Pyung Woo Lee

Hemorrhagic Fever with Renal Syndrome Caused by the Seoul Virus

The Seoul virus is an important etiologic agent in hemorrhagic fever with renal syndrome (HFRS), and infections with the Seoul virus are less severe than those with the Hantaan virus. However, the information on HFRS caused by the Seoul virus is limited in Korea. Retrospective clinical analysis was done on 30 patients with Seoul virus infection who had been diagnosed as having HFRS by clinical features and serologic testing by the plaque reduction neutralization test from 1986 to 1991 at the Seoul National University Hospital. They were compared with 69 patients with Hantaan virus infection. The Seoul virus was the etiologic agent in 25% of Korean HFRS and the major cause of HFRS during the summer season although infections occurred throughout the year. The Seoul virus infection had a milder degree of bleeding and renal derangement but had severer liver dysfunction than the Hantaan virus infection. Renal histopathologic findings revealed a milder degree of hemorrhage and vascular changes than cases involving Hantaan virus infection. The precise mechanisms of vascular dysfunction and organ involvement in Seoul virus infection, however, still remain to be explored.

Korean haemorrhagic fever in staff in an animal laboratory.

In March, 1975, and January, 1978, there were outbreaks of Korean haemorrhagic fever (K.H.F.) among staff in the animal laboratory of the clinical research building of Tohoku University hospital. 13 doctors and 1 veterinarian had K.H.F., and all except 1 had a mild but typical clinical course. K.H.F. antibody titres were significantly raised in all 14 patients. 12 other doctors working in the same room had no symptoms and no K.H.F. antibody. K.H.F. antibody was also detected in 3 animal technicians who had not been ill, but who had worked in the same room. Antibody was not detected in any of the 4 technicians who worked in different animal rooms in another building. Epidemiological studies suggest that laboratory rats were the source of the infection. High titres of K.H.F. antibody were most common in rats reared in the animal laboratory associated with the outbreak.

Hantavirus infections in humans and commensal rodents in Singapore

To determine the extent of hantavirus infection in Singapore, serological studies using the indirect immunofluorescent antibody (IFA) test were conducted on commensal rodents and on human patients in 4 diagnostic groups. Virus isolation using a Vero E6 cell line was performed on hantaviral antigen-positive rodent lung tissue. Of 142 rodents and 3 insectivores studied, 37 (26%) were seropositive for IFA. Rattus norvegicus was the predominant species captured, with the highest species-specific seropositive rate of 32% (36 of 113). A hantavirus strain, R36, was isolated from one R. norvegicus. Seropositive rates for human patients were: 8% respectively for dengue haemorrhagic fever suspects and for non-A non-B hepatitis patients, 3% for leptospirosis suspects and 2% for acute nephritis patients. 2 patients had marked liver dysfunction but mild renal involvement. This hepatitis-like manifestation appears to be a clinical variant of hantavirus infection.

ACUTE PANCREATITIS ASSOCIATED WITH HAEMORRHAGIC FEVER WITH RENAL SYNDROME

To the Editor, Hemorrhagic fever with renal syndrome (HFRS) is a disease caused by the Hantaan, Puumala, Seoul, Prospect Hill, Sin Nombre and Dobrava-Belgrade viruses. 1 Clinically, the infection is characterized by acute disease with a sudden onset of fever with chill, conjunctival injection, anorexia, nausea, abdominal pain, haemorrhagic manifestation, proteinuria, hypotension and acute renal failure. 2,3