title: Seroepidemiological study in a Puumala virus outbreak area in South-East Germany.
abstract: Puumala virus (PUUV) is the cause of the majority of haemorrhagic fever with renal syndrome cases in Germany. In 2004, a nephropathia epidemica outbreak was recorded in Lower Bavaria, South-East Germany. For a seroepidemiological study in this region including the resident population at four locations (n = 178) and soldiers from one location (n = 208) indirect immunoglobulin M (IgM) and immunoglobulin G (IgG) enzyme-linked immunosorbent assays (ELISAs) and immunoblot tests based on a yeast-expressed PUUV nucleocapsid protein were established. The validation using human serum panels originating from Germany revealed a diagnostic sensitivity and specificity of 98/100% for the IgM ELISA, 99/99% for the IgG ELISA, 99/100% for the IgM immunoblot test and 100/96% for the IgG immunoblot test. Using the novel IgG assays as well as a commercial IgG ELISA and an immunofluorescence assay for the resident population an average prevalence of 6.7% (12 of 178) with a range of 0% (0 of 21) to 11.9% (7 of 59) was observed. Positive serological results were equally distributed between males and females with an average age of 63 for males and 52 for females. The seroprevalence in the soldier group was found to be about 1% with one positive male of 203 (age 46 years) and one positive female of five (age 47 years). In conclusion, the PUUV seroprevalence in the residents of the outbreak region in Lower Bavaria was found to be up to fivefold higher than the average hantavirus seroprevalence of the German population.
authors.affiliation: Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, OIE Collaborating Centre for Zoonoses in Europe, Institute for Novel and Emerging Infectious Diseases, Südufer 10, 17493 Greifswald, Insel Riems, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Mertens
authors.forename: Roman
authors.initials: R
authors.lastname: Wölfel
authors.forename: Katrin
authors.initials: K
authors.lastname: Ullrich
authors.forename: Kumiko
authors.initials: K
authors.lastname: Yoshimatsu
authors.forename: Jana
authors.initials: J
authors.lastname: Blumhardt
authors.forename: Ina
authors.initials: I
authors.lastname: Römer
authors.forename: Jutta
authors.initials: J
authors.lastname: Esser
authors.forename: Jonas
authors.initials: J
authors.lastname: Schmidt-Chanasit
authors.forename: Martin H
authors.initials: MH
authors.lastname: Groschup
authors.forename: Gerhard
authors.initials: G
authors.lastname: Dobler
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Essbauer
authors.forename: Rainer G
authors.initials: RG
authors.lastname: Ulrich
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005858:Germany / Q000453:epidemiology; D006480:Hemorrhagic Fever with Renal Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015151:Immunoblotting; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D009500:Neutralization Tests; D019590:Nucleocapsid Proteins / Q000302:isolation & purification; D015995:Prevalence; D029262:Puumala virus / Q000302:isolation & purification*; D012680:Sensitivity and Specificity; D016036:Seroepidemiologic Studies
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D019590:Nucleocapsid Proteins; C100886:nucleocapsid protein, Puumala virus