engleski

HFRS outbreak and Puumala virus in Croatia in 2002

Puumala virus (PUUV), causative agent of the mild type of hemorrhagic fever with renal syndrome (HFRS) belongs to the Hantavirus genus in the Bunyaviridae family. HFRS is an endemic disease throughout Croatia. The incidence of HFRS varies in a cyclic fashion, with peaks occurring every couple of years, coinciding with peaks in vole populations. PUUV was shown to be dominant pathogen during the last HFRS outbreak in Croatia in 2002. We focused our research on two localities (Okučani and Nova Gradiška) with the high number of reported HFRS cases and a significant increase in rodent population. HFRS was serologically confirmed in 19 patients coming from two study sites. PUUV infection was verified in 84.2% of cases with higher incidence in Okučani then Nova Gradiška. All, but one patient with lethal outcome, showed mild to moderate clinical picture and recovered well. Genetic analysis of wild-type (wt) PUUV strains from the two localities was performed. Fifty seven bank voles Clethrionomys glareolus originating from PUUV-associated HFRS areas were screened for the presence of PUUV N antigen and 15 (26 %) were found positive. Total RNA isolated from rodent lung tissues was reverse transcribed followed by PCR amplification with primers specific for PUUV medium (M) or small (S) genome segments. Partial PUUV M segment sequences (approximately 450 bp long) were recovered from five bank voles and partial S segment sequences (app. 250 nt long) - from two bank voles. Genetic analysis of Croatian wt-PUUV strains revealed their close relatedness suggesting that the two localities belong to the same natural focus of infection. On phylogenetic trees Croatian PUUV strains clustered together with the strains from Slovenia and Austria forming together distinct genetic lineage.

HFRS; Puumala virus; hantavirus; molecular epidemiology; phylogeny

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