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Molecular and epidemiological characteristics of human Puumala and Dobrava-Belgrade hantavirus infections, Germany, 2001 to 2017.
Euro Surveill. 2019 Aug; 24(32)ES

Abstract

IntroductionTwo hantavirus species, Puumala (PUUV) and Dobrava-Belgrade (DOBV) virus (genotype Kurkino), are endemic in Germany. Recent PUUV outbreaks raised questions concerning increasing frequency of outbreaks and expansion of PUUV endemic areas.AimsTo describe the epidemiology of human PUUV and DOBV infections in Germany.MethodsWe conducted an observational retrospective study analysing national hantavirus surveillance data notified to the national public health institute and hantavirus nucleotide sequences from patients collected at the national consultation laboratory between 2001 and 2017. Matching molecular sequences with surveillance data, we conducted epidemiological, phylogenetic and phylogeographic analyses.ResultsIn total, 12,148 cases of symptomatic hantavirus infection were notified 2001-17 (mean annual incidence: 0.87/100,000; range: 0.09-3.51). PUUV infections showed a highly variable space-time disease incidence pattern, causing large outbreaks every 2-3 years with peaks in early summer and up to 3,000 annually reported cases. Sex-specific differences in disease presentation were observed. Of 202 PUUV nucleotide sequences obtained from cases, 189 (93.6%) fall into well-supported phylogenetic clusters corresponding to different endemic areas in Germany. DOBV infections caused few, mostly sporadic cases in autumn and winter in the north and east of Germany.ConclusionsThe frequency of PUUV outbreaks increased between 2001 and 2017 but our data does not support the suggested expansion of endemic areas. The epidemiology of PUUV and DOBV-Kurkino infections differs in several aspects. Moreover, the latter are relatively rare and combining efforts and data of several countries to identify risk factors and develop specific recommendations for prevention could be worthwhile.

Authors+Show Affiliations

Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany.Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany.Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.These authors contributed equally and share last authorship. Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany.These authors contributed equally and share last authorship. Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31411134

Citation

Faber, Mirko, et al. "Molecular and Epidemiological Characteristics of Human Puumala and Dobrava-Belgrade Hantavirus Infections, Germany, 2001 to 2017." Euro Surveillance : Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin, vol. 24, no. 32, 2019.
Faber M, Krüger DH, Auste B, et al. Molecular and epidemiological characteristics of human Puumala and Dobrava-Belgrade hantavirus infections, Germany, 2001 to 2017. Euro Surveill. 2019;24(32).
Faber, M., Krüger, D. H., Auste, B., Stark, K., Hofmann, J., & Weiss, S. (2019). Molecular and epidemiological characteristics of human Puumala and Dobrava-Belgrade hantavirus infections, Germany, 2001 to 2017. Euro Surveillance : Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin, 24(32). https://doi.org/10.2807/1560-7917.ES.2019.24.32.1800675
Faber M, et al. Molecular and Epidemiological Characteristics of Human Puumala and Dobrava-Belgrade Hantavirus Infections, Germany, 2001 to 2017. Euro Surveill. 2019;24(32) PubMed PMID: 31411134.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Molecular and epidemiological characteristics of human Puumala and Dobrava-Belgrade hantavirus infections, Germany, 2001 to 2017. AU - Faber,Mirko, AU - Krüger,Detlev H, AU - Auste,Brita, AU - Stark,Klaus, AU - Hofmann,Jörg, AU - Weiss,Sabrina, PY - 2019/8/15/entrez PY - 2019/8/15/pubmed PY - 2020/7/17/medline KW - Central Europe KW - Disease Notification KW - Dobrava-belgrade virus KW - Environmental Exposure KW - Germany KW - HFRS KW - Hantavirus KW - Humans KW - Molecular epidemiology KW - Outbreak KW - Phylogeography KW - Puumala virus KW - Zoonoses JF - Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin JO - Euro Surveill. VL - 24 IS - 32 N2 - IntroductionTwo hantavirus species, Puumala (PUUV) and Dobrava-Belgrade (DOBV) virus (genotype Kurkino), are endemic in Germany. Recent PUUV outbreaks raised questions concerning increasing frequency of outbreaks and expansion of PUUV endemic areas.AimsTo describe the epidemiology of human PUUV and DOBV infections in Germany.MethodsWe conducted an observational retrospective study analysing national hantavirus surveillance data notified to the national public health institute and hantavirus nucleotide sequences from patients collected at the national consultation laboratory between 2001 and 2017. Matching molecular sequences with surveillance data, we conducted epidemiological, phylogenetic and phylogeographic analyses.ResultsIn total, 12,148 cases of symptomatic hantavirus infection were notified 2001-17 (mean annual incidence: 0.87/100,000; range: 0.09-3.51). PUUV infections showed a highly variable space-time disease incidence pattern, causing large outbreaks every 2-3 years with peaks in early summer and up to 3,000 annually reported cases. Sex-specific differences in disease presentation were observed. Of 202 PUUV nucleotide sequences obtained from cases, 189 (93.6%) fall into well-supported phylogenetic clusters corresponding to different endemic areas in Germany. DOBV infections caused few, mostly sporadic cases in autumn and winter in the north and east of Germany.ConclusionsThe frequency of PUUV outbreaks increased between 2001 and 2017 but our data does not support the suggested expansion of endemic areas. The epidemiology of PUUV and DOBV-Kurkino infections differs in several aspects. Moreover, the latter are relatively rare and combining efforts and data of several countries to identify risk factors and develop specific recommendations for prevention could be worthwhile. SN - 1560-7917 UR - https://www.unboundmedicine.com/medline/citation/31411134/Molecular_and_epidemiological_characteristics_of_human_Puumala_and_Dobrava_Belgrade_hantavirus_infections_Germany_2001_to_2017_ L2 - http://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2019.24.32.1800675 DB - PRIME DP - Unbound Medicine ER -