Heyman Paul, Thoma Bryan R, Marié Jean-Lou, Cochez Christel, Essbauer Sandra Simone
Epidemiology and Biostatistics, Research Laboratory for Vector-Borne Diseases, Queen Astrid Military Hospital Brussels, Belgium.
Front Physiol. 2012 Jul 10;3:237. doi: 10.3389/fphys.2012.00237. eCollection 2012.
In Europe, hantaviruses (Bunyaviridae) are small mammal-associated zoonotic and emerging pathogens that can cause hemorrhagic fever with renal syndrome (HFRS). Puumala virus, the main etiological agent carried by the bank vole Myodes glareolus is responsible for a mild form of HFRS while Dobrava virus induces less frequent but more severe cases of HFRS. Since 2000 in Europe, more than 3000 cases of HFRS have been recorded, in average, each year, which is nearly double compared to the previous decade. In addition to this upside long-term trend, significant oscillations occur. Epidemic years appear, usually every 2-4 years, with an increased incidence, generally in localized hot spots. Moreover, the virus has been identified in new areas in the recent years. A great number of surveys have been carried out in order to assess the prevalence of the infection in the reservoir host and to identify links with different biotic and abiotic factors. The factors that drive the infections are related to the density and diversity of bank vole populations, prevalence of infection in the reservoir host, viral excretion in the environment, survival of the virus outside its host, and human behavior, which affect the main transmission virus route through inhalation of infected rodent excreta. At the scale of a rodent population, the prevalence of the infection increases with the age of the individuals but also other parameters, such as sex and genetic variability, interfere. The contamination of the environment may be correlated to the number of newly infected rodents, which heavily excrete the virus. The interactions between these different parameters add to the complexity of the situation and explain the absence of reliable tools to predict epidemics. In this review, the factors that drive the epidemics of hantaviruses in Middle Europe are discussed through a panorama of the epidemiological situation in Belgium, France, and Germany.
在欧洲，汉坦病毒（布尼亚病毒科）是与小型哺乳动物相关的人畜共患新兴病原体，可引起肾综合征出血热（HFRS）。普马拉病毒是黄毛姬鼠携带的主要病原体，可引发症状较轻的HFRS，而多布拉瓦病毒引发的HFRS病例虽较少，但病情更严重。自2000年以来，欧洲平均每年记录到3000多例HFRS病例，几乎是前十年的两倍。除了这种长期上升趋势外，还出现了显著波动。疫情年份通常每2 - 4年出现一次，发病率上升，且一般集中在局部热点地区。此外，近年来该病毒在新的地区被发现。为评估宿主动物感染的流行情况以及确定与不同生物和非生物因素的关联，已开展了大量调查。导致感染的因素与黄毛姬鼠种群的密度和多样性、宿主动物感染的流行情况、病毒在环境中的排泄、病毒在宿主外的存活以及人类行为有关，人类行为通过吸入受感染啮齿动物排泄物影响主要病毒传播途径。在啮齿动物种群层面，感染流行率随个体年龄增长而增加，但其他参数，如性别和遗传变异性也会产生影响。环境污染可能与新感染啮齿动物的数量相关，这些动物大量排泄病毒。这些不同参数之间的相互作用增加了情况的复杂性，也解释了为何缺乏可靠的疫情预测工具。在本综述中，通过对比利时、法国和德国流行病学情况的全景描述，讨论了中欧汉坦病毒流行的驱动因素。
