasound examinations using hospital equipment. Determination of immunoglobulins M and G to hantavirus by immunofluorescence analysis was conducted in a reference laboratory. Results. The child was admitted with complaints of headache, fever, epigastric pain, vomiting and stools with blood, shortness of breath, cough, blood in sputum, muscle pain, decreased diuresis. Laboratory findings included leukocytosis, anemia, thrombocytopenia, elevated ESR, elevated procalcitonin and creatinine levels, and hypercoagulability. Instrumentally, right-sided interstitial pneumonia and duodenal ulcer were diagnosed. The positive result for hantavirus infection was confirmed by the levels of immunoglobulins M and G to hantavirus and the increase in their titers in the dynamics. Comprehensive intensive care resulted in relatively rapid recovery of the child. Conclusions. The criteria for the diagnosis of hantavirus infection with pulmonary and renal syndromes are: the presence of interstitial pulmonary edema, fever with myalgias, arthralgias, cephalgia, nausea, vomiting and headache, followed by oliguria. Neutrophilic leukocytosis, anemia, thrombocytopenia, increased hematocrit, proteinuria, and microhematuria are characteristic. Determination of IgM and G to hantavirus and their dynamics is effective for confirming the diagnosis. Hantavirus infection is rather rare in Ukraine. Clinical discussions of diseases that are rarely occurring in practice are useful for physicians and will facilitate a faster diagnostic search.

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Hantaviruses are spread worldwide and cause haemorrhagic fever with renal syndrome(HMRS). The two serotypes occurring in Slovenia are Puumala and Dobrava viruses. Puumala virus causes a milder disease, whereas Dobrava virus causes a more severe form. The transmission of the virus in Slovenija occurs mainly from mice to human hosts, giving the disease its second, colloquial name, »mice chills/mice fever«. The most common clinical presentation is fever with chills and headache. The most typical laboratory finding is thrombocytopenia, but in more severe cases, serum creatinine and urea levels can also be elevated. Serological tests such as indirect immunofluorescence (IIF) and ELISA (enzyme-linked immunosorbent assay) will detect specific IgM and IgG antibodies to confirm the diagnosis. The treatment is primarily supportive. In 2021 almost half of the cases of Hantavirus infections in Slovenia originated from the Goriška region. There were 24 cases of Hantavirus infection among children, 13 of which originated from the Goriška region, and nine of 13 needed hospital treatment. This article presents the incidence, clinical course, and treatment of Hantavirus infections at primary and secondary healthcare levels in children of the Goriška region in 2021. Side note: The epidemiologic data for the year 2021 is preliminary

The paper provides the analysis of epidemiological process of hemorrhagic fever with renal syndrome (HFRS) in the Russian Federation in the context of federal districts in 2022 and a forecast of the HFRS incidence for 2023. According to the results of the analysis, there was a three-fold increase in the morbidity rates of HFRS in Russia in 2022 as compared to the indicators of 2021. The evidence of epizootiological survey and laboratory studies in certain federal districts of the Russian Federation indicate the continuing tense epidemiological situation on HFRS. In a number of regions of the country, high risk of infection with HFRS is predicted due to the favorable natural and climatic conditions of the winter period 2022/2023 for reservoir hosts of pathogenic for humans Hantaviruses. The findings of infected rodents attest to a high probability of complication of the epidemiological situation in the territories of increased epidemic hazard as regards HFRS.

We describe a case of hemorrhagic fever with renal syndrome caused by Seoul virus in a woman in Scotland, UK. Whole-genome sequencing showed the virus belonged to a lineage characterized by recent international expansion, probably driven by trade in pet rats.

Pathogenic hantaviruses are members of the family Hantaviridae and genus Orthohantavirus. These viruses are responsible for hantavirus pulmonary syndrome (HPS) in the Americas. In Argentina, HPS was first described in [...]

A disease outbreak in North America caused by a hantavirus occurred in 1993 in the Four Corners area of the southwestern United States (1). Deer mice (Peromyscus maniculatus) were identified [...]

We describe a case of hemorrhagic fever with renal syndrome caused by Seoul virus in a woman in Scotland, UK. Whole-genome sequencing showed the virus belonged to a lineage characterized by recent international expansion, probably driven by trade in pet rats. [ABSTRACT FROM AUTHOR]

ABSTRACT Hantavirus Cardiopulmonary Syndrome (HCPS) is an important emergent zoonosis associated with wild rodents in Brazil, where this viral infection in children is generally rare. We present HCPS in a child from the Pantanal Biome and a review of all reported pediatric cases in Mato Grosso State, an endemic area for HCPS in Brazil. The investigation used the Information System for Notifiable Diseases database (SINAN). A 12-year-old boy was hospitalized with fever and respiratory failure and hantavirus IgM and IgG antibodies were detected by ELISA in serum samples. During the period of 1999 to 2016, 32 HCPS pediatric cases confirmed by serology were reported to SINAN with a mortality rate of 34.4%. The possibility of hantavirus infection in children with acute febrile illness associated with respiratory failure should be considered mainly in recognized endemic areas as Mato Grosso State, contradicting a hypothesis that children are more protected from lung involvement.

