Explore the vast range of titles available.

Hemorrhagic Fever with Renal Syndrome (HFRS) is the most frequently diagnosed zoonosis in Asia. This zoonotic infection is the result of exposure to the virus-contaminated aerosols. Orthohantavirus infection may cause Hemorrhagic Fever with Renal Syndrome (HRFS), a disease that is characterized by acute kidney injury and increased vascular permeability. Several species of orthohantaviruses were identified as causing infection, where Hantaan, Puumala, and Seoul viruses are most common. Orthohantaviruses are endemic to several Asian countries, such as China, South Korea, and Japan. Along with those countries, HFRS tops the list of zoonotic infections in the Far Eastern Federal District of Russia. Recently, orthohantavirus circulation was demonstrated in small mammals in Thailand and India, where orthohantavirus was not believed to be endemic. In this review, we summarized the current data on orthohantaviruses in Asia. We gave the synopsis of the history and diversity of orthohantaviruses in Asia. We also described the clinical presentation and current understanding of the pathogenesis of orthohantavirus infection. Additionally, conventional and novel approaches for preventing and treating orthohantavirus infection are discussed.

Thromboelostograms (TEG) are indicators that reflect the dynamic changes in blood coagulation objectively. Compared with traditional coagulation tests, TEG are easy to perform; imparting a head start in determining patients'coagulation status. The aim of this study was to explore the role of thromboelastography as an early predictor of disease severity and as a prognostic factor in patients with haemorrhagic fever of renal syndrome (HFRS). This was a retrospective study in which we collected clinical data from 342 patients with HFRS who were hospitalized from January 2017 to January 2021. The predictive value of laboratory parameters for HFRS criticalization was assessed via receiver operating characteristic (ROC) curves. After that, a model of criticalization was developed using stepwise analysis, subsequently, the model was evaluated and validated internally as well as externally. This study was approved by the Ethics Committee of the Hospital. The study population was categorized into critical and noncritical groups according to their condition during hospitalization, with a median age of 52.00 (39.00-61.50) years for the critical group and 39.00 (16.00-53.25) years for the noncritical group. Both groups had a large proportion of male patients (65.3% and 72.3%, respectively). The median duration of hospitalization was 15.00 (3.50-25.00) days in the critical group and 13.00 (10.00-17.25) days in noncritical group. In the critical group 40.8% of patients died. The incidence of bleeding was greater in critical patients (51.0%) than in noncritical patients (15.1%). The coagulation indices: CI, K, MA, R and angle were significantly different between the two groups (p < 0.05). Critical patients had higher levels of K and R and lower levels of CI, MA and angle. Multivariate analysis revealed that K, ALB, CK, SCR, angle, WBC and LYM were independently associated with disease severity in patients with HFRS. ROC curve analysis revealed that the criticality model equation had an AUC of 0.9058, a sensitivity of 88.9% and a specificity of 80.2%, which were better than that of any single parameter in predicting the patient's outcome. The internal validation C index was 0.866, the GOF P value was 0.825, and the external validation AUC was 0.762, with a sensitivity of 71.4% and a specificity of 74.2%. The results of the calibration plots indicated that there was some agreement between the model-estimated HFRS critical illness rates and the final observed critical illness rates in the study population. Decision curve analysis indicated that the model had significant clinical utility and comparable net benefit over a range of threshold probabilities. Critical HFRS have significantly abnormal coagulation function and high incidence of bleeding associated with poor outcome. A criticalization prediction model constructed on the basis of thromboelastography indices in early stages of the disease has a good predictive ability and may be helpful in the early identification of critically ill patients for timely clinical intervention and treatment.

Seoul virus (SEOV) is a worldwide ratborne orthohantavirus. We describe an SEOV infection in an adult returning to France from Kenya, followed by Guillain-Barré syndrome. We confirmed SEOV infection by PCR and sequencing. Although transmission might have occurred in Kenya, the epidemiologic information available is not sufficient to confirm that possibility.

We report a case of severe acute kidney injury in a patient in Germany infected with Seoul virus. Clinical and laboratory analysis linked the infection to a pet rat breeding facility in central Germany. Increased surveillance and a One Health approach are needed, given the rising popularity of pet rats.

