detection of nephropathia epidemica virus rna in patient samples using a nested primer-based polymerase chain reaction.a nested primer-based polymerase chain reaction was constructed for the detection of puumala virus rna in patient samples. puumala virus rna was detected in cells from the urinary and the respiratory tracts and in peripheral blood mononuclear cells of patients with nephropathia epidemica. after inoculation with nephropathia epidemica patient material on vero e6 cells and propagation for nine passages (4 months), puumala virus rna was detected at every passage. hybridization under high-stringency ...19921349033
haemorrhagic fever with renal syndrome, virological and epidemiological aspects.haemorrhagic fever with renal syndrome (hfrs) is characterized by fever, headache, abdominal pain, renal dysfunction and various haemorrhagic manifestations. the viruses causing hfrs all belong to the hantavirus genus in the bunyaviridae family. at least three of the different hantaviruses are associated with human disease: hantaan, seoul, and puumala viruses. hfrs is endemic in a belt from norway in the west, through sweden, finland, the soviet union, china, korea to japan in the east. the clin ...19921349231
seroprevalence of antibodies to hantaviruses and leptospires in selected italian population groups.a study of hantaviral and leptospiral antibodies in selected population groups was performed. among high risk subjects in the rome area, hantaan antibody was found in mammalogists (10%) and dialysis patients (6%), while none of the trappers, oarsmen, river policemen and firemen studied tested positive for antibodies to hantaviruses. in occupationally-exposed subjects (farmers, rangers, lumbermen, hunters) from rural and densely forested areas of northern italian regions, the prevalence of hantaa ...19921349288
cloning and sequencing of puumala virus sotkamo strain s and m rna segments: evidence for strain variation in hantaviruses and expression of the nucleocapsid protein.the prototype puumala virus (pv) sotkamo strain small (s) and medium (m) rna genome segments were amplified by the polymerase chain reaction (pcr), cloned and sequenced. the s segment is 1830 nucleotides long with an open reading frame coding for 433 amino acids. the identity to the pv hällnäs strain was 83% at the nucleotide and 96% at the amino acid level. the m segment in the sotkamo strain is 3616 nucleotides long and contains one open reading frame of 1148 amino acids with 83% nucleotide an ...19921353107
complications of nephropathia epidemica: three cases.haemorrhagic fever with renal syndrome (hfrs) in scandinavia is called nephropathia epidemica (ne), and is caused by the puumala-virus, which belongs to the hanta-virus genus. the clinical course of ne is mostly benign, complications are uncommon, and deaths are rarely observed. we report the cases of three patients who developed serious complications in the course of ne caused by the puumala-virus. one patient died within 24 h after admission, another developed progressive neuromuscular dysfunc ...19921353521
a study of nephropathia epidemica among military personnel in sweden.the incidence of nephropathia epidemica (ne), caused by puumala virus, among military troops operating in an endemic area of sweden was investigated. a total of 705 soldiers (age 18-25) involved in field training in three different endemic counties were bled twice within a 6-month interval. three individuals seroconverted when tested for puumala virus antibodies by igg elisa. symptoms typical of ne were not recorded in any of the patients. however, mild febrile episodes were recorded in 2 of the ...19921355610
anti-endothelial cell antibodies in nephropathia epidemica and other viral diseases.increased capillary permeability is a central feature of the severe forms of haemorrhagic fever with renal syndrome (hfrs) and occurs also, though less frequently, in nephropathia epidemica (ne), one of the milder forms of this syndrome, caused by puumala virus. we therefore searched for antiendothelial cell antibodies (aeca) in patients with ne and in those with other presumed or serologically proven acute viral illnesses. by enzyme immunoassay, using human umbilical vein endothelial cells (huv ...19921356668
antibodies to puumala virus in humans determined by neutralization assay for detection of neutralizing antibodies to puumala virus using 96-well microtiter plates (nt-elisa) was developed and evaluated. the test proved to have similar sensitivity and specificity as an igg elisa and indirect immunofluorescence test, when screening 187 sera (with an antibody prevalence rate of 19%) from normal populations in an endemic area of nephropathia epidemica (ne) in sweden. ne-patients monitored for 2 years had neutralizing antibodies in early sera collected 1-4 days a ...19921358908
bank vole monoclonal antibodies against puumala virus envelope glycoproteins: identification of epitopes involved in vole (clethrionomys glareolus) monoclonal antibodies (mabs) against the two envelope glycoproteins (g 1 and g 2) of the puumala (puu) virus were generated and characterized. analyses of the mabs' antigen and epitope specificities showed non-overlapping reactivities of one anti-g 1 and two anti-g 2 mabs. a significant neutralizing activity was shown by the anti-g 1 and one of the anti-g 2 mabs, suggesting the existence of at least one neutralizing domain on each of the two glycoproteins. the ...19921381914
nephropathia epidemica (hemorrhagic fever with renal syndrome) in scandinavia.nephropathia epidemica (ne) in scandinavia is a zoonosis caused by puumala virus. the main animal reservoir is the bank vole. ne predominantly affects men. its annual incidence varies in a cyclic fashion, with peaks occurring every third to fourth year. the clinical picture of ne in scandinavia is similar to that of hemorrhagic fever with renal syndrome in other parts of the world, although ne generally has a milder course. the case-fatality rate is approximately 0.2%. the most common clinical f ...19911681581
rapid diagnosis of hantavirus disease with an igg-avidity assay.nephropathia epidemica (ne), due to puumala virus, is endemic in eastern europe and scandinavia. serodiagnosis of ne relies on conventional indirect immunofluorescence to detect igg against puumala virus. however, in conventional serology, most patients with acute ne have raised but stable non-diagnostic antibody titres. for better serodiagnosis of ne, we have developed a test that measures the avidity (functional affinity) of igg antibodies against puumala virus. this new assay was highly speci ...19911682736
a swedish fatal case of nephropathia epidemica.a previously healthy 55-year-old man with nephropathia epidemica (ne) developed disseminated intravascular coagulation, anuria and shock and died on day 6 of his disease. by use of indirect immunofluorescence technique and elisa, specific serum igm antibodies against puumala virus could be detected, thus confirming the clinical diagnosis. this case demonstrates that ne in scandinavia is a potentially lethal disease.19911683493
