Korean Hemorrhagic Fever was recognized during the Korean War (1950-1953) and intensive studies have been done especially in early 1950's. However, the etiologic agent, vector, and reservoir are not known conclusively. The occurrence has two peak seasons in spring and autumn, and is not limited to military personnel in front lines but also civilians are attacked. Still the study is going on.
Diagnosis, Differential ; Hemorrhagic Fever with Renal Syndrome/epidemiology* ; Hemorrhagic Fever with Renal Syndrome/pathology ; Hemorrhagic Fever with Renal Syndrome/transmission ; Human ; Korea

Child ; Diagnostic Errors ; Hemorrhagic Fever with Renal Syndrome ; diagnosis ; Humans

Dengue/*diagnosis ; Diagnosis, Differential ; Hemorrhagic Fever with Renal Syndrome/*diagnosis ; *Seoul virus

Hantaviruses cause two forms of human disease: hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome. Hantavirus infection can occur in pregnant women and it can have an influence on the maternal and fetal outcomes, although this is a rare finding even in endemic areas. We describe here a recent case of HFRS complicating pregnancy.
Pregnancy Complications, Infectious/*diagnosis ; Pregnancy ; Humans ; Hemorrhagic Fever with Renal Syndrome/*diagnosis ; Female ; Adult

Multiple species of muridae and arvicolidae rodents serve as the natural reserviors of hantaviruses. Hantaviruses are distributed in rodent populations world-widely even in geographical areas where hemorrhagic fever with renal syndrome (HFRS) has not been reported. Serologic diagnosis of infection, using hantaviral antigen, indicates that hantaviruses are wider distributed in wild rodents. This study was designed to intended the hantavirus infection among wild rodents captured in Kyebang mountain, Kangwon-do in Korea. A total of 216 wild rodents in 3 species were trapped in July and September in 1995. Serological evidence for hantaviruses infection were tested against five hantavirus antigens by indirect immunofluorescent antibody technique (IFA). Among 100 Eothenomys regulus, 78 Apodemus peninsulae and 38 Apodemus agrarius (IFA). Among 100 Eothenomys regulus, 78 Apodemus peninsulae and 38 Apodemus agrarius; 12 C. regulus, 15 A. peninsulae and 6 A. agrarius were IF antibody positive against hantaviruses. This data suggest that Eothnomys regulus and Apodemus peninsulae would be a natural reservoir of hantaviruses.
Animals ; Diagnosis ; Gangwon-do ; Hantavirus Infections* ; Hantavirus* ; Hemorrhagic Fever with Renal Syndrome ; Korea ; Muridae ; Murinae ; Rodentia*

PURPOSE: The purpose of this study was to look for possible changes from typical clinical features of 5 sequential clinical phases described in 1950s. METHODS: The clinical features and laboratory data of hemorrhagic fever with renal syndrome (HFRS) with acute renal failure (ARF) and its subdivided 2 groups of correct and incorrect impression of HFRS on admission before the serological confirmation were reevaluated in 35 patients admitted at a single tertiary center from 1995 to 2000. RESULTS: We experienced the high failure rate (74%, 26/35) to recognize HFRS as the cause of ARF on admission. On admission, fever was present in all patients (100 %), and thirty three (94%) had either single or combined gastrointestinal symptoms. However, no one had clinical shock and only 4 patients (11%) had hypotension. Also, oliguria was noted only in 5 patients (14%) during the first 24 hrs on admission. When compared between 2 groups of correct (n=9) and incorrect impression of HFRS (n=26), febrile (100% vs 100%) and gastrointestinal symptoms (89% vs 96%) were present high both but hematologic (67% vs 23%) and hemodynamic signs (67% vs 4%) were much less present in the latter. The patients of incorrect impression on admission were admitted more than half (14/26, 54%) under non-renal care, and were exposed to antibiotics (46%) and even steroids (15%), respectively. In addition, these patients with incorrect impression on admission showed the unwanted outcomes of longer hospitalization than those with correct impression of HFRS (mean+/-SD, 21+/-3 vs. 12+/-4 days, p<0.01). CONCLUSION: Its well awareness of the changing clinical features in endemic area of HFRS would avoid overlooking Hantaviruses as a causal agent of ARF on the initial admission stage of HFRS leading to unnecessary treatments and longer hospitalization.
Acute Kidney Injury ; Anti-Bacterial Agents ; Diagnosis ; Fever ; Hantavirus ; Hemodynamics ; Hemorrhagic Fever with Renal Syndrome* ; Hospitalization ; Humans ; Hypotension ; Oliguria ; Shock ; Steroids

