Hantavirüs Enfeksiyonları

Özet

Doğal rezervuarı kemirciler olan hantavirüsler; renal sendromlu hemarojik ateş ve hantavirus pulmoner sendrom olmak üzere iki ciddi akut ateşli hastalığa neden olur. “Eski dünya” olarak adlandırılan Asya ve Avrupa’daki virusler hantavirüs renal sendroma, Amerika kıtasında yaygın olan “Yeni dünya” virüsleri ise pulmoner sendroma yol açmaktadır. Farklı klinik tablolar farklı virüs alt tipleri ile ilişkilidir. Klinik seyir hantavirus tipine ve konak immun cevabına bağlı olarak değişiklik göstermektedir. Asemptomatik ve hafif semptomatik olabileceği gibi ciddi seyir de gösterebilir.Tanı epidemiyoloji öykü ile birlikte serolojik testler ile koyulur. Etkin bir antiviral tedavi olmayıp esas tedavi destek tedavisidir. Hantavirus patogenezi, antiviral tedavi ve aşı geliştirme dahil önleyici tedbirler konusunda daha fazla araştırmaya ihtiyaç vardır.

Hantaviruses, whose natural reservoir is rodents, cause two serious acute febrile diseases, hemarogenic fever with renal syndrome and hantavirus pulmonary syndrome. The so-called "Old World" viruses from Asia and Europe cause hantavirus renal syndrome, while the "New World" viruses common in the Americas cause pulmonary syndrome. Different clinical pictures are associated with different virus subtypes. The clinical course varies depending on the type of hantavirus and host immune response. It can be asymptomatic, mildly symptomatic or severe. The diagnosis is based on epidemiology, history and serologic tests. There is no effective antiviral treatment and the main treatment is supportive therapy. More research is needed on hantavirus pathogenesis, antiviral therapy and preventive measures including vaccine development.

