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Abstract
Although serologic studies have identified hantaviral infection in the United States,
acute disease has not been recognized. This study describes 3 cases of domestically
acquired hemorrhagic fever with renal syndrome (HFRS) in the United States. Infection
was due to a local strain of Seoul virus (Baltimore rat virus). A review of the clinical
features indicated a mild illness characterized by nausea, vomiting, renal and liver
failure similar to HFRS described elsewhere for rat-borne viruses. Follow-up of 2
patients identified persitent hypertension and renal disease providing further evidence
of an association between past hantaviral infection and hypertensive renal disease.