Hantaviruses in Estonia

Human serum samples collected from healthy individuals in 14 counties were screened by ELISA in order to investigate the presence of hantavirus infections in Estonia. Out of 1,234 serum samples, 124 were found positive for hantavirus-specific IgG and were subsequently serotyped by a focus reduction neutralization test. A total of 112 samples neutralized at least one of the examined hantaviruses-Puumala (PUUV), Saaremaa (SAAV), Dobrava (DOBV), Hantaan, and Seoul viruses-and thereby, the focus reduction neutralization test confirmed the overall hantavirus seroprevalence rate in Estonia to be 9.1%. Most of the sera showed a specific reaction (at least 4-fold higher endpoint titer) of neutralizing antibodies to PUUV (5.1%), while 3.4% showed a SAAV- or SAAV/DOBV-specific reaction. The fact that seven sera (0.6%) could not be serotyped may indicate the presence of an unknown hantavirus serotype. Hantavirus infections were confirmed in 13 of 14 investigated counties, with highly varying seroprevalence rates (1.0-28.4%). The sex ratio was 1.8:1.0 (M:F), and the antibody prevalence peaked in the age group 45-54 years. A total of 513 rodents of seven species trapped in seven counties were examined for the presence of hantavirus antigen, in order to study the distribution of hantavirus natural carriers. Two species, Clethrionomys glareolus and Apodemus agrarius, were found positive for hantaviral antigen in 13.7% and 4.5% of the investigated rodents, respectively. Analyses of viral sequences recovered from infected C. glareolus tissue samples showed that the infecting virus belonged to the PUUV genotype, confirming that PUUV circulates in mainland Estonia. The Estonian PUUV strains were placed in the closest proximity to Russian PUUV strains in phylogenetic trees, suggesting a common evolutionary history. Together with earlier data on SAAV in A. agrarius, the results revealed that two hantaviruses, PUUV and SAAV, are common in Estonia and that the incidence of human infection is high in both cases.     

Rodent host specificity of European hantaviruses: evidence of Puumala virus interspecific spillover

In order to investigate rodent host specificity of European hantaviruses, experimental infection of colonized and wild-trapped rodents was performed. In addition to the natural rodent reservoir, Clethrionomys glareolus, Puumala hantavirus (PUUV) could infect colonized Microtus agrestis and Lemmus sibiricus, but not Syrian hamsters or Balb/C mice. Neither C. glareolus, nor M. agrestis, could be readily infected by Tula hantavirus (TULV). Wild-trapped Apodemus flavicollis and A. agrarius, the natural reservoirs of Dobrava (DOBV) and Saaremaa (SAAV) hantaviruses, respectively, could both be infected by SAAV. NMRI mice could also be infected by SAAV, but with lower efficiency as compared to Apodemus mice. Balb/C and NMRI laboratory mice, but not C. glareolus, could be infected by DOBV. To our knowledge, this is the first time DOBV and SAAV have been shown to infect adult laboratory mice. Moreover, potential hantavirus spillover infections were investigated in wild-trapped rodents. In addition to the natural host C. glareolus, we also found M. arvalis and A. sylvaticus with a history of PUUV infection. We did not find any C. glareolus or A. sylvaticus infected with TULV, a hantavirus which is known to circulate in the same geographical regions of Belgium.     

A retrospective study of hantavirus infection in Kinmen, Taiwan.

In this retrospective study, 140 serum samples collected from 85 scrub typhus-negative patients in Kinmen Island in 2000 were tested for antibodies to hantavirus using enzyme-linked immunosorbent assay. Seven patients (8.23%) were confirmed as having hantavirus infection as demonstrated by increased hantavirus-specific immunoglobulin M and/or immunoglobulin G antibodies in their convalescent serum samples. Analysis of indirect immunofluorescence assay showed that Seoul type was the etiologic agent. Serosurvey of rodents caught in the resident township of these hantavirus-infected human cases showed that the seroprevalence of antibodies to hantavirus among Rattus norvegicus, Mus musculus, and R. flavipectus was 50% (4/8), 20% (1/5), and 2% (7/348), respectively. Molecular analysis showed that these reservoir hosts carried a Seoul type hantavirus. To our knowledge, this is the first report demonstrating indigenous hantavirus cases in Kinmen.     

