Abstract
Puumala virus (PUUV) is the most common cause of hantavirus infection in Europe, with thousands of cases occurring particularly in Northern, Central and Eastern Europe and Russia. It causes a mild form of hemorrhagic fever with renal syndrome also known as nephropathia epidemica (NE) with clinical picture ranging from mild to severe. Currently, the laboratory diagnosis of NE is mainly based on serology. Here, we evaluated a real-time one-step qRT-PCR (PUUV-qRT-PCR) for detection of PUUV with 238 consecutive diagnostic serum samples from patients with suspected PUUV infection. The PUUV-qRT-PCR was both specific and sensitive for PUUV RNA. The analytical sensitivity (limit of detection) was estimated to be four copies of PUUV per reaction. Altogether 28 out of 30 (93%) PUUV IgM positive samples were positive also for PUUV RNA. No false positives were detected and the specificity was thus 100%. Interestingly, one sample was found positive in PUUV-qRT-PCR prior to subsequent IgM and IgG seroconversion. PUUV-qRT-PCR could be used for diagnostics in the early phase of NE infection and might be helpful especially in the rare severe cases when the patient’s condition may deteriorate rapidly.
Highlights
Puumala virus (PUUV) is a member of the orthohantavirus genus of the Hantaviridae family.Hantaviruses cause two types of clinical outcomes, hemorrhagic fever with renal syndrome (HFRS) in Europe and Asia and hantaviruspulmonary syndrome (HCPS) on the American continent.The currently known pathogenic hantaviruses are carried by rodents and transmitted to humans by aerosolized excreta of an infected animal with an incubation period of two to four weeks
30 PUUV IgM positive serum samples from patients with acute nephropathia epidemica (NE) were stored a maximum of a few weeks in −20 ◦ C in order to evaluate the diagnostic sensitivity of the assay
An alternative could be nucleic acid detection, and we have evaluated here the usefulness of PUUV-qRT-PCR for laboratory diagnostics
Summary
The currently known pathogenic hantaviruses are carried by rodents and transmitted to humans by aerosolized excreta of an infected animal with an incubation period of two to four weeks. Several newly found hantaviruses are carried by insectivores and bats but their pathogenicity to humans is unknown [1]. One of the pathogenic hantaviruses is PUUV that causes nephropathia epidemica (NE), a mild form of HFRS, which is endemic in Finland, Sweden, Norway, Russia, the Balkans and parts of central Europe. It is carried by bank voles (Myodes glareolus) showing large population density fluctuations with human NE epidemics following bank vole peak densities
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