title: High infection rate of bank voles (Myodes glareolus) with Puumala virus is associated with a winter outbreak of haemorrhagic fever with renal syndrome in Croatia.
abstract: An outbreak of haemorrhagic fever with renal syndrome (HFRS) started on Medvednica mountain near Zagreb in January 2012. In order to detect the aetiological agent of the disease in small rodents and to make the link with the human outbreak, rodents were trapped at four different altitudes. Using nested RT-PCR, Puumala virus (PUUV) RNA was detected in 41/53 (77·4%) bank voles (Myodes glareolus) and Dobrava virus (DOBV) RNA was found in 6/61 (9·8%) yellow-necked mice (Apodemus flavicollis). Sequence analysis of a 341-nucleotide region of the PUUV S segment, obtained from all infected bank voles and five HFRS patients, showed 98·8-100% sequence similarity, indicating that the patients were probably exposed to PUUV on Medvednica mountain. A very large bank-vole population combined with an extremely high infection rate of PUUV was responsible for this unusual winter outbreak of HFRS in Croatia.
authors.affiliation: University Hospital for Infectious Diseases 'Dr. Fran Mihaljevic',Zagreb,Croatia.
authors.forename: A
authors.initials: A
authors.lastname: Tadin
authors.affiliation: Faculty of Forestry,University of Zagreb,Zagreb,Croatia.
authors.forename: L
authors.initials: L
authors.lastname: Bjedov
authors.affiliation: Faculty of Forestry,University of Zagreb,Zagreb,Croatia.
authors.forename: J
authors.initials: J
authors.lastname: Margaletic
authors.affiliation: University Hospital for Infectious Diseases 'Dr. Fran Mihaljevic',Zagreb,Croatia.
authors.forename: B
authors.initials: B
authors.lastname: Zibrat
authors.affiliation: University Hospital for Infectious Diseases 'Dr. Fran Mihaljevic',Zagreb,Croatia.
authors.forename: L Cvetko
authors.initials: LC
authors.lastname: Krajinovic
authors.affiliation: University Hospital for Infectious Diseases 'Dr. Fran Mihaljevic',Zagreb,Croatia.
authors.forename: P
authors.initials: P
authors.lastname: Svoboda
authors.affiliation: University Hospital for Infectious Diseases 'Dr. Fran Mihaljevic',Zagreb,Croatia.
authors.forename: I C
authors.initials: IC
authors.lastname: Kurolt
authors.affiliation: Faculty of Veterinary Medicine,University of Zagreb,Zagreb,Croatia.
authors.forename: Z Stritof
authors.initials: ZS
authors.lastname: Majetic
authors.affiliation: Faculty of Veterinary Medicine,University of Zagreb,Zagreb,Croatia.
authors.forename: N
authors.initials: N
authors.lastname: Turk
authors.affiliation: University Hospital for Infectious Diseases 'Dr. Fran Mihaljevic',Zagreb,Croatia.
authors.forename: O Dakovic
authors.initials: OD
authors.lastname: Rode
authors.affiliation: University Hospital for Infectious Diseases 'Dr. Fran Mihaljevic',Zagreb,Croatia.
authors.forename: R
authors.initials: R
authors.lastname: Civljak
authors.affiliation: University Hospital for Infectious Diseases 'Dr. Fran Mihaljevic',Zagreb,Croatia.
authors.forename: I
authors.initials: I
authors.lastname: Kuzman
authors.affiliation: University Hospital for Infectious Diseases 'Dr. Fran Mihaljevic',Zagreb,Croatia.
authors.forename: A
authors.initials: A
authors.lastname: Markotic
mesh_terms: D000818:Animals; D003411:Arvicolinae; D017523:Croatia / Q000453:epidemiology; D004196:Disease Outbreaks; D006480:Hemorrhagic Fever with Renal Syndrome / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D051189:Murinae; D029262:Puumala virus / Q000302:isolation & purification*; D012621:Seasons