Borrelia burgdorferi s.l. in Ixodes ricinus (Acari: Ixodidae) ticks collected from vegetation and small rodents in recreational areas of the city of Poznań

During 1998-1999, Ixodes ricinus (L.) populations were investigated in three different biotopes (deciduous, mixed, coniferous forest) situated in popular recreational areas in Poznań, Poland. In total, 1,123 questing ticks (1,002 nymphs, 69 males, 52 females) were collected by flagging vegetation. Additionally, in 1998 between May and September small rodents were trapped and inspected for feeding ticks. Altogether, 213 rodents of three species: Apodemus agrarius Pall., A. flavicollis Melchior, Clethrionomys glareolus Schreber were captured. Of 323 engorged ticks, 304 were larvae and 19 nymphs. All ticks collected from vegetation, as well as from rodents were examined for the presence of Borrelia burgdorferi Johnson, Schmid, Hyde, Steigenwalt & Brenner s.l. spirochetes by indirect immunofluorescence assay (IFA) using PAB 1B29. The seasonal pattern of activity of questing I. ricinus was always bimodal (May/June and August/September). The most abundant tick population occurred in the deciduous forest. The total infection rate in questing ticks was 16.2%. Differences in mean infection prevalence of host-seeking ticks between three biotopes each year were not significant. On average more larvae parasitized on the genus of Apodemus than on C. glareolus. 17.8% of larvae and 31.6% of nymphs fed on rodents harbored spirochetes. The three rodent species contributed to a different degree in to transmission of the pathogen to subadult stages. Approximately 27% of larvae infested on A. agrarius, 22% on C. glareolus, and only 4.2% on A. flavicollis contained spirochetes. The results suggest that the prevalence of A. agrarius and C. glareolus in disturbed urban forests used for leisure activities seems to be crucial for the maintenance of B. burgdorferi s.l. in I. ricinus populations.     

Ecology of hantaviruses in Mexico: Genetic identification of rodent host species and spillover infection

In our recent epidemiological survey conducted in Mexico for hantavirus infection, we identified three distinct viruses circulating in Mexican wild rodents, namely Montano virus (MTNV), Huitzilac virus (HUIV), and Carrizal virus (CARV). To gain a detailed understanding of hantavirus epidemiology and its associated hosts, 410 rodents were captured at eight collecting points in Morelos and Guerrero, Mexico, and examined for hantavirus seroprevalence, the presence of viral RNA, and rodent host species identification using cytochrome b gene sequences. Of the 32 species captured, seven species were positive for hantavirus: Peromyscus beatae (31/127; 24.4%), Reithrodontomys sumichrasti (6/15; 40%), Reithrodontomys megalotis (2/25; 8%), Peromyscus aztecus evides (1/1; 100%), Peromyscus megalops (1/41; 2.4%), Megadontomys thomasi (1/9; 11.1%), and Neotoma picta (1/6; 16.7%), with an overall prevalence of 10.5%; virus genome persisted in the majority of seropositive rodents. Nucleotide sequence and phylogenetic analysis showed that the viruses belonged mainly to the three lineages previously identified. The data showed that MTNV and CARV were primarily carried by P. beatae and R. sumichrasti, respectively. In addition, the data revealed an apparent complex interaction between hantaviruses and their hosts, suggesting active transmission and/or spillover infections within sympatric rodent species.     

