42
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Risk factors and potential preventive measures for nephropatia epidemica in Sweden 2011–2012: a case–control study

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Introduction

          Nephropatia epidemica (NE), a relatively mild form of hemorrhagic fever with renal syndrome caused by the Puumala virus (PUUV), is endemic in northern Sweden. We aim to study the risk factors associated with NE in this region.

          Methods

          We conducted a matched case–control study between June 2011 and July 2012. We compared confirmed NE cases with randomly selected controls, matched by age, sex, and place of infection or residence. We analyzed the association between NE and several occupational, environmental, and behavioral exposures using conditional logistic regression.

          Results

          We included in the final analysis 114 cases and 300 controls, forming 246 case–control pairs. Living in a house with an open space beneath, making house repairs, living less than 50 m from the forest, seeing rodents, and smoking were significantly associated with NE.

          Conclusion

          Our results could orient public health policies targeting these risk factors and subsequently reduce the NE burden in the region.

          Related collections

          Most cited references23

          • Record: found
          • Abstract: found
          • Article: not found

          Hantavirus infections in Europe.

          Hantaviruses are enveloped RNA viruses each carried by a specific rodent species. Three hantaviruses, Puumala, Dobrava, and Saaremaa viruses, are known to cause haemorrhagic fever with renal syndrome. In Europe. Puumala causes a generally mild disease, nephropathia epidemica, which presents most commonly with fever, headache, gastrointestinal symptoms, impaired renal function, and blurred vision, whereas Dobrava infections often also have haemorrhagic complications. There are few available data about the clinical picture of confirmed Saaremaa infections, but epidemiological evidence suggests that it is less pathogenic than Dobrava, and that Saaremaa infections are more similar to nephropathia epidemica caused by Puumala. Along with its rodent host, the bank vole (Clethrionomys glareolus), Puumala is reported throughout most of Europe (excluding the Mediterranean region), whereas Dobrava, carried by the yellow-necked mouse (Apodemus flavicollis), and Saaremaa, carried by the striped field mouse (Apodemus agrarius), are reported mainly in eastern and central Europe. The diagnosis of acute hantavirus infection is based on the detection of virus-specific IgM. Whereas Puumala is distinct, Dobrava and Saaremaa are genetically and antigenically very closely related and were previously thought to be variants of the same virus. Typing of a specific hantavirus infection requires neutralisation antibody assays or reverse transcriptase PCR and sequencing.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Hantavirus infections in Europe and their impact on public health.

            Hantaviruses (genus Hantavirus, family Bunyaviridae) are enveloped tri-segmented negative-stranded RNA viruses each carried by a specific rodent or insectivore host species. Several different hantaviruses known to infect humans circulate in Europe. The most common is Puumala (PUUV) carried by the bank vole; another two important, genetically closely related ones are Dobrava-Belgrade (DOBV) and Saaremaa viruses (SAAV) carried by Apodemus mice (species names follow the International Committee on Taxonomy of Viruses nomenclature). Of the two hantaviral diseases, hemorrhagic fever with renal syndrome (HFRS) and hantaviral cardiopulmonary syndrome, the European viruses cause only HFRS: DOBV with often severe symptoms and a high case fatality rate, and PUUV and SAAV more often mild disease. More than 10,000 HFRS cases are diagnosed annually in Europe and in increasing numbers. Whether this is because of increasing recognition by the medical community or due to environmental factors such as climate change, or both, is not known. Nevertheless, in large areas of Europe, the population has a considerable seroprevalence but only relatively few HFRS cases are reported. Moreover, no epidemiological data are available from many countries. We know now that cardiac, pulmonary, ocular and hormonal disorders are, besides renal changes, common during the acute stage of PUUV and DOBV infection. About 5% of hospitalized PUUV and 16%-48% of DOBV patients require dialysis and some prolonged intensive-care treatment. Although PUUV-HFRS has a low case fatality rate, complications and long-term hormonal, renal, and cardiovascular consequences commonly occur. No vaccine or specific therapy is in general use in Europe. We conclude that hantaviruses have a significant impact on public health in Europe. Copyright © 2012 John Wiley & Sons, Ltd.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Disease burden of Puumala virus infections, 1995-2008.

              Puumala virus (PUUV) causes mild haemorrhagic fever with renal syndrome, a rodent-borne zoonosis. To evaluate the disease burden of PUUV infections in Finland, we analysed data reported by laboratories to the National Infectious Disease Registry during 1995-2008 and compared these with data from other national registries (death, 1998-2007; hospital discharge, 1996-2007; occupational diseases, 1995-2006). A total of 22,681 cases were reported (average annual incidence 31/100,000 population); 85% were in persons aged 20-64 years and 62% were males. There was an increasing trend in incidence, and the rates varied widely by season and region. We observed 13 deaths attributable to PUUV infection (case-fatality proportion 0.08%). Of all cases, 9599 (52%) were hospitalized. Only 590 cases (3%) were registered as occupational disease, of which most were related to farming and forestry. The wide seasonal and geographical variation is probably related to rodent density and human behaviour.
                Bookmark

                Author and article information

                Journal
                Infect Ecol Epidemiol
                Infect Ecol Epidemiol
                IEE
                Infection Ecology & Epidemiology
                Co-Action Publishing
                2000-8686
                30 June 2015
                2015
                : 5
                : 10.3402/iee.v5.27698
                Affiliations
                [1 ]European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
                [2 ]European Program for Intervention Epidemiology Training (EPIET), Stockholm, Sweden
                [3 ]Swedish Institute for Communicable Disease Control (SMI), Solna, Sweden
                [4 ]Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
                [5 ]Department of Microbiology, Karolinska Institute, Stockholm, Sweden
                [6 ]Department of Clinical Microbiology, Umeå University, Umeå, Sweden
                [7 ]Department of Communicable Disease Control and Prevention, Jämtland County Council, Östersund, Sweden
                [8 ]Department of Communicable Disease Control and Prevention, Norbotten County Council, Lulea, Sweden
                [9 ]Department of Communicable Diseases Control and Prevention, Vasternorrland County Council, Matfors, Sweden
                [10 ]Division of Infectious Diseases, Department of Clinical Microbiology, Umeå University Hospital, Umeå, Sweden
                [11 ]Department of Medical Sciences, Infectious Diseases, Uppsala University, Uppsala, Sweden
                Author notes
                [* ]Correspondence to: Alin Gherasim, Health Institute Carlos III, National Centre of Epidemiology, C. Sinesio Delgado 5, Madrid, Spain, Email: amgherasim@ 123456externos.isciii.es

                Responsible Editor: Tanja Strand, Uppsala University, Sweden.

                Article
                27698
                10.3402/iee.v5.27698
                4488335
                26134289
                ce16e690-5040-4b53-8dc4-f22a94133f05
                © 2015 Alin Gherasim et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 February 2015
                : 24 April 2015
                : 24 May 2015
                Categories
                Original Research Article

                Infectious disease & Microbiology
                puumala virus,risk factors,sweden
                Infectious disease & Microbiology
                puumala virus, risk factors, sweden

                Comments

                Comment on this article