Referanslar

Bente DA. California Encephalitis, Hantavirus Pulmonary Syndrome, and Bunyavirus Hemorrhagic Fevers. In: Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Elsevier; 2015. p. 2025-2030.e1.
Bellomo C, Alonso DO, Ricardo T et al. Emerging hantaviruses in Central Argentina: First case of Hantavirus Pulmonary Syndrome caused by Alto Paraguay virus, and a novel orthohantavirus in Scapteromys aquaticus rodent. PLoS Negl Trop Dis. 2021 Nov;15(11):e0009842.
Heinemann P, Schmidt-Chanasit J, Günther S. The N terminus of Andes virus L protein suppresses mRNA and protein expression in mammalian cells. J Virol. 2013 Jun;87(12):6975–85.
Mittler E, Dieterle ME, Kleinfelter LM et al. Hantavirus entry: Perspectives and recent advances. Adv Virus Res. 2019;104:185–224.
Gavrilovskaya IN, Gorbunova EE, Mackow NA et al. Hantaviruses direct endothelial cell permeability by sensitizing cells to the vascular permeability factor VEGF, while angiopoietin 1 and sphingosine 1-phosphate inhibit hantavirus-directed permeability. J Virol. 2008 Jun;82(12):5797–806.
Up to date. Epidemiology and diagnosis of hantavirus infections. (24/02/2024 tarihinde https://www.uptodate.com/contents/epidemiology-and-diagnosis-of-hantavirus-infections?search=HANTAVİRUS%20EPİDEMİYOLOJİ&source=search_result&selectedTitle=1%7E37&usage_type=default&display_rank=1. Adresinde ulaşılmıştır).
Holmes EC, Zhang YZ. The evolution and emergence of hantaviruses. Curr Opin Virol. 2015 Feb;10:27–33.
Vaheri A, Henttonen H, Voutilainen L et al. Hantavirus infections in Europe and their impact on public health. Rev Med Virol. 2013 Jan;23(1):35–49.
T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü Zoonotik ve Vektörel Hastalıklar Dairesi Başkanlığı. Hantavı̇rüs Enfeksı̇yonu. Ankara; 2020.
Lednicky JA. Hantaviruses. A short review. Arch Pathol Lab Med. 2003 Jan;127(1):30–5.
Pizarro E, Navarrete M, Mendez C et al. Immunocytochemical and Ultrastructural Evidence Supporting That Andes Hantavirus (ANDV) Is Transmitted Person-to-Person Through the Respiratory and/or Salivary Pathways. Front Microbiol. 2019;10:2992.
Up to date. Epidemiology and diagnosis of hantavirus infections. (24/02/2024 tarihinde https://www.uptodate.com/contents/epidemiology-and-diagnosis-of-hantavirus-infections?source=history_widget#H6. adresinden ulaşılmıştır).
Kruger DH, Figueiredo LTM, Song JW et al. Hantaviruses--globally emerging pathogens. J Clin Virol. 2015 Mar;64:128–36.
Jalal S, Kim CM, Kim DM et al. Geographical clustering of Hantavirus isolates from Apodemus agrarius identified in the Republic of Korea indicate the emergence of a new Hantavirus genotype. J Clin Virol. 2022 Jan;146:105030.
Centers for Disease Control and Prevention. Reported Cases of Hantavirus Pulmonary Syndrome in the United States. (25/02/2024 tarihinde https://www.cdc.gov/hantavirus/surveillance/index.html. adresinden ulaşılmıştır).
Public Health Agency of Canada. Canada Communicable Disease Report. Hantavirus pulmonary syndrome in Canada: An overview of clinical features, diagnostics, epidemiology and prevention. (25/02/2024 tarihinde https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2015-41/ccdr-volume-41-06-june-4-2015/ccdr-volume-41-06-june-4-2015-1.html. adresinden ulaşılmıştır).
Centers for Disease Control and Surveillance. International Hantavirus Pulmonary Syndrome (HPS). (25/02/2024 tarihinde http://www.cdc.gov/hantavirus/surveillance/international.html adresinde ulaşılmıştır).
Laakkonen J, Kallio-Kokko H, Oktem MA et al. Serological survey for viral pathogens in Turkish rodents. J Wildl Dis. 2006 Jul;42(3):672–6.
Ertek M, Buzgan T et al. Refik Saydam National Public Health Agency, Ministry of Health AT. An outbreak caused by hantavirus in the Black Sea region of Turkey, January-May 2009. Euro Surveill. 2009 May 21;14(20).
T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Dökümanlar. İstatistik. Hantavirus Enfeksiyonu ( 26/02/2024 tarihinde https://hsgm.saglik.gov.tr/depo/birimler/zoonotik-ve-vektorel-hastaliklar-db/Dokumanlar/Istatistikler/Hantavirs_istatistik.jpg. adresinden ulaşılmıştır).
