title: Hantavirus infections by Puumala or Dobrava-Belgrade virus in pregnant women.
abstract: BACKGROUND
  Hantavirus infection in humans usually occurs via inhalation of infectious aerosolized excreta of rodents. Horizontal human-to-human transmission was reported only for the highly virulent Andes virus. The likelihood of vertical transmission and the clinical outcome of hantavirus infections in pregnancy is still unpredictable.
  
  
  OBJECTIVE
  Very few data were published about the impact of hantaviruses in pregnancy. Here we present four cases of pregnant women infected by European hantaviruses. The risk of vertical virus transmission was investigated.
  
  
  METHODS
  Four pregnant women with clinical signs of acute hantavirus disease were investigated for hantavirus IgM and IgG after onset of clinical symptoms. Furthermore, the newborns were tested for presence of viral RNA and antibodies in cord blood and, if any parameter was found positive, 8-12 months after delivery.
  
  
  RESULTS
  Four women suffered from a hantavirus infection, two of them due to infection by Puumala virus and two by Dobrava-Belgrade virus. Three women delivered healthy babies by vaginal route and one woman by Caesarean section (week 28). In no case hantavirus RNA was detected in cord blood after delivery or in the 8-12 month old babies. Hantavirus IgG was detectable in the cord blood of 3 babies (but not in the preterm child); these antibodies disappeared after 8-12 months indicating a passive transfer of immunoglobulins. No child had any clinical sign of hantavirus infection.
  
  
  CONCLUSIONS
  In this study, the absence of vertical hantavirus transmission was demonstrated for pregnant women with onset of hantavirus disease between gestation weeks 14 and 28.
authors.affiliation: Institute of Medical Virology, Helmut-Ruska-Haus, Charité University Medicine, Berlin, Germany. joerg.hofmann@charite.de
authors.forename: Jörg
authors.initials: J
authors.lastname: Hofmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Führer
authors.forename: Michael
authors.initials: M
authors.lastname: Bolz
authors.forename: Juliane
authors.initials: J
authors.lastname: Waldschläger-Terpe
authors.forename: Markus
authors.initials: M
authors.lastname: Meier
authors.forename: Dörte
authors.initials: D
authors.lastname: Lüdders
authors.forename: Martin
authors.initials: M
authors.lastname: Enders
authors.forename: Anke
authors.initials: A
authors.lastname: Oltmann
authors.forename: Helga
authors.initials: H
authors.lastname: Meisel
authors.forename: Detlev H
authors.initials: DH
authors.lastname: Krüger
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D005260:Female; D005312:Fetal Blood / Q000276:immunology / Q000821:virology; D006476:Orthohantavirus / Q000302:isolation & purification*; D018778:Hantavirus Infections / Q000635:transmission* / Q000821:virology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology*; D029262:Puumala virus / Q000302:isolation & purification*; D012367:RNA, Viral / Q000097:blood; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral