Risk Factors and Potential Preventive Measures for Nephropatia Epidemica in Sweden 2011-2012: a Case-control Study

Overview

Journal Infect Ecol Epidemiol

Specialty Microbiology

Date 2015 Jul 3

PMID 26134289

Citations 10

Authors

Alin Gherasim

Marika Hjertqvist

Ake Lundkvist

Sharon Kuhlmann-Berenzon

Jenny Verner Carlson

Stephan Stenmark

Mikael Widerstrom

Anders Osterlund

Hans Boman

Clas Ahlm

Anders Wallensten

Affiliations

Soon will be listed here.

Abstract

Introduction: Nephropatia epidemica (NE), a relatively mild form of hemorrhagic fever with renal syndrome caused by the Puumala virus (PUUV), is endemic in northern Sweden. We aim to study the risk factors associated with NE in this region.

Methods: We conducted a matched case-control study between June 2011 and July 2012. We compared confirmed NE cases with randomly selected controls, matched by age, sex, and place of infection or residence. We analyzed the association between NE and several occupational, environmental, and behavioral exposures using conditional logistic regression.

Results: We included in the final analysis 114 cases and 300 controls, forming 246 case-control pairs. Living in a house with an open space beneath, making house repairs, living less than 50 m from the forest, seeing rodents, and smoking were significantly associated with NE.

Conclusion: Our results could orient public health policies targeting these risk factors and subsequently reduce the NE burden in the region.

Citing Articles

Clinical and genomic characterisation of a fatal Puumala orthohantavirus case with low levels of neutralising antibodies.

Back A, Rasmuson J, Thunberg T, Rankin G, Wigren Bystrom J, Andersson C Infect Dis (Lond). 2022; 54(10):766-772.

PMID: 35713235 PMC: 9908776. DOI: 10.1080/23744235.2022.2076904.

Central Nervous System and Ocular Manifestations in Puumala Hantavirus Infection.

Hautala N, Partanen T, Kubin A, Kauma H, Hautala T Viruses. 2021; 13(6).

PMID: 34072819 PMC: 8229408. DOI: 10.3390/v13061040.

Epidemiologic Characteristics of Domestic Patients with Hemorrhagic Fever with Renal Syndrome in Taiwan: A 19-Year Retrospective Study.

Hsieh C, Li C, Cheng C, Wu D, Wu W, Lin F Int J Environ Res Public Health. 2020; 17(15).

PMID: 32708017 PMC: 7432905. DOI: 10.3390/ijerph17155291.

Preliminary insights into the genetics of bank vole tolerance to Puumala hantavirus in Sweden.

Rohfritsch A, Galan M, Gautier M, Gharbi K, Olsson G, Gschloessl B Ecol Evol. 2018; 8(22):11273-11292.

PMID: 30519443 PMC: 6262921. DOI: 10.1002/ece3.4603.

Emerging Rodent-Borne Viral Zoonoses in Trento, Italy.

Tagliapietra V, Rosa R, Rossi C, Rosso F, Hauffe H, Tommasini M Ecohealth. 2018; 15(3):695-704.

PMID: 29796719 DOI: 10.1007/s10393-018-1335-4.

References

Hautala T, Hautala N, Mahonen S, Sironen T, Paakko E, Karttunen A . Young male patients are at elevated risk of developing serious central nervous system complications during acute Puumala hantavirus infection. BMC Infect Dis. 2011; 11:217. PMC: 3166934. DOI: 10.1186/1471-2334-11-217. View

Olsson G, White N, Hjalten J, Ahlm C . Habitat factors associated with bank voles (Clethrionomys glareolus) and concomitant hantavirus in northern Sweden. Vector Borne Zoonotic Dis. 2006; 5(4):315-23. DOI: 10.1089/vbz.2005.5.315. View

Ahlm C, Thelin A, Elgh F, Juto P, Stiernstrom E, Holmberg S . Prevalence of antibodies specific to Puumala virus among farmers in Sweden. Scand J Work Environ Health. 1998; 24(2):104-8. DOI: 10.5271/sjweh.286. View

Schwarz A, Ranft U, Piechotowski I, Childs J, Brockmann S . Risk factors for human infection with Puumala virus, southwestern Germany. Emerg Infect Dis. 2009; 15(7):1032-9. PMC: 2744254. DOI: 10.3201/eid1507.081413. View

