Department of Virology, University of Helsinki, 00290 Helsinki, Finland.
Department of Virology and Immunology, Helsinki University Hospital Laboratory (HUSLAB), 00290 Helsinki, Finland.
Viruses. 2019 Jul 19;11(7):661. doi: 10.3390/v11070661.
Puumala virus (PUUV) is the most common cause of hantavirus infection in Europe, with thousands of cases occurring particularly in Northern, Central and Eastern Europe and Russia. It causes a mild form of hemorrhagic fever with renal syndrome also known as nephropathia epidemica (NE) with clinical picture ranging from mild to severe. Currently, the laboratory diagnosis of NE is mainly based on serology. Here, we evaluated a real-time one-step qRT-PCR (PUUV-qRT-PCR) for detection of PUUV with 238 consecutive diagnostic serum samples from patients with suspected PUUV infection. The PUUV-qRT-PCR was both specific and sensitive for PUUV RNA. The analytical sensitivity (limit of detection) was estimated to be four copies of PUUV per reaction. Altogether 28 out of 30 (93%) PUUV IgM positive samples were positive also for PUUV RNA. No false positives were detected and the specificity was thus 100%. Interestingly, one sample was found positive in PUUV-qRT-PCR prior to subsequent IgM and IgG seroconversion. PUUV-qRT-PCR could be used for diagnostics in the early phase of NE infection and might be helpful especially in the rare severe cases when the patient's condition may deteriorate rapidly.
普马拉病毒（PUUV）是欧洲最常见的汉坦病毒感染原因，数千例病例主要发生在北欧、中欧和东欧以及俄罗斯。它引起一种轻度出血热伴肾综合征，也称为流行性肾病（NE），临床表现从轻到重不等。目前，NE 的实验室诊断主要基于血清学。在这里，我们评估了一种用于检测 PUUV 的实时一步 qRT-PCR（PUUV-qRT-PCR），共检测了 238 份疑似 PUUV 感染患者的连续诊断血清样本。PUUV-qRT-PCR 对 PUUV RNA 具有特异性和敏感性。分析灵敏度（检测限）估计为每个反应 4 个拷贝的 PUUV。总共 30 个（93%）PUUV IgM 阳性样本中有 28 个也为 PUUV RNA 阳性。未检测到假阳性，特异性为 100%。有趣的是，在随后的 IgM 和 IgG 血清转化之前，有一个样本在 PUUV-qRT-PCR 中呈阳性。PUUV-qRT-PCR 可用于 NE 感染的早期诊断，尤其是在病情可能迅速恶化的罕见重症病例中可能会有所帮助。