Scrub typhus and Hemorrhagic fever with renal syndrome (HFRS) are prevalent infectious diseases in South Korea. This study compared the clinical and laboratory characteristics associated with scrub typhus and HFRS treated at Chosun University Hospital, South Korea. A retrospective cross-sectional study was conducted by reviewing the medical records of patients diagnosed with scrub typhus and HFRS between 2010 and 2023. Diagnoses were confirmed through molecular and serological testing. A total of 156 patients with scrub typhus and 45 patients with HFRS were included. Among patients with scrub typhus, 136 (87.18%) patients had Boryong strain, 4 (2.56%) had Taguchi strain, 3 (1.93%) had Karp strain, and 1 (0.64%) had Kanda strain. Most cases of scrub typhus and HFRS occurred in individuals aged ≥65 years. The common clinical features of scrub typhus included fever, fatigue, skin rash, and eschar. In contrast, HFRS commonly presented with fever, gastrointestinal symptoms, and hemorrhagic manifestations. The mean hospital stay was significantly longer for HFRS (14.09 ± 7.67 days) compared to scrub typhus (7.89 ± 7.56 days, p < 0.001). A higher proportion of patients with HFRS (15, 33.33%) required intensive care unit admission compared to patients with scrub typhus (14, 8.97%, p < 0.001). Among patients with scrub typhus, the adjusted odds of presenting with a skin rash, eschar, or lymphopenia (<1500/µL) were 1.37 (95% confidence interval [CI]: 1.18-1.59, p < 0.001), 1.25 (95% CI: 1.11-1.40, p < 0.001), and 1.83 (95% CI: 1.34-2.49, p < 0.001), respectively. While scrub typhus and HFRS share overlapping clinical features, skin rash, eschar, and lymphopenia were more commonly associated with scrub typhus. Further studies are warranted to characterize clinical features and outcomes of various hantavirus subtypes.

Hemorrhagic fever with renal syndrome (HFRS) is the result of acute, zoonotic, natural foci hantavirus infections. It has serious social and medical importance due to its widespread distribution and the disease’s severity. There is a lack of effective etiotropic therapy and specific prophylaxis available. The aim of this review is to observe the etiological, clinical, and epidemiological features of nosologic HFRS forms in Russia, as well as differences and similarities with hantavirus pulmonary syndrome (HPS). The various clinical HFRS manifestations characterized diseases associated with Puumala, Kurkino, and Sochi hantaviruses in the Russian European part, and with Hantaan, Amur, and Seoul hantaviruses in the Russian Far East. Differences were observed for HFRS foci types based on biological characteristics and natural host population dynamics. As a result of clinical and epidemiological analysis six nosological forms were established, all of which were classified as “hemorrhagic fever with renal syndrome” according to the WHO’s expert recommendation from 1983 year. The study showed comparable taxonomic characteristics and determined the mechanism of human infection course for HFRS and HPS. The accumulated knowledge of this study allows for the combination of HFRS and HPS names into a common logical disease name “Hantavirus fever”.

Background Hemorrhagic fever with renal syndrome (HFRS) is an endemic disease occurring in various parts of the world. Prompt access to care with proper treatment is essential for preventing patients from developing renal failure and unfavorite outcomes. This study aimed to elucidate laboratory parameters associated with HFRS severity and prognosis to predict disease course and initiate prompt clinical management. Methods Retrospective analysis of laboratory data was performed on HFRS patients from December 2016 to January 2022 in Baoji City of Shaanxi Province in China using different statistical methods. Results The WBC and neutrophils in peripheral blood, RBC in urine sediments, blood, protein, and glucose in urine, PT/INR, aPTT, TT, AST, ALT, AST/ALT, MAO, AD, urea, creatinine, cystatin C, CK‐MB, LDH, α‐HBDH, mAST, triglycerides, glucose, amylase, ferritin, and PCT in serum increased in HFRS patients along with disease severity, while the lymphocytes, monocytes, platelets, plateletcrit, fibrinogen, serum total protein, albumin, HDL‐c, magnesium, complement C3 and C4, IgG, triiodothyronine, thyroxine, and free triiodothyronine were reduced. Results also indicated that in uncured HFRS patients, the NEUT%, CRP, cast, PT/INR, aPTT, D‐dimer, AST/ALT, CK‐MB, LDH, α‐HBDH, m‐AST, ferritin, and PCT were significantly higher than in cured patients, while platelets, C3, and C4 in uncured patients were significantly lower than in cured patients. The NEUT%, CRP, AST/ALT, and LDH were associated with patients' prognosis. Conclusions Laboratory data are helpful in predicting HFRS patients' progress, severity, and prognosis, thus, these parameters are useful in guiding prompt clinical management of patients. Prompt access to care with proper treatment is essential for preventing patients from developing renal failure and unfavorable outcomes. This study aimed to elucidate laboratory parameters associated with HFRS severity and prognosis to predict disease course and initiate prompt clinical management. Retrospective analysis of laboratory data was performed on HFRS patients from December 2016 to January 2022 in Baoji City of Shaanxi Province in China using different statistical methods. Multiple abnormal laboratory results were found in patients with HFRS when compared with healthy subjects. The WBC and neutrophils in peripheral blood, RBC in urine sediments, blood, protein, and glucose in urine, PT/INR, aPTT, TT, AST, ALT, AST/ALT, MAO, AD, urea, creatinine, cystatin C, CK‐MB, LDH, α‐HBDH, mAST, triglycerides, glucose, amylase, ferritin, and PCT in serum increased along with disease severity, while the lymphocytes, monocytes, platelets, plateletcrit, fibrinogen, serum total protein, albumin, HDL‐c, magnesium, complement C3 and C4, IgG, triiodothyronine, thyroxine, and free triiodothyronine were reduced. Results also indicated that in uncured HFRS patients, the NEUT%, CRP, cast, PT/INR, aPTT, D‐dimer, AST/ALT, CK‐MB, LDH, α‐HBDH, m‐AST, ferritin, and PCT were significantly higher than in cured patients, while platelets, C3, and C4 in uncured patients were significantly lower than in cured patients. The NEUT%, CRP, AST/ALT, and LDH were associated with patients' prognosis. Laboratory data are helpful in predicting HFRS patients' progress, severity, and prognosis; thus, these parameters are useful in guiding prompt clinical management of patients.

