No abstract available.
Evolution, Molecular* ; Hantavirus Pulmonary Syndrome* ; Hantavirus*

Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease with fever, hemorrhage and renal failure caused by hantavirus infection. Hantavirus induces HFRS or hantavirus pulmonary syndrome (HPS). HPS progression to a life-threatening pulmonary disease is found primarily in the USA and very rarely in South Korea. Here, we report a case of HFRS and coexisting HPS.
Fever ; Hantavirus ; Hantavirus Infections ; Hantavirus Pulmonary Syndrome ; Hemorrhage ; Hemorrhagic Fever with Renal Syndrome ; Lung Diseases ; Renal Insufficiency ; Republic of Korea ; Virus Diseases

Hantaviruses belong to the genus Hantavirus and Hantaan, Seoul, Puumala, Belgrade and Sin Nombre viruses are the etiolgic agents of two serious hantaviral diseases of humans. The rodent hosts and the specific etiologic agents of haemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS) are known and many reported cases occurred in Eurasia and Americas. Wild rodents trapped in 13 different areas of Korea from 1994 to 1998 were investigated against hantavirus infection. A total of 718 wild rodents and 10 species were trapped and found 630 (87.7%) of them were Apodemus agrarius. Indirect immunofluorescent antibody technique (IFAT) was performed for hantaviruses infections using different hantavirus antigens. Hantavirus antibodies were found in 68 (10.8%) out of 630 A. agrarius, 8 (42.1%) of 19 Rattus norvegicus. Among 68 lungs and other tissues of antibody positive A. agrarius, 5 (7.4%) were antigen positive. IFA titers of 5 positive A. agrarius sera showed higher titers against Puumala or Sin Nombre viruses than Hantaan virus. These results suggest that there may be are possibilities of existence of a noble hantavirus in Korean wild rodents.
Americas ; Animals ; Antibodies ; Fever ; Hantaan virus ; Hantavirus Infections* ; Hantavirus Pulmonary Syndrome ; Hantavirus* ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea* ; Lung ; Murinae ; Rats ; Rodentia* ; Seoul ; Sin Nombre virus

Hantavirus infection occuring during pregnancy is rarely progressing to adult respiratory distress syndrome (ARDS), which is accompanied by thrombocytopenia, leukocytosis, fever, oliguria, aggravation of bleeding, hematuria, lactacedemia. Pregnancy may have an unfavorable impact on the pathophysiologic characteristics of ARDS. The high oxygen demands of pregnancy are unable to be matched by oxygen delivery in ARDS and may predispose the patient to multiple organ failure, as well as fetal oxygen deprivation. We present the case with hantavirus pulmonary syndrome complicating pregnancy.
Fever ; Hantavirus Infections ; Hantavirus Pulmonary Syndrome* ; Hantavirus* ; Hematuria ; Hemorrhage ; Humans ; Leukocytosis ; Multiple Organ Failure ; Oliguria ; Oxygen ; Pregnancy* ; Respiratory Distress Syndrome, Adult ; Thrombocytopenia

Hantavirus is a genus of the Bunyaviridae family causing two serious diseases, hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). Puumala virus is a member of hantavirus originally found in Europe, and its natural reservoir is Clethrionomys glareolus. It is also associated with the hurnan disease nephropathia epidemica, a milder form of HFRS. To identify the hantaviruses in bats, bats were collected from Jeong-Sun, Won-Joo, Chung-Ju and Hwa-Cheon area in Korea, and nested RT-PCR was performed with serotype specific primer from M segment. Interestingly, Puumala virus was detected in bats (Rhinolophus ferrum-equinum) only from Won-Joo. The 327 bp nested RT-PCR product, was sequenced. The sequence database search indicates that the sequence is homologous to the published sequence of Puumala viruses. The sequence similarities were ranged from 71% to 97%. The highest sequence similarity was 97% with Puumala virus Vranicam strain, and the lowest was 71% with Puumala virus K27 isolate. Puumala virus Vranicam strain was isolated from a bank vole (Clethrionomys glareolus) in Bosnia-Hercegovina. Puumala virus K27 was isolated from human in Russia. This analysis confirms that bats (Rhinolophus ferrum-equinum) in Korea are natural reservoir of Puumala virus.
Arvicolinae ; Base Sequence ; Bunyaviridae ; Chiroptera* ; Chungcheongbuk-do ; Europe ; Hantavirus ; Hantavirus Pulmonary Syndrome ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea* ; Puumala virus* ; Russia ; Sequence Analysis*

