Increased circulating extracellular vesicle tissue factor activity during #orthohantavirus #infection is associated with #intravascular #coagulation (J Infect Dis., abstract)

[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]

Increased circulating extracellular vesicle tissue factor activity during orthohantavirus infection is associated with intravascular coagulation

Clare M Schmedes, Steven P Grover, Yohei M Hisada, Marco Goeijenbier, Johan Hultdin, Sofie Nilsson, Therese Thunberg, Clas Ahlm, Nigel Mackman, Anne-Marie Fors Connolly

The Journal of Infectious Diseases, jiz597,

Published: 13 November 2019




Puumala (PUUV) orthohantavirus causes hemorrhagic fever with renal syndrome (HFRS). HFRS patients have an activated coagulation system with increased risk of disseminated intravascular coagulation (DIC) and venous thromboembolism (VTE). The aim of the study was to determine if circulating extracellular vesicle tissue factor (EVTF) activity levels associates with DIC and VTE (grouped as intravascular coagulation) in HFRS patients.


Longitudinal samples were collected from 88 HFRS patients. Patients were stratified into groups of those with intravascular coagulation (n=27) and those who did not (n=61). We measured levels of circulating EVTF activity, fibrinogen, activated partial prothrombin time, prothrombin time international normalized ratio, D-dimer, tissue plasminogen activator (tPA), plasminogen activator inhibitor 1 (PAI-1) and platelets.


Plasma EVTF activity was transiently increased during HFRS. Levels of EVTF activity significantly associated with plasma tPA and PAI-1, suggesting endothelial cells as a potential source. Patients with intravascular coagulation had significantly higher peak EVTF activity levels compared to those who did not. The peak EVTF activity value predicting intravascular coagulation was 0.51 ng/L with 63% sensitivity and 61% specificity with AUC 0.63 (95% CI 0.51 – 0.76), p-value 0.046.


Increased circulating EVTF activity during HFRS is associated with intravascular coagulation.

Hemorrhagic fever with renal syndrome, tissue factor, disseminated intravascular coagulation, thrombosis, orthohantavirus

Issue Section: Major Article

This content is only available as a PDF.

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (, which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact

Keywords: Orthohantavirus; Hantavirus; Puumala virus; HFRS; DIC.


#Hantavirus Pulmonary Syndrome in #Traveler Returning from #Nepal to #Spain (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 26, Number 1—January 2020 / Research Letter

Hantavirus Pulmonary Syndrome in Traveler Returning from Nepal to Spain

Elena Sulleiro1, Maria Luisa Aznar1, Núria Serre-Delcor, Fernando Salvador, Adrian Sanchez-Montalvá, Mateu Espasa, Daniel Molina, Fernando de Ory, M. Paz Sanchez-Seco, Israel Molina, Candido Diaz-Lagares, Miguel J. Martinez, Tomàs Pumarola, and Inés Oliveira

Author affiliations: Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain (E. Sulleiro, M.L. Aznar, N. Serre-Delcor, F. Salvador, A. Sanchez-Montalvá, M. Espasa, D. Molina, I. Molina, C. Diaz-Lagares, T. Pumarola, I. Oliveira); Instituto de Salud Carlos III, Majadahonda, Spain (F. de Ory, M.P. Sanchez-Seco); Hospital Clínic, Barcelona (M.J. Martinez)



Most human hantavirus infections occur in Asia, but some cases have been described in Europe in travelers returning from Asia. We describe a case of hantavirus pulmonary syndrome in a previously healthy traveler occurring shortly after he returned to Spain from Nepal. Serologic tests suggested a Puumala virus–like infection.

Keywords: Hantavirus; HPS; Puumala virus; Nepal; Spain.


#Hantavirus host assemblages and #human disease in the #Atlantic #Forest (PLoS Negl Trop Dis., abstract)

[Source: PLoS Neglected Tropical Diseases, full page: (LINK). Abstract, edited.]