antigenicity of hantavirus nucleocapsid proteins expressed in e. coli.dna clones representing the small genomic segment of nephropathia epidemica virus strain hällnäs b1 (nev) and hantaan virus strain 76-118 (htv) encoding their nucleocapsid proteins were inserted into the e. coli vector pin-iii-ompa for secretion of proteins into the periplasmic space. the complete htv and nev nucleocapsid proteins and two truncated versions of the nev nucleocapsid proteins were expressed as fusion proteins. unexpectedly, all products accumulated as insoluble aggregates. most of ...19911714110
molecular characterization of the prospect hill virus m rna segment: a comparison with the m rna segments of other hantaviruses.complementary dna representing the genomic m rna segment of the prospect hill (ph) hantavirus was cloned and its nucleotide sequence determined. the ph virus m rna segment is 3707 nucleotides in length and has a long open reading frame in the viral complementary-sense rna with a coding capacity of 1142 amino acids. the predicted gene product of the ph virus m segment was compared with the corresponding gene products of hantaan virus strain 76-118 (hantaan), sapporo rat virus strain sr-11 (sr) an ...19911840609
monoclonal antibodies to three strains of hantaviruses: hantaan, r22, and puumala.thirty hybrid cell lines that produce monoclonal antibodies to three strains of hantaviruses have been generated and characterized. one clone specific to hantaan 76-118 strain, four clones specific to rattus strains and one clone specific to puumala virus have been identified. most of the monoclones produced antibodies specific to nucleoproteins. only two monoclones were found to produce glycoprotein specific, neutralizing antibodies. the immunofluorescent (ifa) staining patterns of the monoclon ...19911907448
[nephropathia epidemica. hantavirus and acute renal insufficiency].puumala virus belongs to the hantavirus group and as other members of the group it can cause acute renal insufficiency. other hantaviruses are responsible for korean hemorrhagic fever and other hemorrhagic fevers with renal involvement. in scandinavia, hantavirus nephropathy is better known as nephropathia epidemica. hantavirus cause asymptomatic infections in mice and rats and the virus is thought to be transmitted to man via inhalation of desicated saliva, urine or feces from infected animals. ...19901967859
coding properties of the s and the m genome segments of sapporo rat virus: comparison to other causative agents of hemorrhagic fever with renal syndrome.three serologically distinct groups of hantaviruses have been associated with severe, moderate, and mild forms of hemorrhagic fever with renal syndrome (hfrs). to gain a better understanding of the genetic variation among these viruses, we cloned and sequenced the m and the s genome segments of sapporo rat virus, an etiologic agent of moderate hfrs, and compared the predicted gene products to those of hantaan virus, and the hällnäs strain of puumala virus, which are etiologic agents of severe an ...19901970443
infection with the puumala virus in pregnancy. case report. 19901970741
haemorrhagic fever with renal syndrome: evaluation of elisa for detection of puumala-virus-specific igg and igm.igm and igg elisa to puumala virus were evaluated using sera from patients with haemorrhagic fever with renal syndrome (hfrs) from different geographical regions: sweden, denmark, norway, belgium and the european ussr. igm elisa proved useful in the diagnosis of hfrs in patients from all the regions mentioned above. specific igm could be detected as early as day 1 post onset of disease, and patients remained igm-positive for several months. specific igg elisa antibodies were also frequently dete ...19901982371
primary structure of the large (l) rna segment of nephropathia epidemica virus strain hällnäs b1 coding for the viral rna polymerase.the l rna segment of the nephropathia epidemica virus (nev) strain hällnäs b1 was characterized by molecular cloning of the corresponding cdna and subsequent determination of the dna nucleotide sequence. the l rna segment is 6550 nucleotides long with complementarity of 20 bases at the 3' and 5' termini. the viral messenger sense rna contains one major open reading frame (orf) with a coding capacity of 2156 amino acid residues encoding a protein with a calculated molecular weight of 246 kda and ...19912053288
molecular characterization of the rna s segment of nephropathia epidemica virus strain hällnäs b1.the s segment rna of nephropathia epidemica virus (nev) strain hällnäs b1 was isolated by molecular cloning of the corresponding cdna. the rna is 1785 nucleotides long with the 3' and 5' termini being complementary for 23 bases. the viral messenger-sense rna contains one major open reading frame (orf) with a coding capacity of 433 amino acids encoding a 49-kda polypeptide. compared to the hantaan s segment cdna sequence there is a nucleotide homology of 60 and 61% at the amino acid level. many o ...19902104684
rapid detection of genomic variations in different strains of hantaviruses by polymerase chain reaction techniques and nucleotide sequence analysis.the polymerase chain reaction (pcr) with subsequent nucleotide sequence analysis was employed to rapidly detect genomic variations among different hantavirus strains. using synthetic oligonucleotide primers derived from the m and s segment rnas of nephropathia epidemica virus strain hällnäs b1 (nev) we succeeded in amplifying the corresponding sequences of hantaan and puumala viruses. the nucleotide sequences of the cdnas derived from the puumala m and s rna segments were analyzed. it was found ...19902385957
determination of the coding capacity of the m genome segment of nephropathia epidemica virus strain hällnäs b1 by molecular cloning and nucleotide sequence analysis.the m genome rna segment of nephropathia epidemica virus (nev) strain hällnäs b1 was characterized by molecular cloning and dna nucleotide sequencing of the corresponding cdna clones. the size of the m rna segment is 3682 nucleotides. the 3' and 5' terminal sequences are complementary for 21 bases and their predicted secondary structure is very stable. the viral complementary messenger rna possesses a single long open reading frame with a coding capacity of 1148 amino acids (polypeptide of 126 k ...19892508317
the minor problem of hemostatic impairment in nephropathia epidemica, the mild scandinavian form of hemorrhagic fever with renal syndrome.nephropathia epidemica (ne) is the mild scandinavian form of hemorrhagic fever with renal syndrome (hfrs). its hemorrhagic manifestations are so mild that initially--as its name implies--it was not considered a hemorrhagic fever. it is, however, clinically, histologically, and epidemiologically similar to korean hemorrhagic fever (khf) except that hemorrhagic manifestations are fewer and mortality is lower. the etiologic agents of the two disorders, puumala virus (ne) and hantaan virus (khf), ar ...19892568675
epidemic hemorrhagic fever with renal syndrome in yugoslavia, epidemic of hemorrhagic fever with renal syndrome (hfrs) occurred in yugoslavia may-november 1986; all republics and provinces were involved. serum samples were received from 260 of 276 persons with symptoms clinically compatible with a diagnosis of hfrs. presumptive infection with a hantavirus was determined serologically for 161 of these. many patients with serious clinical pictures, including severe renal insufficiency and shock, were hospitalized; 11 died. indirect fluorescent antibody te ...19892569845
