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European Journal of Clinical Microbiology & Infectious Diseases

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Open Access 01-05-2011 | Article

Time to revise the paradigm of hantavirus syndromes? Hantavirus pulmonary syndrome caused by European hantavirus

Authors: J. Rasmuson, C. Andersson, E. Norrman, M. Haney, M. Evander, C. Ahlm

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 5/2011

Abstract

Hantaviruses have previously been recognised to cause two separate syndromes: hemorrhagic fever with renal syndrome in Eurasia, and hantavirus pulmonary syndrome (HPS) in the Americas. However, increasing evidence suggests that this dichotomy is no longer fruitful when recognising human hantavirus disease and understanding the pathogenesis. Herein are presented three cases of severe European Puumala hantavirus infection that meet the HPS case definition. The clinical and pathological findings were similar to those found in American hantavirus patients. Consequently, hantavirus infection should be considered as a cause of acute respiratory distress in all endemic areas worldwide.

Duchin JS, Koster FT, Peters CJ, Simpson GL, Tempest B, Zaki SR, Ksiazek TG, Rollin PE, Nichol S, Umland ET et al (1994) Hantavirus pulmonary syndrome: a clinical description of 17 patients with a newly recognized disease. The hantavirus study group. N Engl J Med 330(14):949–955PubMedCrossRef

Nolte KB, Feddersen RM, Foucar K, Zaki SR, Koster FT, Madar D, Merlin TL, McFeeley PJ, Umland ET, Zumwalt RE (1995) Hantavirus pulmonary syndrome in the United States: a pathological description of a disease caused by a new agent. Hum Pathol 26(1):110–120PubMedCrossRef

Vapalahti O, Mustonen J, Lundkvist A, Henttonen H, Plyusnin A, Vaheri A (2003) Hantavirus infections in Europe. Lancet Infect Dis 3(10):653–661PubMedCrossRef

Botten J, Mirowsky K, Ye C, Gottlieb K, Saavedra M, Ponce L, Hjelle B (2002) Shedding and intracage transmission of Sin Nombre hantavirus in the deer mouse (Peromyscus maniculatus) model. J Virol 76(15):7587–7594PubMedCrossRef

Hardestam J, Karlsson M, Falk KI, Olsson G, Klingström J, Lundkvist A (2008) Puumala hantavirus excretion kinetics in bank voles (Myodes glareolus). Emerg Infect Dis 14(8):1209–1215PubMedCrossRef

Linderholm M, Bjermer L, Juto P, Roos G, Sandström T, Settergren B, Tärnvik A (1993) Local host response in the lower respiratory tract in nephropathia epidemica. Scand J Infect Dis 25(5):639–646PubMedCrossRef

Zaki SR, Greer PW, Coffield LM, Goldsmith CS, Nolte KB, Foucar K, Feddersen RM, Zumwalt RE, Miller GL, Khan AS et al (1995) Hantavirus pulmonary syndrome. Pathogenesis of an emerging infectious disease. Am J Pathol 146(3):552–579PubMed

Mackow ER, Gavrilovskaya IN (2009) Hantavirus regulation of endothelial cell functions. Thromb Haemost 102(6):1030–1041PubMed

Saggioro FP, Rossi MA, Duarte MI, Martin CC, Alves VA, Moreli ML, Figueiredo LT, Moreira JE, Borges AA, Neder L (2007) Hantavirus infection induces a typical myocarditis that may be responsible for myocardial depression and shock in hantavirus pulmonary syndrome. J Infect Dis 195(10):1541–1549PubMedCrossRef

10.

Linderholm M, Billström A, Settergren B, Tärnvik A (1992) Pulmonary involvement in nephropathia epidemica as demonstrated by computed tomography. Infection 20(5):263–266PubMedCrossRef

11.

Linderholm M, Sandström T, Rinnström O, Groth S, Blomberg A, Tärnvik A (1997) Impaired pulmonary function in patients with hemorrhagic fever with renal syndrome. Clin Infect Dis 25(5):1084–1089PubMedCrossRef

12.

Kanerva M, Paakkala A, Mustonen J, Paakkala T, Lahtela J, Pasternack A (1996) Pulmonary involvement in nephropathia epidemica: radiological findings and their clinical correlations. Clin Nephrol 46(6):369–378PubMed

13.