Patterns of avian seroprevalence to western equine encephalomyelitis and Saint Louis encephalitis viruses in California, USA

Temporal and spatial changes in the enzootic activity of western equine encephalomyelitis (WEE) and St. Louis encephalitis (SLE) viruses were monitored at representative wetland study sites in the Coachella, San Joaquin, and Sacramento valleys of California from 1996 to 1998 using three methods: (1) virus isolation from pools of 50 host-seeking Culex tarsalis Coquillett females, (2) seroconversions in flocks of 10 sentinel chickens, and (3) seroprevalence in wild birds collected by mist nets and grain baited traps. Overall, 74 WEE and one SLE isolates were obtained from 222,455 Cx. tarsalis females tested in 4,988 pools. In addition, 133 and 40 seroconversions were detected in 28 chicken flocks, and 143 and 27 of 20,192 sera tested from 149 species of wild birds were positive for antibodies to WEE and SLE, respectively. WEE was active in all three valleys, whereas SLE only was detected in Coachella Valley. Seroconversions in sentinel chickens provided the most sensitive indication of enzootic activity and were correlated with seroprevalence rates in wild birds. Avian seroprevalence rates did not provide an early warning of pending enzootic activity in chickens, because positive sera from after hatching year birds collected during spring most probably were the result of infections acquired during the previous season. Few seroconversions were detected among banded recaptured birds collected during spring and early summer. Age and resident status, but not sex, were significant risk factors for wild bird infection, with the highest seroprevalence rates among after hatching year individuals of permanent resident species. Migrants (with the exception of mourning doves) and winter resident species rarely were positive. House finches, house sparrows, Gambel's quail, California quail, common ground doves, and mourning doves were most frequently positive for antibodies. The initial detection of enzootic activity each summer coincided closely with the appearance of hatching year birds of these species in our study areas, perhaps indicating their role in virus amplification. Bird species most frequently positive roosted or nested in elevated upland vegetation, sites where Cx. tarsalis host-seeking females hunt most frequently. These serosurveys provided important background information for planned host competence and chronic infection studies.     

Genetic characterization of Puumala hantavirus strains from Belgium: evidence for a distinct phylogenetic lineage

Puumala hantavirus (PUUV) sequences were recovered from red bank voles (Clethrionomys glareolus) trapped between 1996 and 1998 in four localities of southern Belgium: Thuin, Montbliart, Momignies and Couvin. In addition, three PUUV isolates originating from bank voles trapped in the 1980s in southern (Montbliart) and northern (Turnhout) Belgium were genetically characterized. Analysis of the complete S and partial M segment sequences showed that the Belgian PUUV strains constitute a genetic lineage, distinct from other known PUUV lineages from Europe and Japan. This lineage also includes a wild strain (Cg-Erft) originating from a neighbouring area of Germany. Within the Belgian lineage, geographical clustering of genetic variants was observed. In the Montbliart site, the range of diversity between the most temporally distant strains (from 1986 and 1996-1998) was higher than between those from 1996 and 1998, suggesting slight genetic drift via accumulation of neutral or quasi-neutral substitutions with time.     

Trends in HIV prevalence among pregnant women in Italy, 1994 to 2002

OBJECTIVE: The aim of the study was to analyze the trends in HIV prevalence among childbearing women through unlinked anonymous testing of newborns. METHODS: Dried-blood specimens, residual to routine metabolic screening of newborns, were collected in Italy during the last quarter of each year, from 1994 to 2002. These samples were tested anonymously for HIV antibodies. RESULTS: Of 844,311 specimens tested, 703 (0.83/1000; 95% confidence interval, 0.76-0.88) resulted as HIV antibody-reactive. Prevalence was 1.05 per 1000 in 1994 and decreased significantly over the following 3 years, reaching 0.60 per 1000 in 1997. Thereafter, a seroprevalence increase was recorded with a figure of 1.01 per 1000 in 1999. A decrease was again observed in 2001 and in 2002, when the seroprevalence rate was significantly lower than that recorded in 1994. During the entire study period, higher prevalence rates were observed in northern Italian regions, where the highest AIDS incidence rates are recorded, and in metropolitan compared with nonmetropolitan areas. The estimated number of children born each year to an HIV-positive mother ranged from 313 to 546. CONCLUSION: The number of children born to an HIV-positive mother calls for continued efforts to prevent vertical transmission of the infection.     

