Identification of Novel Rodent-Borne Orthohantaviruses in an Endemic Area of Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka.

Devinda S Muthusinghe,Tomonori Kawakami,Chandika D Gamage,Akio Koizumi,Pavani Senarathne,Keita Matsuno,Sithumini M W Lokupathirage,Kumiko Yoshimatsu,Hideki Ebihara,Kenta Shimizu,Jiro Arikawa,Nobuo Koizumi,G R Amanda Fonseka,Zhouoxing Wei,Yoshimi Tsuda,Yomani D Sarathkumara,Chaminda Wickramasinghe

doi:10.3390/v13101984

Abstract

We reported the genetic evidence of circulating hantaviruses from small mammals captured in a chronic kidney disease of unknown etiology (CKDu) hotspot area of Sri Lanka. The high seroprevalence of anti-hantavirus antibodies against Thailand orthohantavirus (THAIV) has been reported among CKDu patients and rodents in Sri Lankan CKDu hotspots. We captured 116 small mammals from CKDu endemic regions in the Polonnaruwa District of Sri Lanka. Seven animals (five out of 11 Mus booduga and two out of 99 Rattus rattus) were PCR-positive for the hantavirus. A rat-borne sequence was grouped with a THAIV-like Anjozorobe virus. In contrast, Mus-borne sequences belonged to the THAIV lineage, suggesting a novel orthohantavirus species according to the phylogenetic analyses and whole-genome comparisons. Our genetic evidence indicates the presence of two THAIV-related viruses circulating in this CKDu endemic area, suggesting a basis for further investigations to identify the infectious virus in patients with CKDu and the CKDu induction mechanism of these viruses.

Highlights

A previously unexplained form of renal disease, referred to as a chronic kidney disease of unknown etiology (CKDu), has been increasingly diagnosed over the past three decades in dry zone areas of Sri Lanka, becoming an overwhelming public health burden [1]
The results revealed a notable difference since all the other Thailand orthohantavirus (THAIV)-like hantavirus reservoir hosts were clustered into the Bandicota and Rattus groups (i.e., THAIV (Bandicota indica), ANJZV and Mayotte virus (R. rattus), Serang virus, and Jurong virus (R. tanezumi))
We report the detection of two novel hantaviruses, the Lanka virus and an ANJZV variant from Sri Lanka

Summary

Introduction

A previously unexplained form of renal disease, referred to as a chronic kidney disease of unknown etiology (CKDu), has been increasingly diagnosed over the past three decades in dry zone areas of Sri Lanka, becoming an overwhelming public health burden [1]. This disease has become more prevalent among rural agricultural communities [2], where males are more often affected than females [3]. The scarcity of recent incidence data has made it difficult to understand the current prevalence of CKDu in the country. Despite many studies conducted over the past few decades, the etiology of CKDu remains obscure

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Results

Conclusion