Hantavirus host assemblages and human disease in the Atlantic Forest

Renata L. Muylaert , Ricardo Siqueira Bovendorp, Gilberto Sabino-Santos Jr, Paula R. Prist, Geruza Leal Melo, Camila de Fátima Priante, David A. Wilkinson, Milton Cezar Ribeiro, David T. S. Hayman

Published: August 12, 2019 / DOI: / This is an uncorrected proof.



Several viruses from the genus Orthohantavirus are known to cause lethal disease in humans. Sigmodontinae rodents are the main hosts responsible for hantavirus transmission in the tropical forests, savannas, and wetlands of South America. These rodents can shed different hantaviruses, such as the lethal and emerging Araraquara orthohantavirus. Factors that drive variation in host populations may influence hantavirus transmission dynamics within and between populations. Landscape structure, and particularly areas with a predominance of agricultural land and forest remnants, is expected to influence the proportion of hantavirus rodent hosts in the Atlantic Forest rodent community. Here, we tested this using 283 Atlantic Forest rodent capture records and geographically weighted models that allow us to test if predictors vary spatially. We also assessed the correspondence between proportions of hantavirus hosts in rodent communities and a human vulnerability to hantavirus infection index across the entire Atlantic Forest biome. We found that hantavirus host proportions were more positively influenced by landscape diversity than by a particular habitat or agricultural matrix type. Local small mammal diversity also positively influenced known pathogenic hantavirus host proportions, indicating that a plasticity to habitat quality may be more important for these hosts than competition with native forest dwelling species. We found a consistent positive effect of sugarcane and tree plantation on the proportion of rodent hosts, whereas defaunation intensity did not correlate with the proportion of hosts of potentially pathogenic hantavirus genotypes in the community, indicating that non-defaunated areas can also be hotspots for hantavirus disease outbreaks. The spatial match between host hotspots and human disease vulnerability was 17%, while coldspots matched 20%. Overall, we discovered strong spatial and land use change influences on hantavirus hosts at the landscape level across the Atlantic Forest. Our findings suggest disease surveillance must be reinforced in the southern and southeastern regions of the biome where the highest predicted hantavirus host proportion and levels of vulnerability spatially match. Importantly, our analyses suggest there may be more complex rodent community dynamics and interactions with human disease than currently hypothesized.


Author summary

Hantaviruses cause disease in people, mainly following transmission from wild rodents to people through contact with infected excreta. Wild rodents use different habitats, and many survive even in anthropogenically changed environments, but to an unknown extent. The objective of our study was to understand how these rodents respond to habitat change in the landscape, to biodiversity and to climate. We measured the proportion of pathogenic hantavirus hosts in the rodent community. We then investigated the spatial correspondence between this proportion and a vulnerability to pathogenic hantavirus infection index in humans within the Atlantic Forest. We found 12 well represented species of rodents that can carry at least one hantavirus genotype. Despite high variation in the host proportion data, the peaks of human vulnerability to disease occurs at higher levels of habitat diversity in the landscape, intermediate levels of rainfall, and areas with less than 15 species in the local small mammal community. Our results suggest hantavirus surveillance and prevention measures are needed in the south and south-east regions of Brazil where highest host proportions and levels of vulnerability spatially match.


Citation: Muylaert RL, Bovendorp RS, Sabino-Santos G Jr, Prist PR, Melo GL, Priante CdF, et al. (2019) Hantavirus host assemblages and human disease in the Atlantic Forest. PLoS Negl Trop Dis 13(8): e0007655.

Editor: Colleen B. Jonsson, University of Tennessee Health Science Center College of Medicine Memphis, UNITED STATES

Received: January 17, 2019; Accepted: July 24, 2019; Published: August 12, 2019

Copyright: © 2019 Muylaert et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: The input data is provided in S2 Table. All relevant data are within the manuscript, its Supporting Information files and in the ATLANTIC series files. The data underlying the results presented in the study is available at: Atlantic Forest data is available at:

Funding: This work was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo FAPESP to RLM ( (2015/17739-4, 2017/21816-0), GSSJ ( (2017/21816-0), RSB ( (2013/25441-0), PRP (2017/11666-0), and MCR ( (2013/50421-2); Royal Society Te Apārangi Rutherford Discovery Fellowship to DTSH ( (RDF-MAU1701); Conselho Nacional de Desenvolvimento Científico e Tecnológico CNPQ to MCR (425746/2016-0); Coordenação de Aperfeiçoamento de Pessoal de Nível Superior CAPES to MCR (312045/2013-1; 312292/2016-3) and RLM (33004137); and New Zealand Food Safety Science and Research Centre ( to DW (2019). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Keywords: Orthohantavirus; Hantavirus; Rodents; Human; Brazil.