Serological study of hantavirus in man in the Autonomous Community of Madrid,Spain

Data relating to hantavirus infection in Spain are scarce and limited to rural areas. The aim of this work was to study the seroprevalence of hantavirus infection in the Autonomous Community of Madrid (ACM), a region containing both rural and urban populations in different ecological settings. Sera from 3852 individuals (1849 male, 2003 female) were screened by indirect inmunofluorescence, with Vero E6 cells infected with Puumala, Hantaan and Seoul viruses as antigens. Screen-positive results were confirmed by Western blot with recombinant Seoul virus nucleocapsid protein as antigen. Antibodies against hantavirus were detected in 12 sera (0.31%). No statistical differences were found according to sex and age. The highest prevalence was found in the southeastern area, significantly higher than the central and north-western areas. The most frequent serological pattern was reactivity against all three viruses used (33.3% of all positive sera). Therefore, this study confirms the presence of hantavirus infection in the ACM, including for the first time an urban area of Spain, but with the highest prevalence in a rural area. Serological evidence suggests that there is more than one circulating serotype.     

Ticks (Acari: Ixodidae) and spirochetes (spirochaetaceae: spirochaetales) recovered from birds on a Georgia Barrier Island

From September 1997 through July 1999, 300 individuals and 46 species of birds were mist-netted and screened for ticks and spirochetes on St. Catherine's Island, Liberty County, GA. Seventy-six (25%) of the birds were parasitized by a meal intensity of 4.6 ticks. Seasonally, more birds were infested with ticks during the summer (50% in 1998, 34% in 1999) than in spring (15% in 1998, 11% in 1999) or fall (21% in 1997, 20% in 1998), mainly because of severe infestations on some birds by immature stages of the lone star tick, Amblyomma americanum (L.), during this season. Eight species ofticks were recovered from 14 species of birds during this study: A. americanum (74 nymphs, 168 larvae); the blacklegged tick, Ixodes scapularis Say (11 nymphs, 28 larvae), the Gulf Coast tick, Amblyomma maculatum Koch (two nymphs, 29 larvae); Ixodes minor Neumann (16 larvae); the rabbit tick. Haemaphysalis leporispalustris (Packard) (one nymph, 14 larvae); the bird tick Ixodes brunneus Koch (two larvae); the American dog tick, Dermacentor variabilis (Say) (one nymph); and Ixodes affinis Neumann (one larva). The Carolina wren was parasitized by more species of ticks (seven) than any other bird species, followed by the northern cardinal (five), white-throated sparrow (four) and painted bunting (three). Spirochetes were isolated in BSK II medium from one tick (a nymphal A. americanum) and from skin biopsies of 12 (4%) of the individual birds (three downy woodpeckers, three northern waterthrushes, two Carolina wrens, one American redstart, one pine warbler, one Swainson's thrush, and one white-eyed vireo) all in fall 1997. This concentrated phenology of spirochete isolations might reflect periodic amplification or recrudescence of spirochetes in reservoir avian hosts.     

Characterization of Tula Virus from Common Voles (Microtus Arvalis) in Poland: Evidence for Geographic-Specific Phylogenetic Clustering

Tula virus (TULV), a recently identified arvicolid rodent-borne hantavirus, is harbored by the European common vole (Microtus arvalis) in Central Russia and the Czech and Slovak Republics. We report the isolation and characterization of this hantavirus from M. arvalis captured in Poland, a country where human disease caused by hantaviruses has not been recognized. Of 34 arvicolid rodents (24 Clethrionomys glareolus, 9 M. arvalis, 1 Pitymys sp.) captured in Lodz and Tuszyn, Poland, during June to September 1995, sera from 3 M. arvalis and 3 C. glareolus contained IgG antibodies to Puumala virus (PUUV), as determined by an indirect immunofluorescent antibody assay. Alignment and comparison of the 1852-nucleotide S segment and a 1676-nucleotide region of the G2 glycoprotein-encoding M segment, amplified from lung tissues of two hantavirus-seropositive M. arvalis, revealed 83.9-85.2% and 82.3-83.5% sequence similarity, respectively, with TULV strains from Central Russia and the Czech and Slovak Republics. A > 98% sequence conservation was found at the amino acid level. Phylogenetic analysis indicated that the newly found TULV strains from Poland were closely related to, but distinct from, TULV from elsewhere in Europe.     