Kalaycığlu H. Hantavirus epidemiology and epidemiological research: studies on hantavirus seroprevalence in Giresun province. Türk Hijyen ve Deneysel Biyoloji Dergisi. 2011;68:39–41.
Akar N. Seroprevalence of hantavirus and Borreliaburgdorferi in Düzce (Turkey) forest villages and the relationship with sociodemographic features. Turk J Med Sci. 2019 Apr 18;49(2):483–9.
Okay G. Hantavirus Infection in Turkey. Journal of Microbiology and Infectious Diseases. 2014 Jun 1;4(5).
Kaya S. Prognostic factors in hantavirus infections. Mikrobiyol Bul. 2014 Jan;48(1):179–87.
Avšič-Županc T, Saksida A et al. Hantavirus infections. Clin Microbiol Infect. 2019 Apr;21S:e6–16.
Mäkelä S, Ala-Houhala I, Mustonen J et al. Renal function and blood pressure five years after puumala virus-induced nephropathy. Kidney Int. 2000 Oct;58(4):1711–8.
Miettinen MH, Mäkelä SM, Ala-Houhala IO et al. Ten-year prognosis of Puumala hantavirus-induced acute interstitial nephritis. Kidney Int. 2006 Jun;69(11):2043–8.
Muranyi W, Bahr U, Zeier M et al. Hantavirus infection. J Am Soc Nephrol. 2005 Dec;16(12):3669–79.
Jonsson CB, Figueiredo LTM, Vapalahti O. A global perspective on hantavirus ecology, epidemiology, and disease. Clin Microbiol Rev. 2010 Apr;23(2):412–41.
Turčinov D, Puljiz I, Markotić A et al. Clinical and laboratory findings in patients with oliguric and non-oliguric hantavirus haemorrhagic fever with renal syndrome: an analysis of 128 patients. Clin Microbiol Infect. 2013 Jul;19(7):674–9.
Outinen TK, Mantula P, Laine OK et al. Haematuria is a marker for the severity of acute kidney injury but does not associate with thrombocytopenia in acute Puumala hantavirus infection. Infect Dis (Lond). 2017;49(11–12):840–6.
Koskela S, Mäkelä S, Strandin T et al. Coagulopathy in Acute Puumala Hantavirus Infection. Viruses. 2021 Aug 6;13(8).
Pal E, Korva M, Resman Rus K et al. Sequential assessment of clinical and laboratory parameters in patients with hemorrhagic fever with renal syndrome. PLoS One. 2018;13(5):e0197661.
Mustonen J, Mäkelä S, Outinen T et al. The pathogenesis of nephropathia epidemica: new knowledge and unanswered questions. Antiviral Res. 2013 Dec;100(3):589–604.
Mustonen J, Outinen T, Laine O et al. Kidney disease in Puumala hantavirus infection. Infect Dis (Lond). 2017 May;49(5):321–32.
Mantula PS, Outinen TK, Clement JPG et al. Glomerular Proteinuria Predicts the Severity of Acute Kidney Injury in Puumala Hantavirus-Induced Tubulointerstitial Nephritis. Nephron. 2017;136(3):193–201.
Turčinov D, Puljiz I, Markotić A et al. Clinical and laboratory findings in patients with oliguric and non-oliguric hantavirus haemorrhagic fever with renal syndrome: an analysis of 128 patients. Clin Microbiol Infect. 2013 Jul;19(7):674–9.
Connolly-Andersen AM, Hammargren E, Whitaker H et al. Increased risk of acute myocardial infarction and stroke during hemorrhagic fever with renal syndrome: a self-controlled case series study. Circulation. 2014 Mar 25;129(12):1295–302.
Kim GH, Han JS, Earm J, Jeon US et al. Evaluation of renal tubular functions in convalescent phase of hemorrhagic fever with renal syndrome. Am J Nephrol. 1998;18(2):123–30.
Mustonen J, Huttunen NP, Brummer-Korvenkontio M et al. Clinical picture of nephropathia epidemica in children. Acta Paediatr. 1994 May;83(5):526–9.
Thorp L, Fullerton L, Whitesell A et al. Hantavirus Pulmonary Syndrome: 1993-2018. Pediatrics. 2023 Apr 1;151(4).
Schmaljohn C, Hjelle B. Hantaviruses: a global disease problem. Emerg Infect Dis. 1997;3(2):95–104.
Enria DA, Briggiler AM, Pini N et al. Clinical manifestations of New World hantaviruses. Curr Top Microbiol Immunol. 2001;256:117–34.
Hallin GW, Simpson SQ, Crowell RE et al. Cardiopulmonary manifestations of hantavirus pulmonary syndrome. Crit Care Med. 1996 Feb;24(2):252–8.
Tsai TF, Bauer SP, Sasso DR et al. Serological and virological evidence of a Hantaan virus-related enzootic in the United States. J Infect Dis. 1985 Jul;152(1):126–36.
Jonsson CB, Hooper J, Mertz G. Treatment of hantavirus pulmonary syndrome. Antiviral Res. 2008 Apr;78(1):162–9.
Clement J, Maes P, Lagrou K et al. A unifying hypothesis and a single name for a complex globally emerging infection: hantavirus disease. Eur J Clin Microbiol Infect Dis. 2012 Jan;31(1):1–5.
