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Atypical Severe Puumala Hantavirus Infection and Virus Sequence Analysis of the Patient and Regional Reservoir Host

  1. I. Eckerle1,†,
  2. E. Jakob2,
  3. J. Hofmann3,
  4. A. Schmidt-Bacher2,
  5. J. Ettinger3,
  6. P. Schnitzler4

Article first published online: 7 SEP 2012

DOI: 10.1111/j.1863-2378.2011.01452.x

Issue

Zoonoses and Public Health

Zoonoses and Public Health

Special Issue: Proceedings of the International Conference on Emerging Zoonoses, 24–27 February 2011, Cancun,Mexico

Volume 59, Issue Supplement s2, pages 110–115, September 2012

Additional Information

How to Cite

Eckerle, I., Jakob, E., Hofmann, J., Schmidt-Bacher, A., Ettinger, J. and Schnitzler, P. (2012), Atypical Severe Puumala Hantavirus Infection and Virus Sequence Analysis of the Patient and Regional Reservoir Host. Zoonoses and Public Health, 59: 110–115. doi: 10.1111/j.1863-2378.2011.01452.x

Author Information

  1. 1

     Department of Nephrology, University of Heidelberg, Heidelberg, Germany

  2. 2

    Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany

  3. 3

    Institute of Medical Virology, Helmut-Ruska-Haus, Charité University Medicine, Berlin, Germany

  4. 4

    Department of Infectious Diseases, Virology, University of Heidelberg, Heidelberg, Germany

  1. †

    Present address: Institute of Virology, Bonn Medical Centre, Sigmund-Freud Strasse 25, 53127 Bonn, Germany. Email: eckerle@virology-bonn.de

*P. Schnitzler. Department of Infectious Diseases, Virology, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany. Tel.: +49 6221 56 50 16; Fax: +49 6221 56 50 03; E-mail: paul_schnitzler@med.uni-heidelberg.de

  1. †

    Present address: Institute of Virology, Bonn Medical Centre, Sigmund-Freud Strasse 25, 53127 Bonn, Germany. Email: eckerle@virology-bonn.de

Publication History

  1. Issue published online: 7 SEP 2012
  2. Article first published online: 7 SEP 2012
  3. Received for publication November 24, 2011

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Keywords:

  • Hantavirus;
  • glaucoma;
  • hepatitis;
  • Puumala S segment;
  • reservoir host

Summary

Nephropathia epidemica (NE) caused by Puumala hantavirus (PUUV) is a mild variant of haemorrhagic fever with renal syndrome, which is endemic in Germany. We describe the case of a 67-year-old man initially presenting with acute bilateral angle-closure glaucoma, an atypical clinical presentation of PUUV infection. Subsequently, the patient developed a severe course of disease additionally complicated by profound hepatitis and interstitial nephritis, both phenomena which are rarely described in association with hantavirus infection. Serologic diagnosis was complicated by delayed antibody production until the 10th day of illness; however, PUUV RNA was detectable early in disease. To further analyse this unusual case, sequencing of the PUUV S segment was performed from the patient and regional reservoir host which showed a close relation.

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