ABSTRACT The hantavirus cardiopulmonary syndrome is considered an emerging disease in the Americas. Since 1993, thousands of cases have been reported from different countries, but mainly from Brazil. This study aims to describe some epidemiological, clinical and anatomopathological aspects of patients with hantavirus who presented poor outcome and were autopsied in a teaching hospital in Brazil, from 2000 to 2014. Of the 10 patients included, nine were male (mean age 43.5 years) and seven reported previous contact with rodents. Fever was present in eight of ten patients, dyspnea in nine of ten and myalgia in seven of ten patients; hemoconcentration, leukocytosis, thrombocytopenia and renal involvement were evidenced in all the 10 cases. At autopsy, the main alterations were seen in the lungs: pleural effusion (8/10 cases), increased weight 2.5 to 3 times, congestion/edema (10/10), interstitial mononuclear inflammation (10/10), alveolar hemorrhage (7/10), pulmonary collapse (7/10), hyaline membranes (7/10) and alveolar neutrophilic infiltrate (2/10). Pericardial effusion (2/10), mild myocardium inflammation (4/10), right ventricle dilation (1/10), polyploidy nuclei (3/10) and pericardial diffuse petechial (1/10) were also observed. The other organs exhibited discrete and non-specific alterations. Currently, this syndrome continues to be associated with high mortality directly linked to a late diagnosis and/or a misdiagnosis in the medical centers where these patients were seen for the first time. The anatomopathological findings at autopsy revealed the final phase of the process with pulmonary alterations, allowing a direct correlation with the severity of respiratory distress observed in these patients at admission.

Resumo: Hantavirose é uma doença emergente e com impacto na saúde pública. Por apresentar sinais e sintomas inespecíficos e facilmente confundidos com outras doenças, seu prognóstico poderia ser melhorado por meio do conhecimento de fatores que pudessem contribuir para seu desfecho. O estudo objetivou identificar os fatores associados ao tempo de sobrevivência em pessoas com hantavirose. Trata-se de um estudo com casos confirmados de hantavirose de janeiro/1992 a junho/2016 do Estado do Paraná, Brasil. Cada caso apresentou dois desfechos competitivos possíveis: óbito ou cura. Para a análise de sobrevivência foi utilizado um modelo de riscos competitivos e as probabilidades dos desfechos estimadas pelo estimador de Aalen-Johansen. A medida de associação foi a razão de riscos (RzRiscos), com respectivos intervalos de 95% de confiança (IC95%). Dos 280 indivíduos com hantavirose, 107 (38,21%) evoluíram para o óbito, 161 (57,5%) para a cura e 12 (4,29%) foram censurados. O modelo final de sobrevivência foi composto por uso de respirador mecânico para o óbito (RzRiscos = 2,86; IC95%: 1,76-4,64; p = 0,00002), sinais hemorrágicos para o óbito (RzRiscos = 2,86; IC95%: 1,69-4,84; p = 0,00009) e para a cura (RzRiscos = 0,66; IC95%: 0,45-0,95; p = 0,03), cefaleia para a cura (RzRiscos = 1,99; IC95%: 1,12-3,54; p = 0,02) e menor de 20 anos para a cura (RzRiscos = 1,73; IC95%: 1,05-2,84; p = 0,03). Sinais hemorrágicos e uso de respirador mecânico são fatores relacionados com a gravidade dos casos e não oportunizam tempo suficiente para reverter o desfecho. No entanto, esses sinais de gravidade corroboram o argumento da importância da suspeição oportuna, permitindo um manejo clínico adequado a fim de reduzir a letalidade.

In 2018, a local case of nephropathia epidemica was reported in Scania, southern Sweden, more than 500 km south of the previously known presence of human hantavirus infections in Sweden. Another case emerged in the same area in 2020. To investigate the zoonotic origin of those cases, we trapped rodents in Ballingslöv, Norra Sandby, and Sörby in southern Sweden during 2020‒2021. We found Puumala virus (PUUV) in lung tissues from 9 of 74 Myodes glareolus bank voles by screening tissues using a hantavirus pan-large segment reverse transcription PCR. Genetic analysis revealed that the PUUV strains were distinct from those found in northern Sweden and Denmark and belonged to the Finnish PUUV lineage. Our findings suggest an introduction of PUUV from Finland or Karelia, causing the human PUUV infections in Scania. This discovery emphasizes the need to understand the evolution, cross-species transmission, and disease outcomes of this newly found PUUV variant.

