Seroepidemiologic Analysis and Antigen Detection from Patients with Hemorrhagic Fever with Renal Syndrome

Song, Ki Joon; Kim, Se Yeun; Kim, Sang Hyun; Yun, Jae Kyung; Baek, Luck Ju; Lee, Yong Ju; Song, Jin Won

Abstract

BACKGROUND: Hantaan (HTN) and Seoul (SEO) viruses, harbored by the striped-field mouse(Apodemus agrarius) and the Norway or common rat (Rattus rattus & Rattus norvegicus), respectively, were known to cause hemorrhagic fever with renal syndrome(HFRS) in Korea. We evaluated the seroepidemiologic patterns of hantaviral infections and detect the hantaviral antigens from patients' sera.
METHODS
Total 8,102 HFRS patients' sera were collected from 1994 to 1996, and examined by indirect immunofluorescent antibody technique (IFA), hemagglutination inhibition test (HI), IgM emzyme-linked immunosorbent assay (IgM-ELISA) and nested reverse transcription-polymerase chain reaction(RT-PCR).
RESULTS
The seropositive rate against hantaviral antigen was 12.0% (973/8102) with the high incidence rate (68.3%) in the period from October to January, and males in the thirties were mostly affected. HTN viral infections were detected 3.5 and 5.2 times higher than SEO viral infections by HI and RT-PCR, respectively, and patients in the fifties were the mostly affected age-group in SEO viral infections, IgM antibodies were detected in the 717 sera of the 905 IFA positive cases (79.2%), and the antigen detection rate of HTN and SEO viruses was 7.7% (56/724). Interestingly, 40 sera (4.4%), showed higher antibody titers against the Puumala (PUU) virus than those against HTN or SEO viruses.
CONCLUSION
The results showed HTN and SEO viruses were the main causative agents of HFRS in Korea, and also suggested the possible presence of PUU-related hantaviral infections.