1 institute for clinical microbiology and immunology,st. gallen, switzerland 2 swedish institute for...
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1 Institute for Clinical Microbiology and Immunology,St. Gallen, Switzerland2 Swedish Institute for Infectious Disease Control, Karolinska Institutet, Stockholm,
Sweden 3 University Childrens Hospital, Basel, Switzerland 4 Research Laboratory for Vector-Borne Diseases and National Reference Center for
Hantavirus Infections, Queen Astrid Military Hospital, Brussels, Belgium
FIRST HUMAN CASE OF HANTA VIRUS INFECTION IN SWITZERLAND
Hantavirus: an ignored pandemic in Switzerland ?[Troillet N. Institut Central des Hopitaux Valaisans; Rev Med Suisse Romande 1997 Jan;117(1):3-11]
Switzerland - a white spot for hantaviruses ?[Vaheri A. 2000, Haartman Institute, Helsinki, 2000;personal communication]
Introduction to Hantaviruses
Family Bunyaviridae, Genus Hantavirus, > 20 sero / genotypes, 100 nm, enveloped, negative sense, tri-segmented RNA
Worldwide natural reservoir of hantaviruses pathogenic for humans : Rodentia (Order), Muridae (Family) with chronic persistent infection
D. Schultze 1, Å. Lundkvist 2, U. Blauenstein 3, P. Heyman 4
Hantavirus serology Serology Day 42 Day 49 Day 146 Day 294
Hantavirus IgM (MRL) 5.9 - 0.3 0.3
Hantavirus IgG (MRL) 2.1 - 6.5 2.5
TULV-IgM (EIA) 0.052 0.47 0.030 -
TULV-FRNT - - 160 -
Hantavirus foci peroxidase-stained in one well from a tissue culture plate
[Niklasson et al. Am. J.Trop.Med.Hyg. 1991, 660-665]
Summary
First documented case of Hantavirus infection in CH
First documented case of acute infection with serotype
Tula virus, associated with symptoms uncommon for Hantavirus disease
Rare case of Hantavirus infection in context with arodent bite
Awareness of Hantavirus diseases in Switzerland iswarranted
Summary
First documented case of Hantavirus infection in CH
First documented case of acute infection with serotype
Tula virus, associated with symptoms uncommon for Hantavirus disease
Rare case of Hantavirus infection in context with arodent bite
Awareness of Hantavirus diseases in Switzerland iswarranted
- Asymptomatic & non-specific mild infections outnumber symptomatic, characteristic infections Two broad clinical presentations :
- HFRS - Hemorrhagic Fever with Renal Syndrome, Asia & Europe
- Hantavirus Pulmonary Syndrome, North & South America60'000 to 100'000 hospitalised cases of hantavirus disease / year
Prologue
August 2000 Kaiseraugst, nearby Basel: a 12 year old boy caught a small rodent, hours later rodent bit the boy
Medical record
Out-patient Hospital stay Follow-up
Day Incident Day Incident Day Incident
0 Rodent bite 42 Fever 146 None
6-11 Paronychia 42-49 Exanthema 294 None
8Incision ofparonychia
49-62Antibiotictreatment
8-11 Fever
18 Fever
39-41 Fever
Case report
Clinical features of Hantavirus infections
Acknowledgement This work was enabled by cooperation of the authors within the European Network of <Imported> Viral Diseases (http://www.enivd.de)
Transmission of Hantaviruses to humans via- - respiratory route (common) - bite (rare)- person-to-person (only Andes virus)
Microtus arvalis, known to carry Tula virus
61st Annual Assembly of Swiss Society for Micro-biology, Luzern, 20-21 February 2002
Hantavirus serology indicates a recent infection with TULV: - high IgM index in acute-phase serum samples and a rise of IgG
index (Hantavirus ELISA, MRL Diagnostics, USA)- confirmed by seroconversion of IgM in Tula virus (TULV) enzyme
immuno assay* Definite diagnosis and serological typing of TULV by:- Tula virus -specific focus reduction neutralisation test (FRNT)**- on convalescent serum, 21 weeks after the rodent bite
*Lundkvist Å et al. Virus Research (1996) 45:29-44. **Lundkvist Å et al. Journal of Medical Virology (1997) 53:51-59.
The history of Tula virus[Plyusnin A et al. Journ Virol (1994) 68:7833-7839 / [Plyusnin A, Morzunov SP; Microbiology and Immunology (2001) 256: 47-75]
1994 Tula virus in Microtus arvalis, trapped 1987 in Tula, 100 km south of Moskow
1996/7 Tula virus in voles from Czech Rep, Slovakia & Austria
2001 Tula virus -genome sequences in rodents in CH
Tula virus considered apathogenic to humans so far
2001 Tula virus -specific antibodies in one serum from ahealthy blood donor from the Czech Republic