Department of Microbiology, the Institute for Viral Diseases, Korea University College of Medicine, Seoul, Republic of Korea.
Biosafety Center, Korea University College of Medicine, Seoul, Republic of Korea.
PLoS Negl Trop Dis. 2021 Feb 22;15(2):e0009168. doi: 10.1371/journal.pntd.0009168. eCollection 2021 Feb.
Of various rodent-borne hantaviruses, Seoul orthohantavirus (SEOV) causes haemorrhagic fever with renal syndrome (HFRS), as does Hantaan orthohantavirus (HTNV). Given global-scale of cases of human infection with SEOV, it is of great clinical importance to distinguish SEOV from other HFRS-causing hantaviruses. In May 2019, a middle-aged patient who had lived in a suburban area of Chungcheong Province, Republic of Korea and enjoyed outdoor activities was transferred to Asan Medical Center in Seoul, Republic of Korea with HFRS; his symptoms included high fever and generalized myalgia. The rapid diagnostic test performed immediately after his transfer detected HTNV-specific antibodies, and the patient was treated accordingly. However, two consecutive IFAs performed at ten-day intervals showed no HTNV-specific immunoglobulin (Ig) G. During continuous supportive care, next-generation sequencing successfully identified viral genomic sequences in the patient's serum, which were SEOV and not HTNV. Phylogenetic analysis grouped the L, M, and S genes of this SEOV strain together with those of rat- or human-isolated Korean strains reported previously. Given global outbreaks and public health threats of zoonotic hantaviruses, a causative pathogen of hantavirus HFRS should be identified correctly at the time of diagnosis and by point-of-care testing.
在各种啮齿动物传播的汉坦病毒中，首尔型汉坦病毒（SEOV）可引起肾综合征出血热（HFRS），汉坦病毒（HTNV）也是如此。鉴于全球范围内 SEOV 感染人类的病例数量，将 SEOV 与其他引起 HFRS 的汉坦病毒区分开来具有重要的临床意义。2019 年 5 月，一名居住在韩国忠清道郊区、喜欢户外活动的中年患者因 HFRS 被转诊至首尔的 Asan 医疗中心；他的症状包括高热和全身肌肉疼痛。患者转院后立即进行的快速诊断检测检测到了 HTNV 特异性抗体，并进行了相应治疗。然而，相隔 10 天连续进行的两次间接免疫荧光法（IFA）检测均未检测到 HTNV 特异性免疫球蛋白（Ig）G。在持续的支持性治疗过程中，下一代测序成功在患者血清中鉴定出了病毒基因组序列，结果显示为 SEOV，而非 HTNV。系统进化分析将该 SEOV 株的 L、M 和 S 基因与之前报道的鼠源或人源分离的韩国株聚集在一起。鉴于人畜共患汉坦病毒的全球暴发和对公共卫生的威胁，在诊断和即时检测时应正确识别 HFRS 的病原体。
