Hantavirus Disease Outbreak in Germany: Limitations of Routine Serological Diagnostics and Clustering of Virus Sequences of Human and Rodent Origin

In Europe, hemorrhagic fever with renal syndrome results mainly from infection with Puumala virus (PUUV) or Dobrava virus. For 31 patients from a hantavirus disease outbreak in Lower Bavaria, a district in southeast Germany, serodiagnosis was undertaken by enzyme-linked immunosorbent assay, immunofl...

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Bibliographic Details
Published in:Journal of Clinical Microbiology 2007-09, Vol.45 (9), p.3008-3014
Main Authors: Schilling, Stefan, Emmerich, Petra, Klempa, Boris, Auste, Brita, Schnaith, Ebbo, Schmitz, Herbert, Krüger, Detlev H, Günther, Stephan, Meisel, Helga
Format: Article
Language:English
Subjects:
Adult
Animals
Biological and medical sciences
Clethrionomys glareolus
Cluster Analysis
Disease Outbreaks
Dobrava virus
Enzyme-Linked Immunosorbent Assay
Female
Fluorescent Antibody Technique
Fundamental and applied biological sciences. Psychology
Germany - epidemiology
Hantavirus
Hantavirus Infections - diagnosis
Hantavirus Infections - epidemiology
Hantavirus Infections - virology
Humans
Immunoblotting
Male
Microbiology
Miscellaneous
Molecular Epidemiology
Molecular Sequence Data
Neutralization Tests
Phylogeny
Puumala virus
Puumala virus - classification
Puumala virus - genetics
Puumala virus - isolation & purification
Reverse Transcriptase Polymerase Chain Reaction
RNA, Viral - genetics
Rodentia - virology
Sequence Analysis, DNA
Serologic Tests
Serum - virology
Virology
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Summary:In Europe, hemorrhagic fever with renal syndrome results mainly from infection with Puumala virus (PUUV) or Dobrava virus. For 31 patients from a hantavirus disease outbreak in Lower Bavaria, a district in southeast Germany, serodiagnosis was undertaken by enzyme-linked immunosorbent assay, immunofluorescence assay, and immunoblot analysis. In a few of these cases, however, PUUV-specific typing of antibodies by these standard assays failed and a virus neutralization assay under biosafety level 3 conditions was required to verify the infection by this virus type. PUUV RNA was amplified by reverse transcription-PCR from acute-phase sera of three patients and was found to be very closely related to virus sequences obtained from bank voles (Clethrionomys glareolus) trapped in the same area. These findings link the outbreak with a novel PUUV lineage, "Bavaria," circulating in the local rodent population. The Bavaria lineage associated with the outbreak is only distantly related to other PUUV lineages from Germany.
ISSN:0095-1137
1098-660X
1098-5530
DOI:10.1128/JCM.02573-06