hemorrhagic fever with renal syndrome in yugoslavia: antigenic characterization of hantaviruses isolated from apodemus flavicollis and clethrionomys glareolus.hantavirus antigens were detected in lung tissues of 8/113 apodemus flavicollis and 2/17 clethrionomys glareolus captured in 1984 in fojnica, a region of yugoslavia endemic for hemorrhagic fever with renal syndrome; hantavirus antigens were not detected in lung tissues from 126 other mammals collected in fojnica. three hantaviruses, 2 from a. flavicollis and 1 from c. glareolus, were isolated directly in vero e6 cells and were partially characterized. the isolates from a. flavicollis, designated ...19892569846
[the incidence and clinical picture of hemorrhagic fever with renal syndrome in east slovakia: the eastern and western type].hemorrhagic fever with renal syndrome (hfrs) is endemic in east slovakia. the paper presents the clinical picture of 4 serologically confirmed cases. two of the 4 patients had serological evidence of recent hantaan virus infection. positive immunofluorescent reactions with puumala virus (cg 18-20) were detected in the sera of the other two patients. the obtained results suggest the circulation of two serotypes of hfrs in slovakia.19892574625
experimental infection with puumala virus, the etiologic agent of nephropathia epidemica, in bank voles (clethrionomys glareolus).subclinical chronic infections characterized by transient viremia, prolonged virus shedding in oropharyngeal secretions and feces, and virus persistence in tissues (particularly lung) developed in laboratory-bred weanling bank voles (clethrionomys glareolus) inoculated intramuscularly with puumala virus (strain hällnäs), the etiologic agent of nephropathia epidemica. viral antigen, as evidence by granular fluorescence, was detected in the lungs, liver, spleen, pancreas, salivary glands, and smal ...19852861296
serotypic classification of hantaviruses by indirect immunofluorescent antibody and plaque reduction neutralization tests.antisera prepared against 16 strains of hantaviruses isolated from patients with hemorrhagic fever with renal syndrome (hfrs) or from rodents captured in hfrs-endemic and nonendemic regions were titrated against hantaan virus strain 76-118, puumala virus strain sotkamo, and prospect hill virus strain prospect hill-i by using the indirect immunofluorescent antibody and plaque reduction neutralization tests. isolates fell into one of four distinct groups or serotypes. serotype 1 included apodemus- ...19852866197
detection of hemagglutination-inhibiting antibodies in patients with nephropathia epidemica and korean hemorrhagic fever by using puumala virus cell culture antigen. 19862871114
epidemiological investigations following an outbreak of hemorrhagic fever with renal syndrome in greece.epidemiological investigations were conducted following an outbreak of hemorrhagic fever with renal syndrome (hfrs) which occurred in the state of epirus, northwestern greece, in july and august 1983. a total of 8 patients were hospitalized during the outbreak; 3 were severely ill and 1 died. a serosurvey made in may 1984 sampled 184 of the approximately 400 residents of the village of tsepelovo, where 4 patients resided, and found 12 (6.5%) persons, including convalescent sera from 4 patients, ...19862871769
epidemiology of nephropathia epidemica in sweden.a comprehensive study of nephropathia epidemica (ne), caused by puumala virus, was conducted in sweden. human sera from residents of various regions of sweden were examined for antibody to puumala virus, and the incidence of ne was determined. small mammals were captured at locations throughout sweden and were examined for antibody to puumala virus and for antigen. the human serosurvey found the highest prevalence rates and the highest incidence rates in northern sweden. the bank vole was found ...19872879874
partial characterization of a hantavirus isolated from a clethrionomys glareolus captured in belgium.a hantavirus was isolated in vero-e6 cells from lungs of a free living bank vole (clethrionomys glareolus) captured in turnhout, province of antwerp--northern part of belgium. with help of monoclonal antibodies the belgian hantavirus isolate could be clearly differentiated from hantaan virus strain 76-118, prospect hill virus strain ph1 and sr11, a hantavirus isolated from laboratory wistar rat in japan, but not from the nephropathia epidemica virus strain hällnäs.19872886029
detection of nephropathia epidemica (puumala virus)-specific immunoglobulin m by enzyme-linked immunosorbent assay.nephropathia epidemica (ne), a less severe form of hemorrhagic fever with renal syndrome, is caused by puumala virus (puu). this communication reports the development of a mu-capture enzyme-linked immunosorbent assay (elisa) for detection of specific immunoglobulin m (igm) antibodies to puu virus in human sera. acute- and early-convalescent-phase sera (collected 1 to 41 days after disease onset) from 29 swedish patients with clinical ne were tested for puu virus-specific igg and igm antibodies b ...19882902106
propagation of nephropathia epidemica virus in mongolian gerbils.nephropathia epidemica virus, the etiological agent of hemorrhagic fever with renal syndrome in scandinavia, was serially propagated in mongolian gerbils (meriones unguiculatus). intracerebrally inoculated suckling gerbils developed subclinical infections, with viral antigen found in lung, brain, liver and spleen. the distribution of viral antigen was similar to that seen in experimentally infected bank voles (clethrionomys glareolus), the principal wild rodent reservoir of nephropathia epidemic ...19853882997
definition of three serotypes of hantaviruses by a double sandwich elisa with biotin-avidin amplification system.a total of seven different isolates of hantaviruses from five mammalian species and six geographical areas were examined by a double sandwich elisa with biotin-avidin amplification system. three serotypes were recognized by comparing antigen titres to homologous and heterologous antibody and blocking antibody titres to homologous and heterologous antigens. serotype 1 included four strains: hantaan virus isolated from apodemus agrarius in south korea, hupei-i isolated from acute-phase serum from ...19853926952
muroid virus nephropathies and muroid viruses of the hantaan virus group.hemorrhagic fever with renal syndrome (hfrs) came dramatically to the attention of western medicine in 1951 with the "new" disease becoming a major source of morbidity and mortality in american troops in korea. known there as epidemic hemorrhagic fever (ehf) or korean hemorrhagic fever (khf), it became apparent that it was the same disease as the endemic (epidemic) hemorrhagic nephroso-nephritis of the soviet far east and songo fever of the japanese army in manchuria. the conjecture that the mil ...19826134336
propagation of nephropathia epidemica virus in cell culture. 19846143926
clinical and serological diagnosis of nephropathia epidemica, the mild type of haemorrhagic fever with renal syndrome.the serological diagnosis of nephropathia epidemica (ne), the mild european type of haemorrhagic fever with renal syndrome (hfrs), was studied by means of an indirect immunofluorescent antibody technique (ifat) in a large outbreak in finland (morbidity 1.4/1000 population). acetone-fixed sections of lung of bank voles (clethrionomys glareolus) naturally infected with puumala virus served as antigen. altogether 65 patients were followed serologically for up to 20 months. serological results obtai ...19846151960
