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

OBJECTIVETo study the clinical characteristics of pediatric hemorrhagic fever with renal syndrome (HFRS), and to improve its understanding so as to reduce the misdiagnosis.

METHODSA retrospective analysis was performed on the clinical data of 26 children with HFRS between January 2009 and December 2012.

RESULTSThe age of disease onset was mainly distributed between 7 and 14 years (23 cases, 88%), and the male-to-female ratio was 1.89:l. The clinical manifestations of pediatric HFRS varied. The early symptoms resembled those of a cold, and in the course of HFRS, most patients developed digestive symptoms such as vomiting and abdominal pain. The laboratory examinations usually implicated platelet changes, and the imaging examinations revealed polyserous effusions. The prominent complication was myocardial injury.

CONCLUSIONSPediatric HFRS mainly occurs in school-age children, more commonly in males. HFRS does not have typical clinical manifestations or symptoms, so it should be distinguished from cold or appendicitis at the early stage. When applying the fluid replacement therapy, the cardiac function should be carefully monitored in case of heart failure.

Adolescent ; Child ; Child, Preschool ; Female ; Fluid Therapy ; Hemorrhagic Fever with Renal Syndrome ; diagnosis ; therapy ; Humans ; Male ; Retrospective Studies

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel SFTS bunyavirus (SFTSV), a member of the genus Phlebovirus in the family Bunyaviridae. SFTSV is believed to be transmitted by Haemaphysalis longicornis. Common symptoms of SFTS include high fever, vomiting, diarrhea, thrombocytopenia, leukocytopenia, and multi-organ failure with an average case-fatality rate of 12~30%. In 2009, SFTS was firstly reported in China. In 2013, 27 cases of SFTS were documented in Korea, and 6 cases were confirmed on Jeju Island. Although the pathogenesis and transmission mode of SFTS remain unclear, SFTS is now considered endemic in East Asia. Accordingly, SFTS needs to be differentiated from scrub typhus, leptospirosis, and hemorrhagic fever with renal syndrome. We here report 4 cases of SFTS preceded by a tick bite, which were in need of a differential diagnosis of scrub typhus.
Bunyaviridae ; China ; Communicable Diseases, Emerging ; Diagnosis, Differential ; Diarrhea ; Far East ; Fever* ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea ; Leptospirosis ; Leukopenia ; Phlebovirus ; Scrub Typhus ; Thrombocytopenia* ; Tick Bites ; Vomiting

Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage, and renal failure. Among the various hemorrhagic complications of HFRS, the spontaneous rupture of an arteriovenous malformation of the testicular vessels with a retroperitoneal hematoma is a rare finding. Here, we report a case of HFRS complicated by a massive retroperitoneal hematoma that was treated with transcatheter arterial embolization.
Adult ; Arteriovenous Malformations/*complications ; Embolization, Therapeutic ; Hematoma/diagnosis/*etiology/therapy ; Hemorrhagic Fever with Renal Syndrome/*complications ; Humans ; Kidney Cortex/blood supply ; Male ; Retroperitoneal Space ; Rupture, Spontaneous ; Testis/blood supply

Adult ; Antibodies, Viral ; blood ; Follow-Up Studies ; Hantaan virus ; isolation & purification ; Hemorrhagic Fever with Renal Syndrome ; diagnosis ; Humans ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Male ; Singapore ; Travel

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.

Animals ; Disease Notification ; Disease Outbreaks ; prevention & control ; Early Diagnosis ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; prevention & control ; Humans

This is the first case of virus-associated encephalitis/encephalopathy in which the pathogen was Hantaan virus. A 53-yr-old man presented fever, renal failure and a hemorrhagic tendency and he was diagnosed with hemorrhagic fever with renal failure syndrome (HFRS). In the course of his illness, mild neurologic symptoms such as dizziness and confusion developed and magnetic resonance images revealed a reversible lesion in the splenium of the corpus callosum. This case suggests that HFRS patients with neurologic symptoms like dizziness and mental slowing should be considered to have structural brain lesions and to require brain imaging studies.
Antibodies, Viral/blood ; Corpus Callosum/*pathology ; Diagnosis, Differential ; Hantaan virus/immunology ; Hemorrhagic Fever with Renal Syndrome/*diagnosis/therapy ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Platelet Count ; Renal Dialysis