Background Hantavirus infection is worldwide epidemic and can cause life-threatening consequences. With more and more cases reported in countries with atypical morbidity, it is necessarily urgent to know some atypical symptoms and signs of Hantavirus infection. Case presentation Here we report the case of a 44-year old male with a complaint of fever and diffuse abdominal pain, initially suspiciously diagnosed with acute peritonitis. The patient was eventually diagnosed as hemorrhagic fever with renal syndrome and enhanced CT scan showed peritonitis. The clinical condition of the patient was relatively mild and he was recovered 9 days later. Conclusion Peritonitis secondary to hemorrhagic fever with renal syndrome is rare in clinically practice. When confronted with atypical celialgia, it is important to make differential diagnosis of hantavirus infection.

Background To assess the prevalence, risk factors, clinical characteristics, and outcomes of acute pancreatitis (AP) in patients with hemorrhagic fever with renal syndrome (HFRS). Methods All patients diagnosed with HFRS admitted to the First Affiliated Hospital of Xi’an Jiaotong University from January 2013 to July 2020 were enrolled. Patients with and without AP were compared by two risk stratification models: (1) a multivariate regression analysis using propensity score to adjust for confounding and (2) a propensity-matched nested case-control study. Results A total of 346 patients were enrolled in the cohort study, 29 of whom (8.4%) were diagnosed as AP. There was no significant difference between patients with and without AP with regards to common risk factors and presenting signs/symptoms other than gastrointestinal symptoms ( p  < 0.01). The patients with AP had a significantly higher 90-day mortality rate (24.1% vs. 3.5%, OR 8.9, 95% CI 1.3 to 103.4, p  = 0.045), and significantly shorter duration of therapy free-days to 28 day such as RRT and mechanical ventilation free days ( p  < 0.05, respectively). Conclusions Our study indicated that AP was independently associated with higher mortality in HFRS patients. While considering the difficulty of early recognition of AP among HFRS patients with similar signs and/or symptoms, further laboratory and imaging studies might help identify these patients at risk of poor clinical prognosis.

Orthohantavirus infection is a zoonotic disease transmitted to humans through contact with infected rodents. In Eurasia, Old World Orthohantaviruses can cause haemorrhagic fever with renal syndrome (HFRS), while in the Americas, New World Orthohantaviruses are responsible for hantavirus cardiopulmonary syndrome (HCPS). In Kazakhstan, the first recorded cases of HFRS appeared in the West Kazakhstan region in 2000, which has since then been established as an endemic area due to the presence of stable rodent reservoirs and recurring human infections. Routine diagnosis of HFRS in this region relies primarily on immunoassays. To enhance diagnostic precision, we aimed to implement both serological and molecular methods on samples from suspected HFRS cases in the endemic West Kazakhstan region and non-endemic Almaty City. A total of 139 paired serum, saliva, and urine samples were analysed using IgM/IgG ELISA, immunoblot assays, and qPCR. Our findings confirm that suspected HFRS cases in West Kazakhstan are associated with the Puumala virus serotype.