title: Surveillance of hantaviruses in Poland: a study of animal reservoirs and human hantavirus disease in Subcarpathia.
abstract: The first cluster of hemorrhagic fever with renal syndrome (HFRS) in Poland was identified in 2007 in the Subcarpathian region. The natural environment of this area is a key habitat for hantavirus vectors. The animal reservoir of existing human HFRS clusters was studied to assess the occurrence of viruses (including Tula virus, Puumala virus, and Dobrava-Belgrade virus) among rodents. We examined 70 suspected human cases with symptoms corresponding to the clinical picture of HFRS. Serological analysis (indirect immunofluorescence assay and immunoblot) confirmed the presence of anti-hantavirus antibodies in 18 patients, which were surveyed with regard to developed symptoms and presumed rodent contact. Seroepidemiological analysis of newly confirmed human cases was performed, putative areas of human exposure were studied, and 194 rodents were subsequently captured from identified areas. Internal organs (lungs, heart, spleen, bladder, and kidneys) were collected from 64 Apodemus flavicollis, 55 Apodemus agrarius, 40 Myodes glareolus, 21 Mus musculus, and 14 Microtus arvalis and tested for the presence of hantavirus RNA by reverse transcription and subsequent real-time PCR. Positive samples were also tested by indirect immunofluorescence. Animal reservoir surveillance enabled the first detection of Puumala virus and Dobrava-Belgrade virus among animals in Poland. Furthermore, some places where rodents were captured correlated with areas of residence of laboratory-confirmed human cases and likely detected virus species. Moreover, three species of hantaviruses coexisting in a relatively small area were identified.
authors.affiliation: 1 Biological Threats Identification and Countermeasure Center of Military Institute of Hygiene and Epidemiology , Warsaw-Puławy, Poland .
authors.forename: Aleksander
authors.initials: A
authors.lastname: Michalski
authors.forename: Marcin
authors.initials: M
authors.lastname: Niemcewicz
authors.forename: Agata
authors.initials: A
authors.lastname: Bielawska-Drózd
authors.forename: Anna
authors.initials: A
authors.lastname: Nowakowska
authors.forename: Jerzy
authors.initials: J
authors.lastname: Gaweł
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Pitucha
authors.forename: Justyna
authors.initials: J
authors.lastname: Joniec
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Zielonka
authors.forename: Anna
authors.initials: A
authors.lastname: Marciniak-Niemcewicz
authors.forename: Janusz
authors.initials: J
authors.lastname: Kocik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000914:Antibodies, Viral / Q000097:blood*; D003411:Arvicolinae / Q000821:virology; D004197:Disease Reservoirs / Q000821:virology*; D005260:Female; D006476:Orthohantavirus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006480:Hemorrhagic Fever with Renal Syndrome / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D051189:Murinae / Q000821:virology; D011044:Poland / Q000453:epidemiology; D012367:RNA, Viral / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D012377:Rodentia / Q000821:virology*; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D012367:RNA, Viral
keywords: Hantavirus; Rodent-borne; Zoonosis