Abstract
Puumala virus, which causes nephropathia epidemica (NE), is the most prevalent hantavirus in Germany; bank voles serve as the main reservoir. During 2001-2007, most NE cases reported from Germany occurred in the southwestern state of Baden-Württemberg. We investigated the influence of bank vole habitats (beech forest, seed plants), vole food supply (beechnut mast), climate factors (winter and spring temperatures), and human population density on spatial and temporal occurrence of NE cases in Baden-Württemberg. Using Poisson-regression analyses, we found that all these factors influenced disease incidence. Furthermore, an independent trend of increasing incidence predicted that incidence will nearly double each year. The regression model explained 75% of the annual variation in NE incidence. The results suggest that environmental drivers lead to increasing incidence of NE infections in the southern part or even other parts of Germany.
Highlights
Hantaviruses are the etiologic agents of 2 distinct clinical syndromes: hemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome [1,2]
It has been hypothesized that Peromyscus maniculatus rodents, the reservoir host for Sin Nombre virus (SNV), increased as a result of the El Niño Southern Oscillation [13]
Our objective was to investigate the association between nephropathia epidemica (NE) incidence in southwestern Germany and environmental factors that potentially influence the Puumala virus (PUUV) reservoir abundance and, the risk of acquiring NE
Summary
Hantaviruses (family Bunyaviridae) are the etiologic agents of 2 distinct clinical syndromes: hemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome [1,2] The former occurs in Asia and Europe; the latter, in the Americas (North, Central, and South) [3]. One hypothesis suggests that the risk for human infection with hantaviruses increases with the population size of the reservoir host species, which can be driven to high levels in response to events that enhance host survival, promote early breeding, and increase the food supply [12] Such events may result from climatic perturbations, such as the El Niño Southern Oscillation, which increases precipitation and results in unusually mild winters. The availability of suitable habitat for rodents is a key factor to consider when assessing the risk for hantavirus transmission
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