OBJECTIVES: This study aimed to assess the status of Scrub typhus, Leptospirosis and HFRS(hemorrhagic fever with renal syndrome) among farmers with febrile illness. METHODS: We involved a total of 841 farmers who had febrile illness(508 and 333 village residents were, respectively, three and four district of Gyeongju city) selected during autumn of 2014 and 2015. Data were collected by survey questionnaires and blood sample examination. RESULTS: Serum response rate for Scrub typhus and Leptospirosis was 1.5% each and 1.9% for HFRS. Serum response rate for Scrub typhus was significantly higher for tick-bite cases(38.5%), while Leptospirosis was significantly higher for those who were in fruit–planting work(23.1%). Similarly, serum response rate was significantly higher for HFRS who were working in venyl green house work(25.0%). CONCLUSIONS: Government authority should develop effective and efficient preventive strategies to create awareness of infectious diseases among farmers. Extending information, education and communication be reached to farmers that could change their perception and help early diagnosis and treatment and reduce the disease burden and its complication.
Communicable Diseases ; Early Diagnosis ; Education ; Farmers ; Fever ; Gyeongsangbuk-do ; Hemorrhagic Fever with Renal Syndrome ; Leptospirosis ; Risk Factors ; Scrub Typhus

Members of the genus Hantavirus are the etiologic agents of hemorrhagic fever with renal syndrome (HFRS), the diagnosis of which is somewhat difficult because several diseases share similar early clinical presentations such as fever and petechia. In Korea, Hantaan virus and Seoul virus are the causative organisms of HFRS, and the infection caused by Seoul virus is milder than that caused by Hantaan virus. We report a 44-year-old woman, who visited our hospital due to general weakness, fever, myalgia, facial edema and diarrhea. She was diagnosed with HFRS caused by Seoul virus. The antibody against Hantaan virus was positive by an indirect immunofluorescent test and the discrimination between Hantaan and Seoul viruses was done by RT-PCR-RFLP (reverse transcriptionpolymerase chain reaction-restriction fragment length polymorphism) against viral S segment.
Adult ; Diagnosis ; Diarrhea ; Discrimination (Psychology) ; Edema ; Female ; Fever ; Hantaan virus ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Korea ; Myalgia ; Seoul virus*

OBJECTIVE: The golden standard of serodiagnosis of HFRS is IFA(indirect immunofluorescence antibody test). However, positive IFA for IgG antibody does not always correlate with current infection because IFA may be positive due to past exposure to Hantaan virus such as subclincal infection or due to vaccination in endemic area. So supplementary diagnostic method is needed to diagnosis of HFRS with more accuracy. METHODS: In this study, the usefulness of IgG avidity assay with 8 mole/l urea in diagnosis of HFRS was investigated. Serum samples from 45 patients with acute phase HFRS and 79 residents of endemic area, who had HFRS antibody were tested for IgG avidity. RESULTS: The distribution of IgG avidity index of HFRS antibody was different acute phase of HFRS patients from endemic area residents(p<0.001). Patients with acute phase HFRS exhibited lower avidity of Hantaan virus-specific IgG (mode of 64 of avidity index), in contrast endemic area resident had a higher avidity (mode of 4 of avidity index). CONCLUSION: The IgG avidity assay should assist in the diagnosis of acute phase HFRS and may be used to identify recent infection and past exposure to Hantaan virus.
Diagnosis* ; Fluorescent Antibody Technique ; Hantaan virus* ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Immunoglobulin G* ; Serologic Tests ; Urea ; Vaccination

OBJECTIVETo establish an early-warning indicator system on outbreak of hemorrhagic fever with renal syndrome by Delphi method seeking expert advices.

METHODSFirstly, the literature review and the experts meeting method were used to formulate the initiator frame work and indicators. A two-round consultation was used to filter indicators, discuss the boundary of indicators and determine the weighting coefficient among 25 experts from 14 provinces, municipalities and autonomous regions. The relative weightiless of indicators was determined by the weight coefficients method.

RESULTSThe experts' average length of service in prevention and control of hemorrhagic fever with renal syndrome was (23.80 ± 11.70) years. The positivity coefficients of the two-round experts were 100% and 72%. Kendall's coefficients of the two-round consultation were 0.50 (χ(2)(R) = 148.95, P < 0.01) and 0.54 (χ(2)(R) = 212.63, P < 0.01) and opinions among experts became consistent and the consultation had achieved the need of forecast. Four first-class indicators (host animals, risk population, social environment and case-related indicators) and 14 second-class indicators were filtered to develop the indicators system. The weight coefficients of the first-class indicators were 0.28, 0.23, 0.23 and 0.26.

CONCLUSIONThe early-warning index system of hemorrhagic fever with renal syndrome has been established and it could provide a reference for the forest and warning of HFRS outbreak.