Hantavirus-induced acute renal failure

Abstract

Recently hantavirus-infection and acute renal failure has become more important in almost all countries of Middle- and Northern Europe (nephropathia epidemica). In this part of Europe the course of the disease is commonly mild as compared to hantavirus-infection in South-East Asia and the Balkan. Recently a new subtype of hantavirus-infection with acute pulmonary syndrome has been documented in the United States, a disease with acute pulmonary distress and high mortality. Intensive investigations of nephropathia epidemica in Europe has also shown that pulmonary infiltrates are more common than noted in the past. The distribution of the virus is dependent on the rodent population (vector) and may change with global warming since rodent population may progressively increase. In Argentina a person-to-person transmission of the hantavirus subtype (Andes) was documented recently and may influence the management of the hantavirus-infected patient in the future. In summary one should always be cautious in regard to hantavirus-infection when young patients with exposure to rodents (outdoor activities) present with high fever, thrombocytopenia and severe lumbalgia. Hantavirus-serology is today available in almost all laboratories and antibody-detection is most reliable by recombinant antigen.