Hantavirus hemorrhagic fever with renal syndrome
| Subclass of | hantavirus hemorrhagic fever, kidney disease  |
|---|---|
| Short name | HFRS |
| Health specialty | infectious diseases, nephrology |
| Medical examination | physical examination, immunohistochemistry, polymerase chain reaction, ELISA |
| Possible treatment | intravenous infusion and defusion, hemodialysis, proton-pump inhibitor, diuretic, H2 antagonists |
| Drug or therapy used for treatment | ribavirin, prednisolone, furosemide |
| Disease transmission process | contact transmission |
| Anatomical location | kidney, blood vessel |
| Has phenotype | kidney failure |
| ICD-9-CM | 078.6 |
Hantavirus hemorrhagic fever with renal syndrome (HFRS) be a hemorrhagic fever wey hantaviruses cause. Signs den symptoms usually dey occur 2 weeks after exposure to de virus wey e dey cam in five distinct clinical stages: febrile (toxic), hypotensive, low urine production (oliguric), high urine production (diuretic), den recovery. Early symptoms dey include headache, lower back pain, nausea, vomiting, diarrhea, bloody stool, de appearance of spots on de skin, bleeding insyd de respiratory tract, den renal symptoms such as kidney swelling, proteinuria, den hematuria. During de hypotensive phase, blood pressure lower secof microvascular leakage. Renal failure then dey cause de oliguric phase, before recovering den increasing urine production as disease progression dey improve. De severity of symptoms dey vary dey depend on wich virus dey cause HFRS den dey range from mild illness to severe. De case fatality rate likewise dey vary by virus, from less dan 1% up to 15%.
HFRS be caused mainly by four viruses insyd Asia den Europe: Hantaan virus, Seoul virus, Puumala virus, den Dobrava-Belgrade virus. Insyd East Asia, de Hantaan virus be de most common cause of HFRS, wey dey cause a severe form of HFRS, wey e be spread by striped field mice. Seoul virus dey account give about a quarter of HFRS cases, wey cause a moderate form of de disease, wey dem dey find am worldwide secof de global distribution of ein natural reservoir, de brown rat. Puumala virus be de most common cause of HFRS insyd Russia den northern den central Europe, usually dey cause a mild form of HFRS, wey e be transmitted by de bank vole. Dobrava-Belgrade virus be de most common cause of HFRS insyd southern Europe, den dey vary insyd disease severity den natural reservoir wey dey depend on ein genotype. A mild form of HFRS dem often call nephropathia epidemica (NE) be caused by de Puumala virus den de Dobrava-Belgrade virus. Transmission dey occur mainly thru inhalation of aerosols wey contain rodent saliva, urine, anaa feces, buh sanso fi occur thru contaminated chow, bites, den scratches. Vascular endothelial cells den macrophages be de primary cells wey be infected by hantaviruses, den infection dey cause abnormalities plus blood clotting, all of wich dey result in fluid leakage responsible for de more severe symptoms. Recovery from infection likely dey confer lifelong protection.
De main way to prevent HFRS be to avoid anaa minimize contact plus rodents wey dey carry hantaviruses. Removing sources of chow give rodents, safely cleaning up after dem, den preventing dem from entering one ein house all be important means of protection. People wey be at risk of interacting plus infected rodents fi wear masks to protect demaselves. Bivalent vaccines wey dey protect against de Hantaan virus den de Seoul virus be in use insyd China den South Korea. Initial diagnosis of infection fi be made based on epidemiological information den symptoms. Confirmation of infection fi be done by testing for hantavirus nucleic acid, proteins, anaa hantavirus-specific antibodies. Treatment of HFRS be supportive den dey depend on de phase of de disease den clinical presentation. Intravenous hydration, electrolyte therapy, den platelet transfusions fi be performed, as well as intermittent hemodialysis for renal failure den continuous renal replacement therapy insyd critical cases. No specific antiviral drugs dey exist give hantavirus infection.
More dan 100,000 cases of HFRS dey occur each year. China be de most affected country insyd Asia, while Finland be de most affected country insyd Europe. More dan 10,000 cases of NE be diagnosed annually. De distribution of viruses wey dey cause HFRS directly be tied to de distribution of dema natural reservoirs. Transmission sanso greatly be influenced by environmental factors such as rainfall, temperature, den humidity, wich dey affect de rodent population den virus transmissibility. Outbreaks of HFRS occur thru out history, especially among soldiers during wartime wey live insyd poor conditions. During de Korean War insyd de 1950s, an epidemic of HFRS occur among United Nations soldiers dem station near de Hantan river. De outbreak be determined insyd de 1970s den 1980s to be caused by de Hantaan virus, wich na dem name after de river den wich na be de first hantavirus dem discover. Oda HFRS epidemics dey include an outbreak insyd Finland insyd World War Two among German den Finnish soldiers, wey Puumala virus cause, den an outbreak insyd Croatia during de Balkan Wars, wey Puumala virus den Dobrava-Belgrade virus cause.
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