• Hantaan, Puumala, Seoul

Hemorrhagic fever with renal syndrome

• abrupt onset of fever, headache and myalgias; abdominal pain; vomiting and diarrhea.
• the appearnace of petechiae (reddish purple, blood-filled spots) on the palate.
• in the severe form of the disease, initial febrile period may be followed by hypotension and hemorrhage from multiple sites.
• most survivors regain normal renal function.
• the most severe disease is caused by the Hantaan virus.

• hantaviruses, a group of RNA viruses.
• several different subtypes exist, each associated with a single rodent resevoir species (Hantaan - Apodemus field mouse; Puumala - Clethrionomys bank vole; Seoul - rats).

• contact with infective material (feces, urine, saliva, tissue, etc) of rodents.
• contact is usually by aerosol.
• transplacental transmission has been documented; other person to person spread has not been reported.

• hantaviruses are found on all continents.
• endemic and epidemic disease in China, Korea, and the Commonwealth of Independent States.
• Hantaan virus is widely distributed in eastern Asia.
• Puumala virus is common to Scandinavia and Western Europe.

• 4 to 42 days; average is 12 to 16 days.

• supportive only.
• recent studies show that ribavirin may shorten the illness and reduce mortality.

Thanks to the World Health Organisation
for much of this information.