isolation and propagation of nephropathia epidemica virus in bank voles.three strains of nephropathia epidemica (ne) virus were isolated from lung tissues of bank voles (clethrionomys glareolus) and a grey-sided vole (c. rufocanus) trapped in västerbotten county, sweden. two of these isolates were serially passaged in seronegative laboratory-bred bank voles. experimentally infected animals developed a subclinical infection characterized by virus persistence, particularly in lung tissue. attempts to infect other species of colonized rodents with ne virus and to isola ...19846208601
elevated levels of total and puumala virus-specific immunoglobulin e in the scandinavian type of hemorrhagic fever with renal a previous study, it was reported that the total immunoglobulin e (ige) level was increased in patients with hemorrhagic fever with renal syndrome (hfrs). the aim of the present study was to investigate whether specific ige is synthesized during the course of the disease. for this purpose, an epsilon-capture enzyme-linked immunosorbent assay was developed. a total of 72 patients with hfrs caused by puumala virus were studied. three different control groups were included: 20 blood donors, 20 p ...19947496961
characterization of human antibody responses to four corners hantavirus infections among patients with hantavirus pulmonary syndrome.hantavirus pulmonary syndrome (hps) is a human disease caused by a newly identified hantavirus, which we will refer to as four corners virus (fcv). fcv is related most closely to puumala virus (puu) and to prospect hill virus (phv). twenty-five acute hps serum samples were tested for immunoglobulin g (igg) and igm antibody reactivities to fcv-encoded recombinant proteins in western blot (immunoblot) assays. all hps serum samples contained both igg and igm antibodies to the fcv nucleocapsid (n) p ...19947512156
mapping of b-cell determinants in the nucleocapsid protein of puumala virus: definition of epitopes specific for acute immunoglobulin g recognition in humans.the complete amino acid sequence of the puumala (puu) virus nucleocapsid protein (n), deduced from the genome of the prototype strain sotkamo, was synthesized as decapeptides with 5-amino-acid overlaps. by use of the pepscan method, 86 peptides were examined for reactivity with sera from serologically confirmed nephropathia epidemica (ne) patients and 11 puu virus n-specific bank vole monoclonal antibodies. the human sera showed reactivity with several different regions, while only one of the mo ...19957536616
evidence for the existence of puumula-related virus among clethrionomys rufocanus in hokkaido, japan.we conducted field surveys of indigenous rodent species in hokkaido, japan from 1980 to 1993. serum samples were collected from 663 rodents, including clethrionomys rufocanus, apodemus speciosus, a. argenteus, and c. rutilus. antibody to hantavirus was determined by the protein g antibody assay. positive c. rufocanus were detected in seven of eight collection sites, but no antibody was detected in the remaining rodent species. to reveal the serotype of the circulating virus in c. rufocanus, anti ...19957573700
cross-neutralization of hantaviruses with immune sera from experimentally infected animals and from hemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome patients.plaque-reduction neutralization tests were done with eight of nine known representative hantaviruses and immune sera from experimentally infected animals and from patients with hemorrhagic fever with renal syndrome (hfrs) or hantavirus pulmonary syndrome (hps). results obtained with animal sera demonstrated each virus to be antigenically unique. neutralization with the hps patient sera was highest with sin nombre (sn) virus and to a lesser extent with black creek canal (bcc) virus. sera from kor ...19957594720
human b-cell epitopes of puumala virus nucleocapsid protein, the major antigen in early serological response.puumala virus (puu) is a member of the hantavi rus genus in the family bunyaviridae and the etiologic agent of nephropathia epidemica (ne), a form of haemorrhagic fever with renal syndrome (hfrs). in this study we compared the immunofluorescence patterns of ne sera and antibodies raised against recombinant puu proteins and confirm that the nucleocapsid protein is the major target in the early igg response of ne patients and provides the molecular basis for simple and rapid differentiation betwee ...19957595404
short report: isolation and partial characterization of a puumala virus from a human case of nephropathia epidemica in france.puumala (puu) virus (bunyaviridae: hantavirus), the etiologic agent of nephropathia epidemica (ne), the mid form of hemorrhagic fever with renal syndrome, is enzootic in europe and has been known to occur in france since 1983. we report the first isolation of puu virus in france and western europe from a case of ne acquired in france. the virus was isolated from a serum collected in the acute phase of the clinical course by successive blind passages in vero e6 cells. serologic typing using monoc ...19957611568
a vaccinia virus-vectored hantaan virus vaccine protects hamsters from challenge with hantaan and seoul viruses but not puumala investigate the ability of a vaccinia virus-vectored vaccine expressing the m and the s segments of hantaan (htn) virus (c. s. schmaljohn, s. e. hasty, and j. m. dalrymple, vaccine 10:10-13, 1992) to elicit a protective immune response against other hantaviruses, we vaccinated hamsters with the recombinant vaccine and challenged them with htn, seoul (seo), or puumala (puu) virus. neutralizing antibodies to htn virus were found in all vaccinated hamsters both before and after challenge. neutra ...19957666542
mixed natural focus of tick-borne encephalitis, tularemia and haemorrhagic fever with renal syndrome in west of 923 small mammals of 7 species were collected in locality záhorská ves, west slovakia, in 1990-1992. among examined small mammal species it was clethrionomys glareolus (48.7% of total, 17.5% positive for tick-borne encephalitis (tbe) virus antibodies), apodemus flavicollis (29.7% of total, 17.5% positive), a. sylvaticus (11.3% of total, 16.3% positive), and microtus arvalis (6.2% of total, 10.5% positive). the most abundant tick species (larval and nymphal stages) on small mammals was i ...19957676942
temporal dynamics of puumala virus antibody prevalence in voles and of nephropathia epidemica incidence in humans.puumala (puu) virus is the etiologic agent of nephropathia epidemica (ne) in humans. this disease is highly endemic in vasterbotten county, sweden, with an annual incidence of 19.2 (range 3.7-37.4) per 100,000 inhabitants. voles are considered to be both the main reservoir and the vector of puu virus. a total of 3,591 rodents (mainly clethrionomys glareolus, c. rufocanus, and microtus agrestis) trapped in vasterbotten between 1979 and 1987 were tested for the presence of puu virus antibodies by ...19957677213
