Abstract
Pathogenic hantaviruses (family Bunyaviridae, genus Hantavirus) are rodent-borne viruses causing hemorrhagic fever with renal syndrome (HFRS) in Eurasia. In Europe, there are more than 10,000 yearly cases of nephropathia epidemica (NE), a mild form of HFRS caused by Puumala virus (PUUV). The common and widely distributed bank vole (Myodes glareolus) is the host of PUUV. In this study, we aim to explain and predict NE incidence in boreal Sweden using bank vole densities. We tested whether the number of rainy days in winter contributed to variation in NE incidence. We forecast NE incidence in July 2013–June 2014 using projected autumn vole density, and then considering two climatic scenarios: 1) rain-free winter and 2) winter with many rainy days. Autumn vole density was a strong explanatory variable of NE incidence in boreal Sweden in 1990–2012 (R2 = 79%, p<0.001). Adding the number of rainy winter days improved the model (R2 = 84%, p<0.05). We report for the first time that risk of NE is higher in winters with many rainy days. Rain on snow and ground icing may block vole access to subnivean space. Seeking refuge from adverse conditions and shelter from predators, voles may infest buildings, increasing infection risk. In a rainy winter scenario, we predicted 812 NE cases in boreal Sweden, triple the number of cases predicted in a rain-free winter in 2013/2014. Our model enables identification of high risk years when preparedness in the public health sector is crucial, as a rainy winter would accentuate risk.
Highlights
Zoonotic diseases are diseases transmitted from vertebrate animal hosts to humans
As the proportion of landscape occupied by bank voles varies among phases of the vole cycle [18], we evaluated whether the strength of association between nephropathia epidemica (NE) incidence and bank vole density differs between phases
As Puumala virus (PUUV) has one competent host and does not depend on an arthropod vector for transmission, the ecological link between bank vole density and NE incidence is not modified by vector dynamics and distribution
Summary
Zoonotic diseases are diseases transmitted from vertebrate animal hosts to humans. They constitute more than half of known human pathogens [1] and incur severe health and economic costs on societies [2]. Predicting the likelihood of zoonotic-disease outbreaks under different ecological settings enables implementing adequate measures to raise public awareness, preparedness, and disease prevention. Pathogenic hantaviruses (family Bunyaviridae, genus Hantavirus) are rodent-borne RNA viruses and etiologic agents of hantavirus pulmonary syndrome in the Americas and hemorrhagic fever with renal syndrome (HFRS) in Eurasia [8,9]. Human infections mostly occur through inhalation of viral particles secreted or excreted by infected rodents. Mortality due to NE is low, but morbidity may be high especially in the event of renal impairment [12,13]
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