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Puumala Virus

Puumala virus (PUUV) is an emerging Hantavirus that is common in Scandinavia, Western Europe and Russia. PUUV is a rodent borne-disease transmitted by bank voles. In humans, PUUV infection causes nephrophathia epidemica, which is a mild form of haemorrhagic fever with renal syndrome (HFRS) in humans.

Puumala Virus Background

Puumala virus (PUUV) is an enveloped, single-stranded negative-sense RNA virus. PUUV is a Hantavirus that belongs to the Hantavirus genus, within the family Bunyaviridae. Hantaviruses are zoonotic pathogens that have global distribution. Rodents and small mammals act as natural reservoirs for Hantaviruses, with each Hantavirus strain being transmitted by a different rodent host species or related species. Puumala virus is classed as an Arvicolinae-associated phylogroup IV Hantaviruses, and the natural host of PUUV is the bank vole (Kruger, DH).

Airborne transmission of hantaviruses to humans occurs via inhalation of dust or aerosols contaminated by urine, saliva or droppings from infected animals. Cases of hantavirus infection are sporadic and predominantly occur in rural areas where rodents are prevalent. Individuals working with rodents are also potentially at risk of becoming infected with Hantavirus.

In humans, hantaviruses cause two acute febrile disease syndromes, haemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS).  HFRS and HCPS are caused by different strains of hantavirus. The strains of hantavirus causing HFRS are referred to as Old World hantaviruses and include Hantaan, Dobrava, Saaremaa, Seoul and Puumala. Hantavirus strains that cause HFRS are endemic in Europe, Asia and Africa. The clinical symptoms associated with HFRS include fever, renal dysfunction, thrombocytopenia, haemorrhage and shock (CDC). HFRS can be fatal in 1-15% of cases.

Puumala virus is the most common hantavirus in Western Europe, Scandinavia and Russia. It causes a mild form of HFRS known as nephrophathia epidemica. The symptoms of nephrophathia epidemica include fever, muscle pain, thrombocytopenia and myopia. In some cases, acute renal failure may occur, and patients may require dialysis. Diagnosis of PUUV infection is carried out using serological methods. Currently there is no specific antiviral treatment for patients with PUUV infection, or licensed vaccine to prevent PUUV infection.

References

Krüger DH, Schönrich G, Klempa B. (2011). Human pathogenic hantaviruses and prevention of infection. Hum Vaccin. 2011 Jun;7(6):685-93

Centers for Disease Control and Prevention: Hantavirus

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