Indonesia Research Partnership on Infectious Disease (INA-RESPOND), Jakarta 10560, Indonesia.
Ima Nurisa Ibrahim, National Institute of Health Research and Development, Ministry of Health of Republic of Indonesia, Jakarta 10560, Indonesia.
Viruses. 2019 Jul 31;11(8):698. doi: 10.3390/v11080698.
Dengue and other common tropical infectious diseases of similar clinical presentation are endemic in Indonesia, which may lead to an underestimation of the prevalence of hantavirus (HTV) infection in the country. To better understand the current burden of HTV infection, this study aimed to both identify acute HTV infection among hospitalized patients with fever and to determine the overall seroprevalence of HTV. These results were further considered within the context of previously reported HTV infection in humans and animals in Indonesia by conducting a review of published literature. As part of an observational cohort study of acute febrile illness, this sub-study retrospectively analyzed blood specimens obtained during admission, during the 2-4-week convalescent period, and three months after admission. Convalescent specimens from patients with clinical signs and symptoms of HTV infection were first screened for HTV IgG. When positive, convalescent specimens and paired acute specimens were screened for HTV IgM, and paired acute specimens were tested for HTV by Reverse Transcription Polymerase Chain Reaction (RT-PCR). A literature review of HTV in Indonesia was conducted on manuscripts manually reviewed for relevance after identification from a search using the terms "hantavirus/Seoul virus" and "Indonesia". From patients at eight hospitals in seven provincial capitals, HTV IgG seroprevalence was 11.6% (38/327), with the highest being in Denpasar (16.3%, 7/43) and the lowest being in Yogyakarta (3.4%, 1/31). Anti-HTV IgG was most prevalent in adults (13.5%, 33/244) and males (15.6%, 29/186). Acute HTV infections were identified in two subjects, both of whom had Seoul virus. In Indonesia, HTVs have been studied in humans and animals since 1984. Over the past 35 years, the reported seroprevalences in rodents ranged from 0% to 34%, and in humans from 0% to 13%. Fourteen acute infections have been reported, including one in a tourist returning to Germany, but only two have been confirmed by RT-PCR. Almost all rodent and human surveillance results demonstrated serological and molecular evidence of Seoul virus infection. However, in Semarang, anti-Puumala virus IgM has been detected in humans and Puumala RNA in one rodent. In Serang, a new virus named Serang virus was identified due to its differences from Seoul virus. In Maumere, HTV and were identified simultaneously in rodents. The burden of HTV infection in Indonesia is underestimated, and additional studies are needed to understand the true prevalence. Seroprevalence data reported here, previous observations of HTV co-infections in rodents, and the prevalence of rodent-borne bacterial infections in Indonesia suggest that the population may be routinely encountering HTVs. While Seoul virus appears to be the most prevalent HTV in the country, further studies are needed to understand which HTVs are circulating.
登革热和其他具有类似临床特征的常见热带传染病在印度尼西亚流行，这可能导致该国汉坦病毒（HTV）感染的流行率被低估。为了更好地了解 HTV 感染的当前负担，本研究旨在鉴定住院发热患者中的急性 HTV 感染，并确定 HTV 的总体血清流行率。通过对印度尼西亚已发表文献中人类和动物 HTV 感染的回顾性综述，进一步考虑了这些结果。作为急性发热性疾病的观察性队列研究的一部分，该子研究回顾性分析了入院期间、2-4 周恢复期和入院后三个月获得的血液标本。首先对有 HTV 感染临床症状和体征的患者的恢复期标本进行 HTV IgG 筛查。当呈阳性时，对恢复期和配对急性标本进行 HTV IgM 筛查，对配对急性标本进行逆转录聚合酶链反应（RT-PCR）检测 HTV。对印度尼西亚的 HTV 进行文献综述，对使用“汉坦病毒/汉城病毒”和“印度尼西亚”这两个术语进行手动搜索后确定的相关文献进行综述。从七个省会的八家医院的患者中，HTV IgG 血清流行率为 11.6%（38/327），其中登巴萨最高（16.3%，7/43），日惹最低（3.4%，1/31）。抗-HTV IgG 在成年人（13.5%，33/244）和男性（15.6%，29/186）中最为常见。有 2 例急性 HTV 感染，均为汉城病毒。自 1984 年以来，印度尼西亚一直在人类和动物中研究 HTV。在过去的 35 年里，鼠类的报告血清流行率为 0%至 34%，人类为 0%至 13%。已报告了 14 例急性感染，包括一名返回德国的游客，但只有 2 例通过 RT-PCR 得到证实。几乎所有的啮齿动物和人类监测结果都表明存在汉城病毒感染的血清学和分子证据。然而，在三宝垄，人类中检测到抗普马拉病毒 IgM，在一只啮齿动物中检测到普马拉病毒 RNA。在西朗，由于与汉城病毒的差异，鉴定出一种名为西朗病毒的新病毒。在马穆雷，在啮齿动物中同时检测到 HTV 和 。印度尼西亚的 HTV 感染负担被低估了，需要进一步的研究来了解真实的流行率。这里报告的血清流行率数据、以前在啮齿动物中观察到的 HTV 合并感染以及印度尼西亚携带细菌的啮齿动物感染的流行率表明，人群可能经常接触 HTV。虽然汉城病毒似乎是该国最流行的 HTV，但需要进一步的研究来了解哪些 HTV 正在传播。