Ahlm C, Linderholm M, Juto P, Stegmayr B, Settergren B . Prevalence of serum IgG antibodies to Puumala virus (haemorrhagic fever with renal syndrome) in northern Sweden. Epidemiol Infect. 1994; 113(1):129-36. PMC: 2271219. DOI: 10.1017/s0950268800051542. View

Reusken C, Heyman P . Factors driving hantavirus emergence in Europe. Curr Opin Virol. 2013; 3(1):92-9. DOI: 10.1016/j.coviro.2013.01.002. View

Vapalahti O, Mustonen J, Lundkvist A, Henttonen H, Plyusnin A, Vaheri A . Hantavirus infections in Europe. Lancet Infect Dis. 2003; 3(10):653-61. DOI: 10.1016/s1473-3099(03)00774-6. View

Lundkvist A, Fatouros A, Niklasson B . Antigenic variation of European haemorrhagic fever with renal syndrome virus strains characterized using bank vole monoclonal antibodies. J Gen Virol. 1991; 72 ( Pt 9):2097-103. DOI: 10.1099/0022-1317-72-9-2097. View

Sjolander K, Elgh F, Kallio-Kokko H, Vapalahti O, Hagglund M, Palmcrantz V . Evaluation of serological methods for diagnosis of Puumala hantavirus infection (nephropathia epidemica). J Clin Microbiol. 1997; 35(12):3264-8. PMC: 230159. DOI: 10.1128/jcm.35.12.3264-3268.1997. View

10.

Winter C, Brockmann S, Piechotowski I, Alpers K, An der Heiden M, Koch J . Survey and case-control study during epidemics of Puumala virus infection. Epidemiol Infect. 2009; 137(10):1479-85. DOI: 10.1017/S0950268809002271. View

11.

Van Loock F, Thomas I, Clement J, Ghoos S, Colson P . A case-control study after a hantavirus infection outbreak in the south of Belgium: who is at risk?. Clin Infect Dis. 2000; 28(4):834-9. DOI: 10.1086/515196. View

12.

Vapalahti O, Lundkvist A, Kallio-Kokko H, Paukku K, Julkunen I, Lankinen H . Antigenic properties and diagnostic potential of puumala virus nucleocapsid protein expressed in insect cells. J Clin Microbiol. 1996; 34(1):119-25. PMC: 228743. DOI: 10.1128/jcm.34.1.119-125.1996. View

13.

Olsson G, Dalerum F, Hornfeldt B, Elgh F, Palo T, Juto P . Human hantavirus infections, Sweden. Emerg Infect Dis. 2004; 9(11):1395-401. PMC: 3035548. DOI: 10.3201/eid0911.030275. View

14.

Lundkvist A, Hukic M, Horling J, Gilljam M, Nichol S, Niklasson B . Puumala and Dobrava viruses cause hemorrhagic fever with renal syndrome in Bosnia-Herzegovina: evidence of highly cross-neutralizing antibody responses in early patient sera. J Med Virol. 1997; 53(1):51-9. View

15.

Crowcroft N, Infuso A, Ilef D, Le Guenno B, Desenclos J, Van Loock F . Risk factors for human hantavirus infection: Franco-Belgian collaborative case-control study during 1995-6 epidemic. BMJ. 1999; 318(7200):1737-8. PMC: 31102. DOI: 10.1136/bmj.318.7200.1737. View

16.

Viel J, Lefebvre A, Marianneau P, Joly D, Giraudoux P, Upegui E . Environmental risk factors for haemorrhagic fever with renal syndrome in a French new epidemic area. Epidemiol Infect. 2010; 139(6):867-74. DOI: 10.1017/S0950268810002062. View

17.

Makary P, Kanerva M, Ollgren J, Virtanen M, Vapalahti O, Lyytikainen O . Disease burden of Puumala virus infections, 1995-2008. Epidemiol Infect. 2010; 138(10):1484-92. DOI: 10.1017/S0950268810000087. View

18.

Vaheri A, Henttonen H, Voutilainen L, Mustonen J, Sironen T, Vapalahti O . Hantavirus infections in Europe and their impact on public health. Rev Med Virol. 2012; 23(1):35-49. DOI: 10.1002/rmv.1722. View

19.

Vapalahti K, Virtala A, Vaheri A, Vapalahti O . Case-control study on Puumala virus infection: smoking is a risk factor. Epidemiol Infect. 2009; 138(4):576-84. DOI: 10.1017/S095026880999077X. View