title: Clinical and molecular epidemiological features of hemorrhagic fever with renal syndrome in Korea over a 10-year period.
abstract: BACKGROUND
  Laboratory diagnosis of hemorrhagic fever with renal syndrome (HFRS), an infectious disease caused by rodent-borne hantaviruses in Asia and Europe, depends primarily on serological methods. Since the advent of such serodiagnostic tests, few reports are available about the clinical and molecular epidemiological features of HFRS.
  
  
  OBJECTIVE
  To investigate the epidemioclinical features of HFRS patients treated at a tertiary-care teaching hospital in Seoul over a 10-year period.
  
  
  METHODS
  Medical records of HFRS patients, admitted to a tertiary-care teaching hospital during February 2002 to February 2012, were reviewed. Sera from patients were tested for Hantaan virus (HTNV) and Seoul virus (SEOV) RNA using RT-PCR.
  
  
  RESULTS
  Among 35 HFRS patients (mean age was 44.2±14.7 years), 29 were male (82.9%). Acute renal failure developed in 27 patients (77.1%), and 12 patients (34.3%) were admitted to the intensive care unit (ICU). Conjunctival injection (OR 10.32, 95% CI 1.09-97.77, P=.04) and initial serum albumin less than 3g/dL (OR 22.83, 95% CI 1.45-359.93, P=.03) were risk factors for ICU admission. Of 35 acute-phase sera, 11 (31.4%) were positive for HTNV RNA. None were positive for SEOV RNA.
  
  
  CONCLUSIONS
  HFRS was characterized by the clinical triad of fever, renal insufficiency and gastrointestinal symptoms. Conjunctival injection and serum albumin level were related to severity. A large-scale multi-center study is needed to enhance insights into epidemioclinical characteristics of HFRS in Korea.
authors.affiliation: Department of Microbiology, College of Medicine, Korea University, Seoul 136-705, Republic of Korea.
authors.forename: Ji Yun
authors.initials: JY
authors.lastname: Noh
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Cheong
authors.forename: Joon Young
authors.initials: JY
authors.lastname: Song
authors.forename: Woo Joo
authors.initials: WJ
authors.lastname: Kim
authors.forename: Ki-Joon
authors.initials: KJ
authors.lastname: Song
authors.forename: Terry A
authors.initials: TA
authors.lastname: Klein
authors.forename: Sam H
authors.initials: SH
authors.lastname: Lee
authors.forename: Richard
authors.initials: R
authors.lastname: Yanagihara
authors.forename: Jin-Won
authors.initials: JW
authors.lastname: Song
mesh_terms: D000328:Adult; D005260:Female; D018063:Hantaan virus / Q000235:genetics / Q000302:isolation & purification; D006480:Hemorrhagic Fever with Renal Syndrome / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D012367:RNA, Viral / Q000235:genetics; D056910:Republic of Korea / Q000453:epidemiology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D029263:Seoul virus / Q000235:genetics / Q000302:isolation & purification; D017422:Sequence Analysis, DNA; D062606:Tertiary Care Centers
chemical_list: D012367:RNA, Viral
keywords: Hantaan virus; Hantavirus; Hemorrhagic fever with renal syndrome; Korea