HIV in Vietnam: the evolving epidemic and the prevention response, 1996 through 1999

OBJECTIVES: To describe epidemiologic patterns and trends in HIV infection in Vietnam from 1996 through 1999, and to summarize the national response to the epidemic. METHODS: We reviewed nationwide HIV case reports, and we analyzed annual seroprevalence among different sentinel populations in 21 provinces, using the chi2 test for linear trend to assess trends in HIV prevalence. HIV prevention efforts were also reviewed. RESULTS: Through 1999, 17,046 HIV infections, including 2947 AIDS cases and 1523 deaths had been reported in Vietnam. The cumulative incidence rate for the country was 22.5 per 100,000 population. Injection drug users (IDUs) represented 89.0% of all those for whom risk was reported before 1997 and 88.0% in the period 1997 to 1999. In 1999, HIV prevalence rates among IDUs ranged by province from 0% to 89.4%. Significantly increasing HIV trends among IDUs (p <.05) were found in 14 of the 21 sentinel provinces during 1996 to 1999. HIV prevalence among commercial sex workers (CSWs) ranged from 0% to 13.2%, increased significantly in 6 of 21 provinces. In 1999, prevalence among pregnant women, blood donors, and military recruits were 0.12%, 0. 20% and 0.61%, respectively. Major prevention activities include mass information; peer education and outreach among groups at increased risk; availability of low-cost syringes and condoms through pharmacies; needle exchange pilot projects; widely available treatment for sexually transmitted diseases; antibody screening of blood for transfusion; and free medical treatment at government hospitals. DISCUSSION: The HIV epidemic continues to evolve rapidly, intensifying among IDUs and increasing among CSWs. Serosurveillance indicators of HIV in the population at large continue to indicate the relatively slow extension beyond those at highest risk. Immediate, intensive preventions in high-risk groups may decelerate expansion to the broader population.     

Seroprevalence Study of Herpes Simplex Virus Type 2 among Pregnant Women in Germany Using a Type-Specific Enzyme Immunoassay

 In a German seroepidemiological study to determine the proportion of pregnant women infected with herpes simplex virus type 2 (HSV-2) and at risk of transmitting the infection to the newborn during delivery, IgG antibodies to HSV-2 in 1999 sera collected from pregnant women in 1996–1997 were measured using an automated type-specific enzyme immunoassay (Cobas Core HSV-2 IgG EIA; Roche Diagnostics, Switzerland). The seroprevalence of HSV-2 was 8.9%, and control studies with a type-common HSV assay measuring antibodies to HSV-1 and HSV-2 revealed that 20.7% of pregnant women were seronegative for HSV antibodies and are therefore at risk of acquiring primary genital HSV infection of either type.     

Nephropathia Epidemica and Puumala Virus in Austria

To study the epidemiology of hantavirus infections in Austria, 1215 humans and 596 rodents of different species were tested for the presence of antibodies against Puumala and Hantaan virus. Direct virus identification by polymerase chain reaction in lung tissue of serologically positive rodents was performed to verify antibody results and to determine the genetic identity of viral RNA by phylogenetic analysis of a part of the hantavirus M segment. For 32 of the 37 cases of nephropathia epidemica diagnosed in Austria, the location where transmission took place could be traced to specific areas in the Austrian federal states of Carinthia and Styria. The overall seroprevalence in humans was 1.2% and ranged from 0.02% in Villach, Carinthia, to 0.8% in Korneuburg, Lower Austria, and 1.8% in Wolfsberg, Carinthia. Virus RNA could be amplified from three Clethrionomys glareolus voles collected in Klippitztörl, Carinthia, and from one collected in Ernstbrunn, Lower Austria. The sequences were all identified as Puumala virus by phylogenetic analysis and were found to be most closely related to the western European Puumala viruses from Germany and France. No evidence of the existence of Hantaan-like infections and viruses in Austria was found.     