Hantavirus is known to a causative agent of hemorrhagic fever with renal syndrome and it can cause hantavirus pulmonary syndrome, a rare disease in Korea. Hantavirus pulmonary syndrome is usually associated with pulmonary hemorrhage and fever. The common hematologic features of this syndrome are elevated hematocrit level, leukocytosis and thrombocytopenia. We report a case of hantavirus pulmonary syndrome with pancytopenia. This patient with severe neutropenia with pulmonary infiltration mimicked aplastic anemia with invasive aspergillosis.
Anemia ; Anemia, Aplastic ; Aspergillosis ; Fever ; Hantavirus ; Hantavirus Pulmonary Syndrome ; Hematocrit ; Hemorrhage ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea ; Leukocytosis ; Neutropenia ; Pancytopenia ; Rare Diseases ; Thrombocytopenia

Hantavirus pulmonary syndrome(HPS) is a systemic disease that is caused by a newly discorved and characterized virus of the Hantavirus genus, which is most frequently referred to as the sin nombre virus. The clinical syndrome resembles other hantavirus syndromes worldwide, except that it is characterized by a brief prodromal illness followed by rapidly progressive, noncardiogenic edema, and that it is more deadly than any previously recognized hantavirus infection. The clinical manifestations of HPS are characterized by four clinical phases prodrome, pulmonary edema and shock, diuresis, and convalescence. Mortality is greatest in the first 24 hours of the pulmonary edema and shock phase of the illness. These phases are strikingly similar to the clinical phases of Hemorrhagic fever with renal syndrome(HFRS) induced by Hantaan virus, except that HPS has not been associated with renal failure and Disseminated intravascular coagulation(DIC). We here report a case of hantavirus pulmonary syndrome developed in a 58 year-old man. He had a flu-like illness followed by the rapid onset of respiratory failure due to noncardiogenic pulmonary edema. HPS was diagnosed by clinical manifestations, identification of high titer antibody to Hantaan virus antigen and histologic finding of transbronchial lung biopsy (TBLB) specimen. The patient was treated with mechanical ventilation and initial corticosteroid pulse therapy resulting in successful outcome.
Biopsy ; Convalescence ; Diuresis ; Edema ; Fever ; Hantaan virus ; Hantavirus Infections ; Hantavirus Pulmonary Syndrome* ; Hantavirus* ; Humans ; Lung ; Middle Aged ; Mortality ; Pulmonary Edema ; Renal Insufficiency ; Respiration, Artificial ; Respiratory Insufficiency ; Shock ; Sin Nombre virus

OBJECTIVETo confirm the existence of Amur-like viruses in Apodemus peninsulae in China, and to understand the molecular characteristics of these viruses.

METHODSTotal RNA was extracted from lungs of A. peninsulae captured in Jilin of Northeast China with Trizol reagent. Complete S and partial M segments of Amur virus were amplified and sequenced. Phylogenetic analyses on multiple nucleotide sequences were performed with the Clustal method and DNASTAR software.

RESULTS383 bp cDNA of M segment and 1696 bp of S segment of Amur like virus were recovered from lung tissue of A. peninsulae, named JilinAP06. The full-length of its S gene comprised of 1696 nucleotides with ORF including 1287 nucleotides and encoding a protein which comprised 429 amino acids. The phylogenetic analysis of this sample with other hantaviruses revealed that the complete S and partial M segment sequence of JilinAP06 both were closely related to those Amur viruses such as AP63, AP61, AP1371 and AP1168 found in A. peninsulae from Far East region of Russia and B78 strain, Liu strain and H5 strain, which were all from Chinese patients. The complete S and partial M segment sequence of JilinAP06 had only 81.0% identities with the nucleotide sequences of HV prototype 76-118 strain.

