Emerging Infectious Diseases (Jan 2015)

Clinical Course and Long-Term Outcome of Hantavirus-Associated Nephropathia Epidemica, Germany

  • Joerg Latus,
  • Matthias Schwab,
  • Evelina Tacconelli,
  • Friedrich-Michael Pieper,
  • Daniel Wegener,
  • Juergen Dippon,
  • Simon Müller,
  • David Zakim,
  • Stephan Segerer,
  • Daniel Kitterer,
  • Martin Priwitzer,
  • Barbara Mezger,
  • Birgit Walter-Frank,
  • Angela Corea,
  • Albrecht Wiedenmann,
  • Stefan Brockmann,
  • Christoph Pöhlmann,
  • M. Dominik Alscher,
  • Niko Braun

DOI
https://doi.org/10.3201/eid2101.140861
Journal volume & issue
Vol. 21, no. 1
pp. 76 – 83

Abstract

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Human infection with Puumala virus (PUUV), the most common hantavirus in Central Europe, causes nephropathia epidemica (NE), a disease characterized by acute kidney injury and thrombocytopenia. To determine the clinical phenotype of hantavirus-infected patients and their long-term outcome and humoral immunity to PUUV, we conducted a cross-sectional prospective survey of 456 patients in Germany with clinically and serologically confirmed hantavirus-associated NE during 2001–2012. Prominent clinical findings during acute NE were fever and back/limb pain, and 88% of the patients had acute kidney injury. At follow-up (7–35 mo), all patients had detectable hantavirus-specific IgG; 8.5% had persistent IgM; 25% had hematuria; 23% had hypertension (new diagnosis for 67%); and 7% had proteinuria. NE-associated hypertension and proteinuria do not appear to have long-term consequences, but NE-associated hematuria may. All patients in this study had hantavirus-specific IgG up to years after the infection.

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