neutralizing human monoclonal antibodies against puumala virus, causative agent of nephropathia epidemica: a novel method using antigen-coated magnetic beads for specific b cell isolation.human monoclonal antibodies (mabs) against puumala (puu) virus were generated and characterized. human spleen b lymphocytes were preselected for specific surface immunoglobulin (ig) using magnetic beads coated with the viral glycoproteins, and subsequently immortalized by epstein-barr virus transformation. four igg-positive monoclonal lymphoblastoid cell lines (lcls) were established and have remained stable mab secretors for over 12 months. analyses of the antigen and epitope specificities reco ...19937687648
detection and subsequent sequencing of puumala virus from human specimens by pcr.a sensitive method based on pcr was developed for the detection of puumala virus (puu) in human samples. the assay was found to be specific for puu-like strains and distinguished between these and hantaviruses of other serotypes. the detection limit was found to be 10(-5) focus-forming units. clinical samples were collected from patients with nephropathia epidemica in sweden and western russia. five whole blood samples collected from patients in russia with the acute phase of disease were found ...19957714178
serological evidence of hantaan virus in slovakia during 1989-1991.nephropathia epidemica was supposed to be an european form of haemorrhagic fever with renal syndrome (hfrs). however, in 1989-1991 we found serological evidence of infection with hantaan virus in patients' sera from slovakia. higher titers of antibodies against hantaan virus were detected in sera of 6 out of 75 patients with febrile disease, renal failure and clinical diagnosis of hfrs. the higher titers of antibodies against puumala virus were detected in sera of 6 out of 75 patients. serologic ...19947726005
neurological manifestations of hemorrhagic fever with renal syndrome caused by puumala virus: review of 811 cases.eight-hundred eleven case records of patients with hemorrhagic fever with renal syndrome (hfrs) caused by puumala virus were reviewed, and particular attention was given to data regarding severe neurological manifestations. the most common symptoms were headache (97%), blurred vision (40%), and vomiting (31%); 27% of the patients had all three. nine patients (1%) had severe neurological manifestations: meningism and cerebral hemorrhage occurred during the first week of illness, whereas epileptif ...19957742425
comparison of the kinetics of puumala virus specific igm and igg antibody responses in nephropathia epidemica as measured by a recombinant antigen-based enzyme-linked immunosorbent assay and an immunofluorescence test.immunoglobulin m and g (igm and igg) responses were followed up to 6 months in patients with nephropathia epidemica (ne) by an enzyme-linked immunosorbent assay (elisa) using a recombinant puumala virus (puu) nucleocapsid protein as antigen and an immunofluorescence test (if) using puu infected, acetone-treated cells as antigen. the recombinant protein was produced by cloning and expressing the nucleocapsid encoding gene of puu as a polyhistidine fusion protein in escherichia coli. the product w ...19957775932
a macaque model for hantavirus infection.cynomolgus macaques (macaca fascicularis) were experimentally infected with puumala virus (strain hällnäs), which causes nephropathia epidemica in humans in western europe. during the first week after intratracheal inoculation, the monkeys exhibited signs of lethargy followed by mild proteinuria and microhematuria. histopathologic changes during the first 7 weeks after infection were largely confined to abnormalities in medullary tubular cells of the kidneys, which coincided with the demonstrati ...19957797944
myopic shift and its mechanism in nephropathia epidemica or puumala virus infection.nephropathia epidemica (ne) is a zoonose caused by puumala virus. ne belongs to the group of haemorrhagic fevers with renal syndrome. transient myopia has been described in the acute phase of the disease. this prospective study presents the changes of refraction and the results of ophthalmic a scan measurements of patients who were managed at savonlinna central hospital for ne during an epidemic in the winter of 1992-3. this involved 37 patients and 74 eyes. the incidence of transient myopia was ...19947819173
effect of interferon-alpha and cell differentiation on puumala virus infection in human monocyte/macrophages.pathogenesis of hantavirus infections is poorly understood. puumala virus (puu) is the etiologic agent of nephropathia epidemica, a form of hemorrhagic fever with renal syndrome common in europe. we have studied puu infection in primary human monocyte/macrophages and specifically the role of interferon alpha (ifn-alpha) and cell differentiation in it. puu infection proceeded at a low level in monocyte/macrophages, and nucleocapsid (n) protein accumulation started 2 days postinfection. ifn-induce ...19957831843
isolation and initial characterization of a newfound hantavirus from california.a fatal case of hantavirus pulmonary syndrome (hps) in northern california prompted our attempt to isolate viruses from local rodents. from tissues of two deer mice, peromyscus maniculatus, two hantaviruses (convict creek virus 107 and 74, cc107 and cc74) were established in cell culture. viral antigens, proteins, and rnas of the first and archetypical isolate (cc107) were examined, and portions of the medium (m) and small (s) genome segments of both isolates were sequenced. antigenically, cc107 ...19957856107
risk of infections transmitted by arthropods and rodents in forestry hundred and fifty-one forestry workers and 151 matched office clerks were compared as to the presence of antibodies against borelia burgdorferi, tick-borne encephalitis virus, puumalavirus and lymphocytic choriomeningitis virus. their occupational risks of being infected by borrelia was fourfold and significant, by puumalavirus and lymphocytic choriomeningitis virus was increased but not significant. no seropositivity has been established against tick-borne encephalitis virus.19947859849
a case of haemorrhagic fever with renal syndrome complicated by spleen haemorrhage.a case of haemorrhagic fever with renal syndrome (hfrs) complicated by spleen haemorrhage is described. the patient developed progressive anaemia, hypotension and signs of preshock. computerized tomography demonstrated extensive haematoma in the spleen and splenectomy was performed. this case confirms previous reports that hfrs caused by puumala virus may be associated with severe haemorrhagic manifestations.19947984985
genetic identification of a new puumala virus strain causing severe hemorrhagic fever with renal syndrome in germany.a severe case of suspected hemorrhagic fever with renal syndrome (hfrs) was recently identified in northwestern germany. a genetic detection assay was designed that identified hantavirus-specific rna in the patient's clinical specimens by reverse transcriptase-polymerase chain reaction amplification of virus s and m genome segments. phylogenetic analysis of the nucleotide sequences demonstrated that this virus belonged to the puumala (puu) group, with the closest relationship to a puu isolate fr ...19947995985
immunoglobulin g subclass responses against the structural components of puumala virus.sera from sequentially bled nephropathia epidemica patients (acute-phase, convalescent-phase, and 2-year sera) and sera from 10 to 20 years postinfection were examined by immunoglobulin g (igg) subclass-specific elisas for reactivities against each of the puumala virus structural proteins (n, g1, and g2). igg1 was found to be the dominating antiviral subclass, and most of the patients had igg1 directed to all three structural proteins at all times with a continuous increase over time. igg2 to th ...19938094397