Clement J, Colson P, McKenna P (1994) Hantavirus pulmonary syndrome in New England and Europe. N Engl J Med 331(8):545–546, author reply 547–548PubMedCrossRef

14.

Caramello P, Canta F, Bonino L, Moiraghi C, Navone F, Lipani F, Balbiano R, Caputo AM, Gai V (2002) Puumala virus pulmonary syndrome in a Romanian immigrant. J Travel Med 9(6):326–329PubMedCrossRef

15.

Hoier S, Aberle SW, Langner C, Schnedl W, Hogenauer C, Reisinger EC, Krejs GJ, Krause R (2006) Puumala virus RNA in patient with multiorgan failure. Emerg Infect Dis 12(2):356–357PubMed

16.

Seitsonen E, Hynninen M, Kolho E, Kallio-Kokko H, Pettila V (2006) Corticosteroids combined with continuous veno-venous hemodiafiltration for treatment of hantavirus pulmonary syndrome caused by Puumala virus infection. Eur J Clin Microbiol Infect Dis 25(4):261–266PubMedCrossRef

17.

Pettersson L, Boman J, Juto P, Evander M, Ahlm C (2008) Outbreak of Puumala virus infection, Sweden. Emerg Infect Dis 14(5):808–810PubMedCrossRef

18.

Evander M, Eriksson I, Pettersson L, Juto P, Ahlm C, Olsson GE, Bucht G, Allard A (2007) Puumala hantavirus viremia diagnosed by real-time reverse transcriptase PCR using samples from patients with hemorrhagic fever and renal syndrome. J Clin Microbiol 45(8):2491–2497PubMedCrossRef

19.

CDC (2010) Hantavirus pulmonary syndrome, 2010 case definition. Atlanta: Centers for Disease Control and Prevention (CDC). Available at http://www.cdc.gov/ncphi/disss/nndss/casedef/hantaviruscurrent.htm. Accessed on 1 September 2010

20.

Peters CJ, Khan AS (2002) Hantavirus pulmonary syndrome: the new American hemorrhagic fever. Clin Infect Dis 34(9):1224–1231PubMedCrossRef

21.

Bayard V, Kitsutani PT, Barria EO, Ruedas LA, Tinnin DS, Munoz C, de Mosca IB, Guerrero G, Kant R, Garcia A, Caceres L, Gracio FG, Quiroz E, de Castillo Z, Armien B, Libel M, Mills JN, Khan AS, Nichol ST, Rollin PE, Ksiazek TG, Peters CJ (2004) Outbreak of hantavirus pulmonary syndrome, Los Santos, Panama, 1999–2000. Emerg Infect Dis 10(9):1635–1642PubMed

22.

Puljiz I, Kuzman I, Markotic A, Turcinov D, Matic M, Makek N (2005) Electrocardiographic changes in patients with haemorrhagic fever with renal syndrome. Scand J Infect Dis 37(8):594–598PubMedCrossRef

23.

Mäkelä S, Kokkonen L, Ala-Houhala I, Groundstroem K, Harmoinen A, Huhtala H, Hurme M, Paakkala A, Pörsti I, Virtanen V, Vaheri A, Mustonen J (2009) More than half of the patients with acute Puumala hantavirus infection have abnormal cardiac findings. Scand J Infect Dis 41(1):57–62PubMedCrossRef

24.

Ferres M, Vial P, Marco C, Yanez L, Godoy P, Castillo C, Hjelle B, Delgado I, Lee SJ, Mertz GJ (2007) Prospective evaluation of household contacts of persons with hantavirus cardiopulmonary syndrome in Chile. J Infect Dis 195(11):1563–1571PubMedCrossRef

Title: Time to revise the paradigm of hantavirus syndromes? Hantavirus pulmonary syndrome caused by European hantavirus
Authors: J. Rasmuson
C. Andersson
E. Norrman
M. Haney
M. Evander
C. Ahlm
Publication date: 01-05-2011
Publisher: Springer-Verlag
Published in: European Journal of Clinical Microbiology & Infectious Diseases / Issue 5/2011
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI: https://doi.org/10.1007/s10096-010-1141-6

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