Most of the patients with hemorrhagic fever with renal syndrome (HFRS) by Hantaviruses recover completely. However, the prevalence of hypopituitarism as sequel of HFRS may be approximately 10%. However, it is rare for hyponatremia to present as a manifestation of hypopituitarism due to HFRS. A 42-year-old Asian woman presented with anorexia, nausea, and vomiting. She had a history of HFRS 7 years ago. During her first hospital admission, her serum sodium was 103 mmol/L. The rapid adrenocorticotropic hormone (ACTH) stimulation test showed no abnormal findings suggesting the possibility of adrenal insufficiency. After she underwent fluid therapy for 5 days, her serum sodium level was slightly increased to 131 mmol/L, and her clinical symptoms were improving. The next day after she was discharged, she suffered from the same symptoms and was admitted to our hospital again. On the day of her second admission, her serum sodium was 117 mmol/L. A combined pituitary function test showed diminished function of the anterior pituitary gland, which led to secondary adrenal insufficiency. Magnetic resonance imaging findings of her sella were compatible with empty sella turcica. After the replacement of prednisolone, her serum sodium levels returned to normal. Pituitary dysfunction should be included in the differential diagnosis of severe hyponatremia, especially in patients who suffered HFRS. This case also suggests that the rapid ACTH stimulation test has limitations with regard to the differential diagnosis of primary or secondary adrenal insufficiency.
Adrenal Insufficiency ; Adrenocorticotropic Hormone ; Adult ; Anorexia ; Asian Continental Ancestry Group ; Diagnosis, Differential ; Empty Sella Syndrome ; Female ; Fluid Therapy ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Hyponatremia ; Hypopituitarism ; Magnetic Resonance Imaging ; Nausea ; Pituitary Function Tests ; Pituitary Gland, Anterior ; Prednisolone ; Prevalence ; Sodium ; Vomiting

Graves' disease (GD) is generally presented by thyrotoxicosis with hyperthyroidism, and it is an organ-specific autoimmune disease induced by thyroid-stimulating hormone receptor autoantibodies. However, among diverse etiologies, viral infections have been suggested to trigger or to be involved in the pathogenesis of GD. Hantaan virus infection causing hemorrhagic fever with renal syndrome (HFRS) is common in South Korea and its pathogenesis is suggested to be an immunologic mechanism. We have experienced a patient who was diagnosed as HFRS with thyrotoxicosis. So we herein report the case as GD combined with the hantaan virus infection.
Graves Disease/complications/*diagnosis/ultrasonography ; *Hantaan virus ; Hemorrhagic Fever with Renal Syndrome/complications/*diagnosis ; Humans ; Male ; Radiopharmaceuticals/diagnostic use ; Thyrotoxicosis/diagnosis ; Young Adult

OBJECTIVETo know the genotype and subtype of hantavirus (HV) which infected persons in Hebei province.

METHODSAccording to G2 coding region of 76-118 and R22 strains, specific type primers were designed to detect and identity the types of HV in HFRS patients' sera with RT-nested PCR. Nucleotides were assayed from partial products after purification and reclaim. Then, gene analysis was done with DNAStar package.

RESULTS17 out of 69 positive serum specimens were successfully detected by RT-PCR and the detection rate was 24.64%, among which, or= 14 days were 0. 17 positive specimens were all belonged to SEO. The nucleotide homology of 9 typical specimens was 92.0%-100%. Between HeB7 and other 8 specimens was 92%-95%, and they belonged to different subtypes. When HeB7 compared with R22 strain, it was 97.7%. HeB7 and R22 belonged to S1 subtype. The 8 specimens except HeB7 was 95.7%-100% and they all belonged to S3 subtype. When compared with 76-118 strain, 9 specimens' nucleotide homology was only 70.3%-72.7%, belonged to different type.

CONCLUSIONSEO was the major type of HV from HFRS patients in Hebei province, S3 was the major subtype and S1 was also existed. In a certain area, the HV which belonged to the same type was correspondingly conservative, and had the characteristic of regional stability.

China ; Genotype ; Hantavirus ; classification ; genetics ; Hemorrhagic Fever with Renal Syndrome ; diagnosis ; prevention & control ; therapy ; virology ; Humans ; Phylogeny ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Analysis, DNA ; Viral Envelope Proteins ; genetics