Molecular and #epidemiological characteristics of #human #Puumala and #Dobrava-Belgrade #hantavirus #infections, #Germany, 2001 to 2017 (Euro Surveill., abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Molecular and epidemiological characteristics of human Puumala and Dobrava-Belgrade hantavirus infections, Germany, 2001 to 2017

Mirko Faber1, Detlev H Krüger2, Brita Auste2, Klaus Stark1, Jörg Hofmann2,3, Sabrina Weiss2,3

Affiliations: 1 Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany; 2 Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany; 3 These authors contributed equally and share last authorship

Correspondence:  Mirko Faber

Citation style for this article: Faber Mirko, Krüger Detlev H, Auste Brita, Stark Klaus, Hofmann Jörg, Weiss Sabrina. Molecular and epidemiological characteristics of human Puumala and Dobrava-Belgrade hantavirus infections, Germany, 2001 to 2017. Euro Surveill. 2019;24(32):pii=1800675.

Received: 11 Dec 2018;   Accepted: 09 May 2019




Two 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.


To describe the epidemiology of human PUUV and DOBV infections in Germany.


We 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.


In 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.


The 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.

© This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords: Hantavirus; Puumala virus; Dobrava virus; Human; Germany.


#Serological Evidence of #Thailand #Orthohantavirus or Antigenically Related Virus Infection Among #Rodents in a Chronic #Kidney Disease of Unknown Etiology #Endemic Area, Girandurukotte, #SriLanka (Vector Borne Zoo Dis., abstract)

[Source: Vector Borne and Zoonotic Diseases, full page: (LINK). Abstract, edited.]

Serological Evidence of Thailand Orthohantavirus or Antigenically Related Virus Infection Among Rodents in a Chronic Kidney Disease of Unknown Etiology Endemic Area, Girandurukotte, Sri Lanka

Sithumini M.W. Lokupathirage, Devinda S. Muthusinghe, Kenta Shimizu, Kumpei Nishigami, Kisho Noda, Yoshimi Tsuda, Yomani D. Sarathkumara, Sirimevan Gunawardana, Jiro Arikawa, Chandika D. Gamage, and Kumiko Yoshimatsu

Published Online: 24 Jul 2019 / DOI:



We have reported high seroprevalence to Thailand orthohantavirus (THAIV) or THAIV-related orthohantavirus (TRHV) among patients with chronic kidney disease of unknown etiology in Girandurukotte, Sri Lanka. THAIV or TRHV infection is considered to be transmitted by rodent hosts in this area, but its reservoir rodents have not yet been identified. Hence, 116 rodents were captured, and seroprevalences were examined by indirect immunofluorescent antibody assay (immunofluorescence assay [IFA]) using antigens of THAIV strain Thai749-infected Vero E6 cells and recombinant nucleocapsid protein of THAIV expressed in Vero E6 cell. Molecular biological species identification of rodents was carried out by sequencing rag1, irbp, and mitochondrial cytb genes. The majority (112/116) of the captured rodents were lineage Ib of black rats (Rattus rattus). Among them, 19.6% (22/112) of the rats possessed antibodies against THAIV. Also, a lesser bandicoot rat (Bandicota bengalensis), which belongs to the Sri Lankan endemic genetic lineage, was seropositive (1/1). Two Mus booduga and one Murinae sp. were seronegative. Rodent sera showed less cross-reactivities to antigens of Vero E6 cells infected with Hantaan orthohantavirus (HTNV), Seoul orthohantavirus (SEOV), and Puumala orthohantavirus (PUUV) in IFA. These results suggest that the hantavirus present in rodents in Sri Lanka is related to THAIV or TRHV rather than to SEOV, HTNV, or PUUV. However, it might be serologically distinct from the prototype THAIV strain, Thai749, used in this study. This study revealed that black rats and lesser bandicoot rats belonging to Sri Lankan endemic lineages are possible reservoirs for THAIV or TRHV in Girandurukotte. Further multiple geographical studies are needed to confirm the THAIV or TRHV reservoir status of black and lesser bandicoot rats in Sri Lanka.

