Abstract
The aim of the present study was to analyze an outbreak of hemorrhagic fever with renal syndrome (HFRS), caused by a Hantavirus, in college students in the northern urban area of Xi’an in 2012. The outbreak affected six students and included two deaths. The epidemiological survey revealed that both of the deceased cases were misdiagnosed initially, and treatment was delayed. Furthermore, a higher rodent population density and lower HFRS vaccine coverage were observed in the affected area, which indicates a possible role in the outbreak. Rattus norvegicus (Rn) and Mus musculus (Mm) were the predominant host populations in the area. Genotyping revealed that all HVs from patients and rodents were Hantaan virus (HTNV). Sequence analysis of the S segments revealed that the HTNVs reported in this study had high similarity with strains reported in 2011 and 1985, but these viruses diverged from a strain isolated in 1984 and the HTNV prototype strain 76-118. Detection of anti-HV IgG and amplification of the S segment of HTNV from a non-natural HTNV reservoir indicates that further investigations by increased rodent trapping are necessary.
Highlights
Hemorrhagic fever with renal syndrome (HFRS) is caused by hantaviruses in the Asia-Pacific area.The clinical manifestations of HFRS are fever, hemorrhage and varying degrees of renal and hepatic dysfunction [1]
For the treatment of HFRS, ribavirin was administered by intravenous drip (15 mg/kg body weight, twice a day) for two, four, four, three and five days for cases number 2–5, respectively
After the diagnosis of HFRS, the last four patients were treated with intravenous drips of ribavirin (15 mg/kg body weight, twice a day) until their temperature was normalized, and they recovered in three weeks
Summary
Hemorrhagic fever with renal syndrome (HFRS) is caused by hantaviruses in the Asia-Pacific area. The clinical manifestations of HFRS are fever, hemorrhage and varying degrees of renal and hepatic dysfunction [1]. The HVs that cause HFRS include: Hantaan virus (HTNV), Seoulvirus (SEOV), Puumalavirus (PUUV) and Dobrava virus (DOBV) [2,3]. The main natural reservoir of hantaviruses are murid rodents (order Rodentia; family Muridae; subfamilies Murinae, Arvicolinae and Sigmodontinae). The host rodents, which have no disease manifestations, share a long period of co-evolution with hantaviruses. People are usually infected by inhalation of aerosolized rodent excreta, such as saliva, urine or feces, or from a rodent bite or blood transfusion [4]
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