Orthohantaviruses cause hantavirus cardiopulmonary syndrome; most cases occur in the southwest region of the United States. We discuss a clinical case of orthohantavirus infection in a 65-year-old woman in Michigan and the phylogeographic link of partial viral fragments from the patient and rodents captured near the presumed site of infection.

Seoul orthohantavirus (SEOV) is a rat-borne zoonotic virus that is transmitted via inhalation of aerosolized infectious excreta, and can cause hemorrhagic fever with renal syndrome (HFRS) in humans worldwide. In rats, SEOV predominantly exists as a persistent infection in the absence of overt clinical signs. Lack of disease in rats is attributed to downregulation of pro-inflammatory and upregulation of regulatory host responses. As lung microvascular endothelial cells (LMECs) represent a primary target of infection in both human and rats, infections in these cells provide a unique opportunity to study the central role of LMECs in the dichotomy between pathogenicity in both species. In this study, host responses to SEOV infection in primary human and rat LMECs were directly compared on a transcriptional level. As infection of rat LMECs was more efficient than human LMECs, the majority of anti-viral defense responses were observed earlier in rat LMECs. Most prominently, SEOV-induced processes in both species included responses to cytokine stimulus, negative regulation of innate immune responses, responses to type I and II interferons, regulation of pattern recognition receptor signaling and MHC-I signaling. However, over time, in the rat LMECs, responses shifted from an anti-viral state towards a more immunotolerant state displayed by a PD-L1, B2M-, JAK2-focused interaction network aiding in negative regulation of cytotoxic CD8-positive T cell activation. This suggests a novel mechanism by which species-specific orthohantavirus-induced endothelium and T cell crosstalk may play a crucial role in the development of acute disease in humans and persistence in rodents., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Noack et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

In Brazil, the first confirmed cases of hantavirus cardiopulmonary syndrome in Indigenous populations occurred in 2001. The purpose of this study was to determine the seroprevalence of orthohantavirus infections in the Utiariti Indigenous land located in the southeastern region of the Brazilian Amazon. In December 2014 and 2015, a survey was conducted using an enzyme-linked immunosorbent assay in nine villages belonging to the Haliti–Paresí Indigenous communities. A total of 301 participants were enrolled in the study. Of the two study cohorts, the one from 2014 showed a prevalence of 12.4%, whereas the one from 2015 had a serum prevalence of 13.4%. Analysis of the paired samples of 110 Indigenous people who participated in both stages of the study enabled identification of four individuals who had seroconverted during the study period. Identifying the circulation of orthohantaviruses in the Utiariti Indigenous land highlights a serious public health problem in viral expansion and highlights the need to implement preventive measures appropriate to the sociocultural reality of these communities.

In the United States, 20-40 hantavirus cases are reported annually. Human infections result from inhalation of aerosolized secretions of infected rodents. Hantavirus pulmonary syndrome (HPS) is associated with pneumonitis and [...]

The most prevalent rodentborne zoonotic viruses in Europe are hantaviruses, lymphocytic choriomeningitis virus (LCMV), cowpox virus (CPXV), and Puumala virus (PUUV) (1). In 2016, a total of 18 countries in [...]

A total of 4,626 mammals were serologically tested for antibodies to Sin Nombre virus. All nonrodent species were antibody negative. Among wild rodents, antibody prevalence was 8.5% in murids, 1.4% in heteromyids, and < 0.1% in sciurids. Of 1,921 Peromyscus maniculatus (deer mice), 226 (11.8%) were antibody positive, including one collected in 1975. The highest antibody prevalence (71.4% of 35) was found among P. maniculatus on Santa Cruz Island, off the southern California coast. Prevalence of antibodies among deer mice trapped near sites of human cases (26.8% of 164) was significantly higher than that of mice from other sites (odds ratio = 4.5; 95% confidence interval = 1.7, 11.6). Antibody prevalence increased with rising elevation (> 1,200 meters) and correlated with a spatial cluster of hantavirus pulmonary syndrome cases in the Sierra Nevada.

We report the rare event of two imported cases in the Netherlands presenting with renal syndrome caused by Dobrava (DOBV)/Saaremaa (SAAV) hantaviruses. DOBV/SAAV hantaviruses are not circulating in the Netherlands and their clinical manifestation is typically more severe than that of the endemic Puumala virus (PUUV). This report aims to increase awareness among healthcare professionals and diagnostic laboratories to consider different hantaviruses as a cause of renal failure.