A sero-epidemiological survey on the occurrence of opisthorchiid liver flukes in red foxes (Vulpes vulpes) in Berlin,Germany

Serum samples collected from red foxes in the city of Berlin between 1996 and 1999 were analysed for the presence of antibodies against Opisthorchis felineus and Metorchis bilis using an indirect ELISA. Out of 1,000 specimens, 30.6% and 46.5% reacted positively with specific O. felineus and M. bilis antigens, respectively. Seroprevalence in adult foxes was always higher than in juveniles. While no significant differences were observed in adult foxes throughout the period, in juvenile specimens seroprevalence declined from 1996 to 1997, then stayed at a comparable level in 1998 and increased in 1999. A varying availability of fresh cyprinid fish in different years seems to be the reason for changes in seroprevalence. By grouping the samples from juvenile foxes by season, antibodies against both Metorchis and Opisthorchis antigens started to appear between April and June, increased between July and September()and reached a level comparable to adult foxes in the October to December quarter. The lowest seroprevalence was found in Pankow, which is the district with the lowest share of the surface water.     

Hantavirus Infections in Latvia

In order to investigate the presence of hantavirus infections in Latvia, 333 randomly selected human serum samples were screened using an enzyme-linked immunoassay. Fifteen samples were positive for hantavirus-specific IgG and were subsequently serotyped using a focus reduction neutralization test. Fourteen of these samples neutralized at least one of the hantaviruses included in the test, indicating a 4.2% overall seroprevalence in Latvia. Among 14 focus reduction neutralization test-positive sera, specific reactivity (at least 4-fold higher endpoint titer) of neutralizing antibodies was as follows: six sera were specific for Saaremaa hantavirus, three showed equal titers to Saaremaa and Dobrava hantaviruses, and five showed the highest endpoint titers to Puumala hantavirus. Hantavirus infections were confirmed in individuals residing in 11 of 26 investigated counties. The sex ratio was 1:2.5 (M:F), and the antibody prevalence increased with age. This is the first report on the presence of hantavirus infections in Latvia, and the results indicate that two hantaviruses pathogenic to man, Saaremaa virus and Puumala virus, are widely distributed in this country. Electronic Publication     

Seroprevalence against Norwalk-like human caliciviruses in beijing, China

Serum specimens from 1,109 individuals at different ages in Beijing, China, were collected between April 1996 and March 1997 and tested for IgG antibodies against human caliciviruses using enzyme immune assays (EIAs). Baculovirus-expressed recombinant Norwalk virus (rNV) and Mexican virus (rMxV) capsid proteins were used as antigens. The seroprevalence was 89% for rNV and 91% for rMxV. Similar seroprevalence between the two antigens was observed in individual age groups and both genders. Infants had a high seroprevalence (99% for NV and 94% for MxV) at birth. The lowest seroprevalence (41% for rNV and 36% for rMxV) was at 7-11 months of age. A sharp increase in seroprevalence occurred in early childhood, with 65% and 70% at one, 85% and 90% at three, and 100% and 98% at 8-9 years of age for rNV and rMxV, respectively. Forty-three individuals had antibody against rNV but not rMxV and 63 individuals had antibody against rMxV but not rNV, indicating different levels of exposure to the two strains in these individuals. This is the first report of surveillance of antibodies against NV-like viruses in China. The observed high prevalence and early age antibody acquisition suggest that infection by these two human calicivirus strains is common in this population.