Keywords: Orthohantavirus; Thailand orthohantavirus; Wildlife; Sri Lanka.


#Đakrông virus, a novel #mobatvirus (#Hantaviridae) harbored by the Stoliczka’s Asian trident #bat (Aselliscus stoliczkanus) in #Vietnam (Sci Rep., abstract)

[Source: Scientific Reports, full page: (LINK). Abstract, edited.]

Article | OPEN | Published: 15 July 2019

Đakrông virus, a novel mobatvirus (Hantaviridae) harbored by the Stoliczka’s Asian trident bat (Aselliscus stoliczkanus) in Vietnam

Satoru Arai, Keita Aoki, Nguyễn Trường Sơn, Vương Tân Tú, Fuka Kikuchi, Gohta Kinoshita, Dai Fukui, Hoàng Trung Thành, Se Hun Gu, Yasuhiro Yoshikawa, Keiko Tanaka-Taya, Shigeru Morikawa, Richard Yanagihara & Kazunori Oishi

Scientific Reports, volume 9, Article number: 10239 (2019)



The recent discovery of genetically distinct shrew- and mole-borne viruses belonging to the newly defined family Hantaviridae (order Bunyavirales) has spurred an extended search for hantaviruses in RNAlater®-preserved lung tissues from 215 bats (order Chiroptera) representing five families (Hipposideridae, Megadermatidae, Pteropodidae, Rhinolophidae and Vespertilionidae), collected in Vietnam during 2012 to 2014. A newly identified hantavirus, designated Đakrông virus (DKGV), was detected in one of two Stoliczka’s Asian trident bats (Aselliscus stoliczkanus), from Đakrông Nature Reserve in Quảng Trị Province. Using maximum-likelihood and Bayesian methods, phylogenetic trees based on the full-length S, M and L segments showed that DKGV occupied a basal position with other mobatviruses, suggesting that primordial hantaviruses may have been hosted by ancestral bats.

Keywords: Mobatvirus; Hantavirus; Bats; Bunyavirus; Dakrong virus; Vietnam.


#Kidney Diseases Associated With #Parvovirus B19, #Hanta, #Ebola, and #Dengue Virus #Infection: A Brief #Review (Adv Chronic Kidney Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Adv Chronic Kidney Dis. 2019 May;26(3):207-219. doi: 10.1053/j.ackd.2019.01.006.

Kidney Diseases Associated With Parvovirus B19, Hanta, Ebola, and Dengue Virus Infection: A Brief Review.

Prasad N1, Novak JE2, Patel MR3.

Author information: 1 Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. Electronic address: 2 Division of Nephrology, Henry Ford Hospital, Detroit, MI. 3 Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.



Viral infection-associated kidney diseases are an emerging public health issue in both developing and developed countries. Many new viruses have emerged with new paradigms of kidney injury, either directly through their cytopathic effect or indirectly through immune-mediated glomerulopathy, tubulointerstitial disease, and acute kidney injury as part of multiorgan failure. Herein, we will discuss Parvovirus, which causes glomerulopathy, and Hanta, Ebola, and Dengue viruses, which cause viral hemorrhagic fever and acute kidney injury. Clinical manifestations also depend on extrarenal organ systems involved. Diagnosis of these viral infections is mainly based on a high index of suspicion, serologic testing, and isolation of viral DNA/RNA. Management is largely conservative, as specific antiviral agents are unavailable.

Copyright © 2019 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

KEYWORDS: Acute kidney injury; Glomerular disease; Viral hemorrhagic fever; Virus-associated kidney disease

PMID: 31202393 DOI: 10.1053/j.ackd.2019.01.006

Keywords: Acute kidney injury; Hantavirus; Parvovirus; Dengue Fever; Ebola.