puumala virus antibody and immunoglobulin g avidity assays based on a recombinant nucleocapsid antigen.puumala virus is the causative agent of nephropathia epidemica (ne), a hantavirus infection which occurs widely in northern and central europe and is generally diagnosed by the indirect immunofluorescence (if) method. we have now expressed the puumala virus sotkamo strain nucleocapsid (n) protein-coding s genome segment as a beta-galactosidase fusion protein in escherichia coli by using the pex2 expression vector. the recombinant protein was purified by cutting the protein band from an agarose g ...19938096217
sequences of wild puumala virus genes show a correlation of genetic variation with geographic origin of the experimental scheme was developed for direct sequence analysis of puumala virus-containing specimens from wild rodents (clethrionomys glareolus). total rna isolated from rodent lung tissues was reverse-transcribed in the presence of a universal 11 nucleotide primer complementary to all three viral rna segments followed by amplification in a pcr with gene-specific primers. a full-length pcr product of approximately 1800 bp from the s segment encoding the viral nucleoprotein and a product of ap ...19948113763
[pulmonary syndrome caused by hantavirus--a new syndrome with high mortality].an outbreak of a previously unknown, severe infectious disease with rapidly fatal respiratory distress was reported from southwestern usa in may 1993. the case fatality rate was about 60 per cent. using pcr hantavirus rna could be demonstrated in lungs and other tissues from patients. mice and others rodents, e g peromyscus maniculatus, were shown to be a reservoir of the virus. this new virus, designated four corner virus, has been further characterised and seems to be closely related to puumal ...19948139902
puumala virus infection without signs of renal involvement.five cases of puumala virus infection without renal involvement are described. the main signs were fever, headache, chills and thirst. pulmonary involvement was also common. neither increased levels of serum creatinine nor abnormal urinalyses were detected. we suggest that hantavirus infection is included in the differential diagnosis of any febrile condition when exposure to aerosols from infectious secretions or secretions from rodents is suspected.19938248755
nucleotide and deduced amino acid sequences of the m and s genome segments of two puumala virus isolates from russia.hemorrhagic fever with renal syndrome (hfrs) is caused by viruses in the hantavirus genus, family bunyaviridae. three serologically distinct hantaviruses, hantaan, seoul and puumala viruses, are known to cause hfrs. we report here, for the first time, gene sequences of two human puumala virus isolates, p360 and k27, obtained in an hfrs endemic region of the former soviet union. we compared the nucleotide sequences and the derived amino acid sequences of their gene products to a puumala virus iso ...19938266723
a novel hantavirus associated with an outbreak of fatal respiratory disease in the southwestern united states: evolutionary relationships to known hantaviruses.four corners hantavirus (fcv) is the tentative name of the suspected etiologic agent of the newly identified hantavirus-associated respiratory distress syndrome (hards). the identification in hards patients of serum immunoglobulin m and immunoglobulin g antibodies that cross-reacted with hantaan, seoul, and puumala virus antigens first suggested that fcv is a hantavirus. limited nucleotide sequence data from the fcv glycoprotein-2 (g2) confirmed that fcv is a hantavirus and showed that it is mos ...19948289363
anti-idiotypic antibodies against puumala virus glycoprotein-specific monoclonal antibodies inhibit virus infection in cell cultures.rabbit anti-idiotypic antibodies (anti-ids) were generated against three bank vole and one human monoclonal antibody (mab) specific for the two envelope glycoproteins of puumala virus (g1 and g2). the anti-ids were purified by sequential immunoaffinity chromatography. each anti-id inhibited the antigen binding of its respective mab in a competitive elisa. this inhibition, and the absence of cross-reactivity among the anti-ids for heterologous mabs, showed that they all were specific for unique d ...19938379850
susceptibility of human cells to puumala virus infection.nephropathia epidemica involves several organs including kidney, lung, liver and brain. to investigate the susceptibility of putative target cells to the agent responsible, puumala virus, we screened established human cell lines of lung (wi-38, a-427, ccd-11lu), kidney (a-704), liver (hep g2), pharynx (detroit 562), submaxillary gland (a-253) and neural (sk-n-mc, sh-sy5y) origin as well as primary human kidney glomerular cells, endothelial cells and peripheral blood monocytes/macrophages. propag ...19938445370
rna binding of recombinant nucleocapsid proteins of hantaviruses.genes encoding the nucleocapsid (n) proteins of two hantaviruses, hantaan virus strain 76-118 (htn) and puumala virus strain cg 18-20 (puu), were expressed in escherichia coli as histidine-tagged proteins. they were purified by metal-chelate affinity chromatography under native or denaturing conditions to near homogeneity. the soluble form of htn n protein was associated with rna of e. coli. renatured n proteins were shown to bind in vitro transcribed rna representing the hantaviral small genomi ...19938480424
genetic variation of wild puumala viruses within the serotype, local rodent populations and individual animal.reverse transcriptase polymerase chain reaction cloning and sequencing were used to determine the range of s gene/n protein variability in wild puumala virus (puu) strains and to study phylogenetic relationships between two groups of strains which originated from finland and from european russia. analyses of the nucleotide and predicted amino acid sequences showed: (1) all puu strains shared a common ancient ancestor; and (2) the more recent ancestors were different for the finnish branch and th ...19958546008
genetic characterization of a human isolate of puumala hantavirus from france.puu90-13 is a strain of puumala (puu) virus (family bunyaviridae: genus hantavirus) isolated from a human in northeastern france (rollin et al., 1995). this report describes the full-length sequences of the small (s) and medium (m) genomic rnas of puu90-13. the terminal sequences of both the s and m genomic rnas were found to be conserved and imperfectly complementary. the s rna of puu90-13 is 1847 nt in length and contains the nucleocapsid (n) protein gene and a potential overlapping open readi ...19958578865
increased production of nitric oxide in patients infected with the european variant of hantavirus.serum nitrate levels, a measure of nitric oxide (no) production in vivo, were very high (95 +/- 14 microm) in 13 patients infected with puumala virus, the european variant of hantavirus (htv), as compared to those in healthy subjects (33 +/- 3 microm). serum nitrate levels showed a high and significant correlation with scores on the acute physiological and chronic health evaluation (apache ii) scale and with serum creatinine, and an inverse correlation with platelet counts. serial serum measurem ...19958588134
