Haemorrhagic fever with renal syndrome: an emerging disease

Summary: Worldwide about 150 000 people are hospitalized with haemorrhagic fever with renal syndrome (HRFS; 3–15% fatality) each year. the aetiologic agents of hantavirus infections are Hantaan, Belgrade, Seoul, Puumala and Sin Nombre virus of the genus Hantavirus, family Bunyaviridae. A severe form of HFRS caused by Hantaan and Belgrade virus occurs in Asian and Balcan countries. A new clinical form with 70% fatality, Hantavirus pulmonary syndrome, caused by novel hantaviruses occurs in Americas. A moderate form caused by Seoul virus occurs in Asia and in Europe and a mild form caused by Puumala virus occurs in Europe. Recently, Puumala virus infections in man and field mice were found in Siberia, in Korea and in Japan. the reservoirs of hantaviruses are rodents and other small mammals including bats and birds and mode of transmission is aerosol. Serologic and PCR studies of 72 hantaviruses isolated from patients and from animals throughout the world indicated that there are eight or more serotypes. Many hantavirus patients have been misdiagnosed as influenza, interstitial nephritis, leptospirosis, scrub typhus, dengue, hepatitis and pneumonia. Recently, we developed simple serologic differential diagnostic kits (HDPA test) for Hantaan, Seoul and Puumala virus infections. an inactivated Hantaan virus vaccine against HFRS is available. In the 1990s, it is highly possible to identify new hantavirus illness in parts of the world where the disease is not known because of the availability of diagnostic tools.