Vollmar P, Lubnow M, Simon M et al. Hantavirus cardiopulmonary syndrome due to Puumala virus in Germany. J Clin Virol. 2016 Nov;84:42–7.
Clement J, Maes P, Van Ranst M. Hemorrhagic Fever with Renal Syndrome in the New, and Hantavirus Pulmonary Syndrome in the Old World: paradi(se)gm lost or regained? Virus Res. 2014 Jul 17;187:55–8.
Dzagurova TK, Witkowski PT, Tkachenko EA et al. Isolation of sochi virus from a fatal case of hantavirus disease with fulminant clinical course. Clin Infect Dis. 2012 Jan 1;54(1):e1-4.
Gizzi M, Delaere B, Weynand B et al. Another case of “European hantavirus pulmonary syndrome” with severe lung, prior to kidney, involvement, and diagnosed by viral inclusions in lung macrophages. Eur J Clin Microbiol Infect Dis. 2013 Oct;32(10):1341–5.
Vapalahti O, Mustonen J, Lundkvist A et al. Hantavirus infections in Europe. Lancet Infect Dis. 2003 Oct;3(10):653–61.
Schönrich G, Krüger DH, Raftery MJ. Hantavirus-induced disruption of the endothelial barrier: neutrophils are on the payroll. Front Microbiol. 2015;6:222.
Koster F, Foucar K, Hjelle B et al. Rapid presumptive diagnosis of hantavirus cardiopulmonary syndrome by peripheral blood smear review. Am J Clin Pathol. 2001 Nov;116(5):665–72.
Huttunen NP, Mäkelä S, Pokka T et al. Systematic literature review of symptoms, signs and severity of serologically confirmed nephropathia epidemica in paediatric and adult patients. Scand J Infect Dis. 2011 Jul;43(6–7):405–10.
Mattar S, Guzmán C, Figueiredo LT. Diagnosis of hantavirus infection in humans. Expert Rev Anti Infect Ther. 2015 Aug;13(8):939–46.
Reusken C, Heyman P. Factors driving hantavirus emergence in Europe. Curr Opin Virol. 2013 Feb;3(1):92–9.
Huggins JW, Hsiang CM, Cosgriff TM et al. Prospective, double-blind, concurrent, placebo-controlled clinical trial of intravenous ribavirin therapy of hemorrhagic fever with renal syndrome. J Infect Dis. 1991 Dec;164(6):1119–27.
Yi J, Xu Z, Zhuang R, Wang J et al. Hantaan virus RNA load in patients having hemorrhagic fever with renal syndrome: correlation with disease severity. J Infect Dis. 2013 May 1;207(9):1457–61.
Vial PA, Valdivieso F, Ferres M et al. High-dose intravenous methylprednisolone for hantavirus cardiopulmonary syndrome in Chile: a double-blind, randomized controlled clinical trial. Clin Infect Dis. 2013 Oct;57(7):943–51.
Wagner R, Leicht-Biener U, Mucsi I et al. Ibuprofen or diclofenac is associated with more severe acute kidney injury in nephropathia epidemica. Scand J Urol Nephrol. 2012 Feb;46(1):65–9.
Jonsson CB, Hooper J, Mertz G. Treatment of hantavirus pulmonary syndrome. Antiviral Res. 2008 Apr;78(1):162–9.
Wernly JA, Dietl CA, Tabe CE et al. Extracorporeal membrane oxygenation support improves survival of patients with Hantavirus cardiopulmonary syndrome refractory to medical treatment. Eur J Cardiothorac Surg. 2011 Dec;40(6):1334–40.
Koehler FC, Di Cristanziano V, Späth MR et al. The kidney in hantavirus infection-epidemiology, virology, pathophysiology, clinical presentation, diagnosis and management. Clin Kidney J. 2022 Jul;15(7):1231–52.
Kitterer D, Segerer S, Dippon J et al. Smoking Is a Risk Factor for Severe Acute Kidney Injury in Hantavirus-Induced Nephropathia Epidemica. Nephron. 2016;134(2):89–94.
Bergstedt Oscarsson K, Brorstad A, Baudin M et al. Human Puumala hantavirus infection in northern Sweden; increased seroprevalence and association to risk and health factors. BMC Infect Dis. 2016 Oct 13;16(1):566.
Klempa B, Fichet-Calvet E, Lecompte E et al. Hantavirus in African wood mouse, Guinea. Emerg Infect Dis. 2006 May;12(5):838–40.
Khan A, Khan M, Ullah S et al. Hantavirus: The Next Pandemic We Are Waiting For? Interdiscip Sci. 2021 Mar;13(1):147–52.

Gelecek

29 Nisan 2024

Lisans

Lisans

Nasıl Atıf Yapılır

1.
Gürkaynak P. Hantavirüs Enfeksiyonları. Içinde: Dal T, editör. Mikrobiyolojide Güncel Konular V (Bahar) [Internet]. Türkiye: Akademisyen Yayınevi Kitap DOI Portalı; 2024 [a.yer 13 Temmuz 2026]. ss. 105-18. Erişim adresi: https://www.omp35.books.akademisyen.net/index.php/akya/catalog/book/3058/chapter/13585