characterization of puumala virus nucleocapsid protein: identification of b-cell epitopes and domains involved in protective immunity.b-cell epitopes in the nucleocapsid protein (n) of puumala (puu) virus were investigated by use of truncated recombinant proteins and overlapping peptides. six of seven epitopes, recognized by bank vole monoclonal antibodies, were localized within the amino-terminal region of the protein (aa 1-79). polyclonal antibodies from wild-trapped or experimentally infected bank voles identified epitopes located over the entire protein. antibody end-point titers to different n fragments indicated that the ...19968607269
khabarovsk virus: a phylogenetically and serologically distinct hantavirus isolated from microtus fortis trapped in far-east russia.two hantavirus strains, mf43 and mf113, isolated from microtus fortis trapped in the khabarovsk region of far-eastern russia, were analysed by direct nucleotide sequencing of pcr generated fragments of the m and s segments, by immunofluorescence and by focus reduction neutralization tests (frnt). the nucleotide sequences revealed that the two isolates were closely related to each other but distinct from all other hantaviruses. phylogenetic analysis of the m and s segments showed that the mf stra ...19968627257
characterization of the nucleocapsid protein of hantaan virus strain 76-118 using monoclonal antibodies.we characterized the antigenic sites on the nucleocapsid protein (np) of hantaan virus (htn) using 10 monoclonal antibodies (mabs). at least seven antigenic sites were revealed by a competitive binding assay and divided into three partially overlapping antigenic regions (i, ii and iii). regions i [amino acids (aa) 1-103], ii (aa 104-204) and iii (aa 205-402) were mapped on np by examining the reactivity of truncated gene products. those that corresponded to region i reacted with immune mouse ser ...19968627258
hantaan and puumala virus antibodies in blood donors in samara, an hfrs-endemic region in european russia. 19968676649
antigenic properties and diagnostic potential of puumala virus nucleocapsid protein expressed in insect cells.puumala virus (puu) is a member of the genus hantavirus in the family bunyaviridae and the causative agent of nephropathia epidemica, a european form of hemorrhagic fever with renal syndrome. sera of nephropathia epidemica patients react specifically with puu nucleocapsid (n) protein. in order to safely provide large quantities of antigen for diagnostic purposes, puu sotkamo strain n protein was expressed by using the baculovirus system in sf9 insect cells to up to 30 to 50% of the total cellula ...19968748286
a major antigenic domain for the human humoral response to puumala virus nucleocapsid protein is located at the amino-terminus.nephropathia epidemica (ne), the major form of hemorrhagic fever with renal syndrome in europe, is caused by the hantavirus serotype puumala (puu). the puu virus nucleocapsid protein (n) has been shown to be highly immunogenic both in laboratory animals and in man. we aimed to locate domains important in humoral immune reactivity and to use this information to develop a specific and sensitive enzyme-linked immunosorbent assay (elisa) for serological diagnosis of ne. escherichia coli poly-histidi ...19968793844
vector-borne viral diseases in sweden--a short review.ockelbo disease, caused by a sindbis-related virus transmitted to man by mosquitoes, was first described in the central part of sweden in the 1960s as clusters of patients with fever, arthralgia and rash. an average annual rate of 30 cases was recorded in the 1980s but no cases have been diagnosed during the last few years. nephropathia epidemica (ne) characterized by fever, abdominal pain and renal dysfunction has been known to cause considerable morbidity in sweden during the last 60 years but ...19968800805
nucleotide and deduced amino acid sequences of the m and s genome segments of a swedish puumala virus isolate.the swedish puumala (puu) virus strain vindeln 83-l20, isolated from a bank vole trapped in 1983 near vindeln, västerbotten county, sweden, was characterized by nucleotide sequence analysis. the coding region of the m segment was determined by pcr followed by direct sequencing and the entire s segment was characterized by cloning and nucleotide sequence analysis. the genomic organization was found to be very similar to that of other puu virus strains regarding open reading frames, polypeptide si ...19958837894
inhibition of puumala and tula hantaviruses in vero cells by mxa protein.human mxa protein is a type i interferon-inducible intracytoplasmic protein, which mediates antiviral actions against a variety of negative-strand rna viruses including influenza a, measles, and vesicular stomatitis viruses. recently, it has also been shown that several members of the bunyaviridae family are inhibited by mxa protein. the hantavirus genus in the bunyaviridae family includes important human pathogenic viruses, e.g., puumala (puuv), hantaan, and sin nombre viruses. tula virus (tulv ...19968862399
acute renal failure due to hemorrhagic fever with renal syndrome.the aim of our study was to analyze the clinical course and outcome of acute renal failure (arf) in patients with hemorrhagic fever with renal syndrome (hfrs). from 1983 to 1995, we treated 33 patients (27 males, 6 females) aged from 16 to 71 years. half of patients were connected with work at a farm or in a forest. the disease was confirmed serologically with indirect immunofluorescence test (ift) and enzyme-linked immunosorbent assay (elisa). in 18 patients percutaneous kidney needle biopsies ...19968875690
biotin-labeled antigen: a novel approach for detection of puumala virus-specific igm.a novel enzyme-linked immunosorbent assay, bla igm-elisa, based on baculovirus-expressed puumala (puu) virus nucleocapsid protein, was developed for rapid diagnosis of nephropathia epidemica. the recombinant antigen (bac-puu-n) was purified to homogeneity by hplc and conjugated to biotin. the biotin-streptavidin system, in combination with the mu-capture technique, rendered the bla igm-elisa a sensitivity similar to or higher than that of puu virus igm mu-capture elisa based on native antigen. t ...19968910652
[hantavirus infection in spain: seroepidemiologic study in the province of soria].the aim of the present was to study the seroprevalence of hantavirus infection in the province of soria, spain.19968948928
[a system of immunoenzyme analysis using biotinylated monoclonal antibodies for typing hantavirus antigens].enzyme immunoassay with biotin-labeled monoclonal antibodies to puumala virus was used for typing hantavirus antigens. the system is type-specific, that is, it detects puumala virus only, which was demonstrated by typing 9 hantavirus antigens in infected vero e5 cells and by epizootological analysis of an hfrs outbreak in the yegoryevsk district of the moscow region in november-december 1995. the suggested system may be used as an element of eia screening of natural samples in analysis of the sc ...19968999683
