title: Clinical characterization of Dobrava hantavirus infections in Germany.
abstract: There is increasing evidence that Dobrava (DOBV) but not Hantaan (HTNV) hantavirus is a hemorrhagic fever with renal syndrome (HFRS) causing agent in Central Europe. However, only single clinical cases of HFRS due to acute DOBV infection have been described so far. We report on three male patients from a non-endemic hantavirus focus in Northern Germany who suffered from mild to moderate HFRS strongly resembling nephropathia epidemica. Serotyping by detection of hantavirus species-specific neutralizing antibodies revealed acute infections by the HTNV-related hantavirus DOBV in all three cases. Since DOBV infections in the Balkans frequently present as severe HFRS, our cases suggest that Central-European DOBV infections have a different, less severe clinical outcome. These differences in DOBV virulence towards humans might be due to the existence of different genetic lineages of DOBV.
authors.affiliation: Department of Internal Medicine I, Medical University of Lübeck, Germany. mschuett7@aol.com
authors.forename: M
authors.initials: M
authors.lastname: Schütt
authors.forename: P
authors.initials: P
authors.lastname: Gerke
authors.forename: H
authors.initials: H
authors.lastname: Meisel
authors.forename: R
authors.initials: R
authors.lastname: Ulrich
authors.forename: D H
authors.initials: DH
authors.lastname: Krüger
mesh_terms: D000208:Acute Disease; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D000918:Antibody Specificity; D004797:Enzyme-Linked Immunosorbent Assay; D005858:Germany / Q000453:epidemiology; D018063:Hantaan virus / Q000145:classification / Q000276:immunology; D006476:Orthohantavirus / Q000145:classification* / Q000276:immunology; D018778:Hantavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D006480:Hemorrhagic Fever with Renal Syndrome / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007668:Kidney / Q000473:pathology; D008297:Male; D019590:Nucleocapsid Proteins / Q000276:immunology
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D019590:Nucleocapsid Proteins