CONCLUSIONAmur-like viruses did exist in A. peninsulae from Northeasern China while A. peninsulae might be the natural reservoir of Amur-like viruses in China and was the important infectious source to HFRS patients which were caused by Amur-like viruses.

Animals ; China ; Hantavirus ; classification ; genetics ; isolation & purification ; Hantavirus Pulmonary Syndrome ; virology ; Humans ; Lung ; virology ; Murinae ; virology ; Open Reading Frames ; genetics ; Phylogeny ; Reverse Transcriptase Polymerase Chain Reaction

Hemorrhagic fever with renal syndrome (HFRS) caused by Hantann virus or Seoul virus frequently occurs in Korea. The prodromal clinical symptoms are flu-like symptoms. Rapidly progressive renal failure and hemorrhage follow. Hantavirus pulmonary syndrome (HPS) is usually found in the U.S.A., caused by the Sin-nombre virus. The prodromal symptoms resemble HFRS. However, during the third to fith hospital day after admission, pulmonary edema or pulmonary hemorrhage acutely develops, which results in acute respiratory failure. We here report a case of HFRS with HPS that developed in a 47 year-old man. The patient had flu-like symptoms and diarrhea on admission. Acute renal failure developed and acute hemodialysis was performed. On the fourth hospital day, an asymmetric bilateral haziness as seen on a chest X-ray rapidly developed with reduced O2 saturation, and mechanical ventilation was applied. On the eighth hospital day, the patient was weaned from the ventilator. When acute respiratory failure develops in patients with HFRS, HPS might be considered.
Acute Kidney Injury ; Diarrhea ; Hantavirus Pulmonary Syndrome* ; Hantavirus* ; Hemorrhage ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Korea ; Middle Aged ; Prodromal Symptoms ; Pulmonary Edema ; Renal Dialysis ; Renal Insufficiency ; Respiration, Artificial ; Respiratory Insufficiency ; Seoul virus ; Thorax ; Ventilators, Mechanical

A large number of viruses belonging to Genus Hantavirus in Family Bunyaviridae are etiologic agents for hemorrhagic fever with renal syndrome (HFRS), or hantavirus pulmonary syndrome (HPS). Hantaan (HTN), Seoul (SEO), Belgrade (BEL), Puumala (PUU) serotype viruses are well known causative agents for HFRS in Eurasian continent. Among those viruses Hantaan and Seoul serotypes are well known to cause HFRS in Korea, but there are some sporadic incidence by other than Hantaan or Seoul viruses. Recently we have developed the combined Hantaan-Puumala virus vaccine to prevent world-wide occurring HFRS. This combined vaccine is formalin inactivated, suckling mouse and suckling hamster brain extracts for Hantaan and Puumala viruses, respectively. Protein contents of this purified candidate vaccine is 27 microgram/ml, which contains 1,024 ELISA antigen units to each virus, but content of myelin basic protein which is causing experimental allergic encephalomyelitis is legs than 0.1 ng/ml. Thirty hamsters were given twice at one month interval intra-muscularly and bled on 30 days after each vaccination from retro-orbital sinus vein. Antibody titers were tested against 5 major serotype viruses, Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses by IFA and PRNT. The mean IF antibody titers on 30 days after primary shot were 78.4, 68.8, 68.8, 37.9, and 15.6; mean neutralizing antibody titers were 65.4, 12, 6.1, 65.6 and 0.5 against Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses, respectively. The mean IF antibody titers on 30 days after booster shot were 686.9, 567.5, 550.4, 516.3, and 430.9; and neutralizing antibody titers were 710.8, 41.9, 24.3, 409.9, and 1.6 against Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses, respectively.
Animals ; Antibodies, Neutralizing ; Brain ; Bunyaviridae ; Cricetinae* ; Encephalomyelitis, Autoimmune, Experimental ; Enzyme-Linked Immunosorbent Assay ; Formaldehyde ; Hantavirus ; Hantavirus Pulmonary Syndrome ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Incidence ; Korea ; Leg ; Mice ; Myelin Basic Protein ; Puumala virus ; Seoul ; Seoul virus ; Sin Nombre virus ; Vaccination ; Veins