title: Reappearance of viral hemorrhagic fever with renal syndrome in northwestern Greece.
abstract: BACKGROUND
  Minor outbreaks of viral hemorrhagic fever (VHF) with renal failure have occurred in northwestern Greece over past decades. However, during the most recent decade, there has been a paucity of human cases despite the detection of hantavirus in rodents of this area.
  
  
  METHODS
  We present herein the cases of two patients with VHF, arising in the same area, hospitalized for a short period of time. One patient presented with renal failure, while severe hepatic involvement was predominant in the other. Significantly high ELISA antibody titers for hantavirus established the diagnosis. Supportive treatment led to a successful outcome in both cases. We further discuss the difficulties in differential diagnosis of VHF from other zoonoses with similar endemicity, such as leptospirosis.
  
  
  CONCLUSIONS
  Awareness of the continuing presence of VHF in rural Greece is needed, and a rapid diagnosis is important for the correct therapeutic approach. Continuous surveillance for such diseases, at both the animal (rodents) and human level, is warranted.
authors.affiliation: Internal Medicine Department, General Hospital G. Hatzikosta, Makrygianni Avenue, Ioannina, 45110, Greece. nakritid@cc.uoi.gr
authors.forename: N
authors.initials: N
authors.lastname: Akritidis
authors.forename: C
authors.initials: C
authors.lastname: Boboyianni
authors.forename: G
authors.initials: G
authors.lastname: Pappas
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D006115:Greece / Q000453:epidemiology; D006476:Orthohantavirus / Q000302:isolation & purification*; D006480:Hemorrhagic Fever with Renal Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D016896:Treatment Outcome
chemical_list: D000914:Antibodies, Viral