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Hantavirus infections

Abstract number: S67

Avsic-Zupanc T.

Hantaviruses belong to the emerging pathogens having gained more and more attention in the last decades. These viruses are members of the family Bunyaviridae and are grouped into a separate genus known as Hantavirus. Unlike most other Bunyaviridae, hantaviruses are not arthropod-borne (arboviruses), but are ROdent-BOrne, roboviruses. Each hantavirus is primarily carried by a distinct rodent/insectivore species although a few host switches seem to have occurred during the tens of millions of years of their co-evolution with their carrier animals. Hantaviruses are maintained by cyclical transmission between persistently infected rodents, with incidental infection of humans. Transmission occurs primarily by inhalation of aerosols from infected rodents' urine, faeces or saliva. Hantaviruses are found worldwide and are known to cause two serious and often fatal human diseases: haemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). More than 20 hantaviruses have been identified, approximately half of which are known to cause HFRS or HPS. The serotypes Hantaan (HTN), Seoul (SEO), Puumala (PUU), and Dobrava (DOB) virus predominantly cause haemorrhagic fever with renal syndrome (HFRS), a disease characterised by renal failure, haemorrhages, and shock. Whereas hantavirus cardiopulmonary syndrome (HCPS) is a severe cardiopulmonary illness most often caused by the Sin Nombre virus. The illness begins as a nonspecific febrile prodrome, and then patients quickly develop noncardiogenic pulmonary edema, respiratory failure, and shock. The overall case fatality rate of HCPS is approximately 40 percent. The pathogenesis of HFRS is poorly understood. However, it is known that b3 integrins can mediate the entry of pathogenic hantaviruses and that hantaviruses can regulate apoptosis. Also there is evidence and that increased capillary permeability is an essential component in the pathogenesis of both HFRS and HCPS, although different target tissues, kidneys and lungs are affected in the two diseases. HFRS patients show locally increased levels of TNF-a in the plasma and kidneys and high levels of urinary secretion of the proinflammatory cytokine IL-6. The diagnosis of acute hantavirus infection is primarily based on serology, since viral RNA cannot be regularly detected in the blood or urine of patients. Both immunofluorescence tests and enzyme immunoassays are widely used for detection of specific IgM or low-avidity IgG antibodies, characteristic of acute infection. Vaccines against hantavirus infections have been used for years in China and Korea, but not in Europe or the Americas. No specific therapy is used in Europe, although both Ribavirin and interferon-a have been successfully used in trials in China. The high rate of mortality could be reduced if effective therapeutics could be discovered for treatment of this illness.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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