Vapalahti Olli, Mustonen Jukka, Lundkvist Ake, Henttonen Heikki, Plyusnin Alexander, Vaheri Antti
Division of Microbiology and Epidemiology, Faculty of Veterinary Medicine, University of Helsinki and HUCH Laboratory Diagnostics, Helsinki University Central Hospital, Finland.
Lancet Infect Dis. 2003 Oct;3(10):653-61. doi: 10.1016/s1473-3099(03)00774-6.
Hantaviruses are enveloped RNA viruses each carried by a specific rodent species. Three hantaviruses, Puumala, Dobrava, and Saaremaa viruses, are known to cause haemorrhagic fever with renal syndrome. In Europe. Puumala causes a generally mild disease, nephropathia epidemica, which presents most commonly with fever, headache, gastrointestinal symptoms, impaired renal function, and blurred vision, whereas Dobrava infections often also have haemorrhagic complications. There are few available data about the clinical picture of confirmed Saaremaa infections, but epidemiological evidence suggests that it is less pathogenic than Dobrava, and that Saaremaa infections are more similar to nephropathia epidemica caused by Puumala. Along with its rodent host, the bank vole (Clethrionomys glareolus), Puumala is reported throughout most of Europe (excluding the Mediterranean region), whereas Dobrava, carried by the yellow-necked mouse (Apodemus flavicollis), and Saaremaa, carried by the striped field mouse (Apodemus agrarius), are reported mainly in eastern and central Europe. The diagnosis of acute hantavirus infection is based on the detection of virus-specific IgM. Whereas Puumala is distinct, Dobrava and Saaremaa are genetically and antigenically very closely related and were previously thought to be variants of the same virus. Typing of a specific hantavirus infection requires neutralisation antibody assays or reverse transcriptase PCR and sequencing.
汉坦病毒是包膜RNA病毒，每种病毒由特定的啮齿动物携带。已知三种汉坦病毒，即普马拉病毒、多布拉瓦病毒和萨雷马病毒，可引起肾综合征出血热。在欧洲，普马拉病毒引起的疾病通常较轻，即流行性肾病，最常见的症状是发热、头痛、胃肠道症状、肾功能受损和视力模糊，而多布拉瓦病毒感染通常还伴有出血并发症。关于确诊的萨雷马病毒感染的临床表现，可用数据很少，但流行病学证据表明，它的致病性比多布拉瓦病毒弱，且萨雷马病毒感染与普马拉病毒引起的流行性肾病更为相似。普马拉病毒与其啮齿动物宿主棕背䶄（Clethrionomys glareolus）一起，在欧洲大部分地区（不包括地中海地区）均有报道，而多布拉瓦病毒由黄颈姬鼠（Apodemus flavicollis）携带，萨雷马病毒由条纹田鼠（Apodemus agrarius）携带，主要在东欧和中欧有报道。急性汉坦病毒感染的诊断基于病毒特异性IgM的检测。普马拉病毒有所不同，而多布拉瓦病毒和萨雷马病毒在基因和抗原方面密切相关，以前被认为是同一病毒的变种。特定汉坦病毒感染的分型需要中和抗体检测或逆转录酶PCR及测序。
