Drewes S, Turni H, Rosenfeld U M, Obiegala A, Straková P, Imholt C, Glatthaar E, Dressel K, Pfeffer M, Jacob J, Wagner-Wiening C, Ulrich R G
Friedrich-Loeffler-Institut, Institute for Novel and Emerging Infectious Diseases, Greifswald - Insel Riems, Germany.
Stauss & Turni Gutachterbüro, Tübingen, Germany.
Zoonoses Public Health. 2017 Aug;64(5):381-390. doi: 10.1111/zph.12319. Epub 2016 Dec 5.
Endemic regions for Puumala virus (PUUV) are located in the most affected federal state Baden-Wuerttemberg, South-West Germany, where high numbers of notified human hantavirus disease cases have been occurring for a long time. The distribution of human cases in Baden-Wuerttemberg is, however, heterogeneous, with a high number of cases recorded during 2012 in four districts (H districts) but a low number or even no cases recorded in four other districts (L districts). Bank vole monitoring during 2012, following a beech (Fagus sylvatica) mast year, resulted in the trapping of 499 bank voles, the host of PUUV. Analyses indicated PUUV prevalences of 7-50% (serological) and 1.8-27.5% (molecular) in seven of eight districts, but an absence of PUUV in one L district. The PUUV prevalence differed significantly between bank voles in H and L districts. In the following year 2013, 161 bank voles were trapped, with reduced bank vole abundance in almost all investigated districts except one. In 2013, no PUUV infections were detected in voles from seven of eight districts. In conclusion, the linear modelling approach indicated that the heterogeneous distribution of human PUUV cases in South-West Germany was caused by different factors including the abundance of PUUV RNA-positive bank voles, as well as by the interaction of beech mast and the proportional coverage of beech and oak (Quercus spec.) forest per district. These results can aid developing local public health risk management measures and early warning models.
普马拉病毒（PUUV）的地方性流行区域位于受影响最严重的德国西南部联邦州巴登 - 符腾堡州，长期以来该州报告的人类汉坦病毒病病例数量众多。然而，巴登 - 符腾堡州人类病例的分布并不均匀，2012年在四个区（高病例区）记录了大量病例，但在其他四个区（低病例区）记录的病例数很少甚至没有病例。2012年，在山毛榉（欧洲山毛榉）果实大年之后进行的田鼠监测中，捕获了499只作为PUUV宿主的田鼠。分析表明，在八个区中的七个区，PUUV血清学流行率为7% - 50%，分子流行率为1.8% - 27.5%，但在一个低病例区未检测到PUUV。高病例区和田鼠中的PUUV流行率差异显著。在接下来的2013年，捕获了161只田鼠，除一个区外，几乎所有调查区的田鼠数量都有所减少。2013年，在八个区中的七个区的田鼠中未检测到PUUV感染。总之，线性建模方法表明，德国西南部人类PUUV病例的不均匀分布是由多种不同因素造成的，包括PUUV RNA阳性田鼠的数量，以及山毛榉果实大年与每个区山毛榉和橡树（栎属）森林的比例覆盖率之间的相互作用。这些结果有助于制定当地公共卫生风险管理措施和早期预警模型。
