Characteristics of Puumala and Dobrava infections in Croatia

A. Markoti, S. T. Nichol, I. Kuzman, A. J. Sanchez, T. G. Ksiazek, A. Gagro, S. Rabati, R. Zgorelec, T. Avi-upanc, I. Beus, D. Dekaris

Research output: Contribution to journalArticle

86 Scopus citations

Abstract

In this study, two different hantaviruses, Puumala virus (PUUV) and Dobrava virus (DOBV), were demonstrated for the first time to coexist and cause hemorrhagic fever with renal syndrome (HFRS) in Croatia. Phylogenetic analysis showed some differences among the nucleotide sequences of PUUV originating from Dinara mountain, which was more closely related to Austrian PUUV than other Croatian PUUV from Mala Kapela mountain. More consistency was found among the Croatian DOBV. HFRS was verified in 85 of 201 suspected cases recorded in 1995 during the largest HFRS outbreak in Croatia. Most of these cases were soldiers. With the exception of the coastal region and islands, all of Croatia was found to be an area endemic for HFRS. A statistically significantly higher proportion of DOBV-infected patients had acute renal failure, visual disturbance, severe thrombocytopenia, and elevated levels of nonsegmented leukocytes, creatine, and total bilirubin. The prevalence of gastrointestinal and electrocardiography disorders also was greater in DOBV-infected patients. Interestingly, significantly more PUUV-infected patients had elevated systolic blood pressure on admission to the hospital. Further prospective studies are necessary to shed more light on differences in HFRS severity associated with PUU and DOB viruses.

Original languageEnglish (US)
Pages (from-to)542-551
Number of pages10
JournalJournal of Medical Virology
Volume66
Issue number4
DOIs
StatePublished - Mar 19 2002
Externally publishedYes

Keywords

  • Clinical study
  • Epidemiology
  • HFRS
  • Soldiers
  • War

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

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  • Cite this

    Markoti, A., Nichol, S. T., Kuzman, I., Sanchez, A. J., Ksiazek, T. G., Gagro, A., Rabati, S., Zgorelec, R., Avi-upanc, T., Beus, I., & Dekaris, D. (2002). Characteristics of Puumala and Dobrava infections in Croatia. Journal of Medical Virology, 66(4), 542-551. https://doi.org/10.1002/jmv.2179