Hantavirus hemorrhagic fever with renal syndrome

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Hantavirus hemorrhagic fever with renal syndrome (HFRS) is a group of clinically similar illnesses caused by Hantavirus species. These diseases are characterized by fever, hemorrhage, and renal failure. HFRS is primarily found in Europe and Asia and is transmitted to humans through contact with the urine, feces, or saliva of infected rodents.

Etiology

HFRS is caused by several species of hantaviruses, including:

• Hantaan virus
• Seoul virus
• Puumala virus
• Dobrava-Belgrade virus

These viruses are part of the Bunyavirales order and are primarily carried by rodent hosts.

Transmission

Humans typically contract HFRS through inhalation of aerosolized particles from rodent excreta. Direct contact with rodent excreta or bites can also lead to infection. The primary rodent hosts include:

• Apodemus agrarius (carrier of Hantaan virus)
• Rattus norvegicus (carrier of Seoul virus)
• Myodes glareolus (carrier of Puumala virus)
• Apodemus flavicollis (carrier of Dobrava-Belgrade virus)

Clinical Features

HFRS has a wide range of clinical manifestations, which can be divided into five distinct phases: 1. **Febrile phase**: Sudden onset of fever, chills, headache, back pain, and gastrointestinal symptoms. 2. **Hypotensive phase**: Drop in blood pressure, which can lead to shock. 3. **Oliguric phase**: Reduced urine output, which can result in acute renal failure. 4. **Diuretic phase**: Increased urine output as kidney function begins to recover. 5. **Convalescent phase**: Gradual recovery of renal function and resolution of symptoms.

Diagnosis

Diagnosis of HFRS is based on clinical presentation and confirmed through laboratory tests, including:

• Serological tests to detect hantavirus-specific antibodies.
• Polymerase chain reaction (PCR) to identify viral RNA.
• Immunohistochemistry to detect viral antigens in tissue samples.

Treatment

There is no specific antiviral treatment for HFRS. Management is primarily supportive and includes:

• Maintenance of fluid and electrolyte balance.
• Management of blood pressure.
• Dialysis in cases of severe renal failure.

Prevention

Preventive measures focus on reducing human exposure to rodent carriers. These include:

• Rodent control and exclusion measures.
• Proper sanitation and waste management.
• Use of protective equipment when handling rodents or cleaning rodent-infested areas.

Epidemiology

HFRS is endemic in parts of Europe and Asia, with varying incidence rates depending on the region and the specific hantavirus involved. Notable outbreaks have occurred in countries such as China, Russia, and South Korea.

Related Pages

• Hantavirus
• Hemorrhagic fever
• Renal failure
• Rodent-borne diseases
• Bunyavirales