rapid and specific detection of sin nombre virus antibodies in patients with hantavirus pulmonary syndrome by a strip immunoblot assay suitable for field develop a rapid antibody test for sin nombre hantavirus (snv) infection for diagnosis of hantavirus pulmonary syndrome (hps) in field settings where advanced instrumentation is not available, a strip immunoblot assay bearing four immobilized antigens for snv and a recombinant nucleocapsid protein antigen of seoul hantavirus (seov) was prepared. the snv antigens included a full-length recombinant-expressed nucleocapsid (n) protein (rn), a recombinant-expressed g1 protein (residues 35 to 117), ...19979041397
phage-displayed peptide targeting on the puumala hantavirus neutralization site.we have selected ligands for puumala hantavirus, the causative agent of nephropathia epidemica, from a seven-amino-acid peptide library flanked by cysteines and displayed on a filamentous phage. to direct the selection to areas on the virus particle which are essential for infection, phages were competitively eluted with neutralizing monoclonal antibodies specific for the viral glycoproteins. the selected phage populations were specific for the same sites as the antibodies and mimicked their fun ...19979094664
intraocular pressure changes in nephropathia epidemica. a prospective study of 37 patients with acute systemic puumala virus infection.nephropathia epidemica is a zoonose in the group of hemorrhagic fevers with renal syndrome and is caused by puumala virus in hantavirus genus. the purpose of this study is to find out how the intraocular pressure (iop) is affected by the acute phase of this disease and how it relates to the previous case reports on angleclosure glaucoma attacks.19959098282
puumala hantavirus genome in patients with nephropathia epidemica: correlation of pcr positivity with hla haplotype and link to viral sequences in local rodents.reverse transcription-pcr was used to analyze specimens from 20 finnish nephropathia epidemica (ne) patients hospitalized during the period from october 1994 to january 1995. blood and/or urine sediment specimens from seven patients were found to be positive for the genome sequences of puumala hantavirus (puu). pcr positivity of the specimens from the patients correlated well with the hla-drb1*0301 and hla b8 alleles, which previously were shown to associate with severe courses of ne. genetic an ...19979114386
single amino acid substitutions in puumala virus envelope glycoproteins g1 and g2 eliminate important neutralization epitopes.two monoclonal antibody escape virus mutants (mars), rescued from a human mab to glycoprotein 2 (g2) and a bank vole monoclonal antibody (mab) directed to glycoprotein 1 (g1) of puumala virus, strain sotkamo, were produced by using a combination of neutralization tests and antigen detection. the mars and the original virus were analyzed by nucleotide sequencing and the responsible mutations were defined and characterized. the g1 mutation was found to constitute an a to t nucleotide substitution, ...19979140197
a major antigenic domain of hantaviruses is located on the aminoproximal site of the viral nucleocapsid protein.hantavirus nucleocapsid protein has recently been shown to be an immunodominant antigen in hemorrhagic with renal syndrome (hfrs) inducing an early and long-lasting immune response. recombinant proteins representing various regions of the nucleocapsid proteins as well as segments of the g1 and the g2 glycoproteins of hantavirus strains cg18-20 (puumala serotype) and hantaan 76-118 have been expressed in e. coli. the antigenicity of these proteins was tested in enzyme immunoassays and immunoblots ...19979208453
high prevalence of hantavirus antibodies in bank voles (clethrionomys glareolus) captured in the vicinity of households afflicted with nephropathia epidemica.puumala virus, the causative agent of nephropathia epidemica (ne), occurs endemically in europe and is spread mainly by the bank vole (clethrionomys glareolus). in the vicinity of each of four households afflicted with ne, we studied rodents with regard to population density and prevalence of puumala virus-specific antibodies. for each case area, a control area was randomly selected 10 km away, without regard to the presence of human settlement. during 6,000 trap nights, 328 rodents were caught, ...19979230802
the first human isolate of puumala virus in scandinavia as cultured from phytohemagglutinin stimulated leucocytes.a virus isolate was recovered from blood leucocytes of a patient with nephropathia epidemica (ne). leucocytes were isolated from edta-blood by dextran sedimentation and cultured on monolayers of vero e6 cells in the presence of phytohemagglutinin (pha) in roller tubes during the first 72 hours of incubation followed by rolling culture for three weeks in total. thereafter the first subculture was done in a plastic flask and afterward at at least 6 week intervals. antigen was first detected after ...19979334926
cell culture adaptation of puumala hantavirus changes the infectivity for its natural reservoir, clethrionomys glareolus, and leads to accumulation of mutants with altered genomic rna s segment.this paper reports the establishment of a model for hantavirus host adaptation. wild-type (wt) (bank vole-passaged) and vero e6 cell-cultured variants of puumala virus strain kazan were analyzed for their virologic and genetic properties. the wt variant was well adapted for reproduction in bank voles but not in cell culture, while the vero e6 strains replicated to much higher efficiency in cell culture but did not reproducibly infect bank voles. comparison of the consensus sequences of the respe ...19979371614
sequence analysis of the puumala hantavirus sotkamo strain l segment.sequence of the puumala virus (puu) sotkamo strain l segment is provided, completing the total genome of this prototype puu virus strain. the l segment is 6530 nucleotides long and it can encode 2156 amino-acids-long l protein, rna-dependent rna polymerase. the strain sotkamo, originally isolated in finland, showed for the l genome segment nucleotide (84.6%) and amino acid (97.3%) homology to a previously sequenced puu russian isolate, strain bashkiria/cg1820 (b1820) and the l genome segment app ...19979381791
evaluation of serological methods for diagnosis of puumala hantavirus infection (nephropathia epidemica).nephropathia epidemica (ne), puumala (puu) virus infection, is a febrile disease which is commonly associated with acute renal impairment. to differentiate ne from other acute febrile illnesses, a rapid and reliable serological diagnosis is important, and a number of different protocols have recently been introduced. in the present report we describe a comparative evaluation of six puu virus immunoglobulin m (igm) and seven igg enzyme-linked immunosorbent assay (elisa) protocols based on native, ...19979399531
severe thrombocytopenia and response to corticosteroids in a case of nephropathia epidemica.nine days after working in the woods, a previously healthy 32-year-old man fell seriously ill. his symptoms included high fever, chills, diffuse myalgia, severe headache, and back pain. on the fifth day of onset of symptoms, blood tests showed creatinine levels of 5.4 mg/dl accompanied by marked proteinuria. after admission to the hospital, a diagnosis of nephropathia epidemica (ne) caused by puumala virus was made using solid-phase enzyme-linked immunosorbent assay (elisa). the patient graduall ...19989428461
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