Abstract
Hantaviruses have the potential to cause two different types of diseases in human: hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). HFRS, initially described clinically at the turn of the 20th century, occurs endemically in the Asian and European continents, while HPS, recognized as a clinical entity since 1993, represents the prototype of emerging diseases occurring in the Western hemisphere. Approximately 150,000 to 200,000 cases of HFRS are hospitalized each year world wide, with most of the cases occurring in the developing countries. The case fatality rate of HFRS varies from <1% to 12% depending on the viruses. Although HPS is much smaller in number than HFRS, with approximately 200 HPS cases per year in the Americas, the average case fatality rate is 40%. The reported cases of hantaviral infection is increasing in many countries and new hantavirus strains have been increasingly identified worldwide, which constitutes a public health problem of increasing global concern. Hantaviral infection might be underestimated due to its asymptomatic and non-specific mild infection, and the lack of simple standardized laboratory diagnostics in hospitals, especially in the developing countries. This review summarizes the current knowledge on virology, epidemiology, clinical manifestation, laboratory diagnostics, treatment and prevention of hantaviruses and hantaviral infections.
Highlights
Since the first hantavirus, Hantaan virus (HTNV), was isolated in 1976 [1], many other hantaviruses have been identified [2], with at least 22 being pathogenic to humans
hemorrhagic fever with renal syndrome (HFRS), which includes diseases formerly known as Korean hemorrhagic fever (KHF), epidemic hemorrhagic fever (EHF) and nephropathia epidemica (NE), denotes a group of clinically similar illnesses that occur throughout the Eurasian landmass and adjoining areas [3]
The high yield of stable and highly pure nucleocapsid proteins of HTNV, Puumala virus (PUUV) and Dobrava virus (DOBV) in yeast Saccharomyces cerevisiae represents a useful tool for vaccine development against hantavirus infection [225]
Summary
Hantaan virus (HTNV), was isolated in 1976 [1], many other hantaviruses have been identified [2], with at least 22 being pathogenic to humans. Hantavirus has been shown to replicate in cultured human endothelial cells and is present in endothelial cells in HFRS and HPS patients [16,17], there is considerable evidence that immunopathology, especially T-cell responses rather than direct viral cytopathology, is responsible for its pathogenesis [18,19]. Cytokines such as tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-10, and γ-interferon may play some roles in pathogenesis of hantaviral infection [20,21]. In Japan, there have been no HFRS cases reported since 1985, HFRS outbreaks were reported from the 1960s to the 1970s, and seropositive R. norvegicus have been identified in ports and reclaimed areas in different locations through the country [30]
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