| Disease/Syndrome |
Hemorrhagic fever with renal syndrome |
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| Category |
Infection, Occupational |
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| Acute/Chronic |
Acute-Severe |
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| Synonyms |
HFRS; Epidemic hemorrhagic fever; Korean hemorrhagic fever; Nephropathia epidemica; Hemorrhagic nephrosonephritis; Hantaan, Dobrava, Puumala, or Seoul virus infections; |
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| Biomedical References |
Search PubMed |
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| Comments |
FINDINGS: In the severe disease caused by Hantaan and Dobrava viruses, five clinical phases have been described: febrile, hypotensive, oliguric, diuretic, and convalescent. Common symptoms during the febrile phase include flu-like symptoms, abdominal pain, low back pain, vomiting, facial and chest flushing, petechiae, and conjunctival injection. Pulmonary edema is recognized in about 10% to 20% of the cases. After appearance of the petechiae, capillary leaking and hemoconcentration are marked by elevation of the hematocrit. The ensuing shock is fatal in some cases. Renal failure for 3-7 days is followed by slow recovery. Fatal hemorrhages, usually of the CNS, occur rarely. Laboratory abnormalities after the initial phase include leukocytosis with left shift, thrombocytopenia, proteinuria, hematuria, and elevated BUN and creatinine. Case-fatality rates for this syndrome range from less than 1% for the Puumala virus to 5%-15% for the Hanta and Dobrava viruses. EPIDEMIOLOGY: Field rodents are the reservoir, and the virus is present in feces, urine, and saliva of infected animals. Workers are infected by inhaling dust contaminated with rodent excreta. Person-to-person transmission occurs rarely. Two of the viruses cause severe HFRS: Hantaan in East Asia and Dobrava in the Balkans. Puumala virus causes mild disease in Europe and the Balkans, and Seoul virus causes mild to severe disease worldwide. HFRS is a rural disease except for Seoul virus that infects urban rats. Seoul virus also infects laboratory rats and the technicians and scientists who handle them. An estimated 100,000 Hantaan virus infections occur in China each year. Dobrava virus infects a few hundred people a year. Exposure usually occurs indoors where mice live or search for food. The highest infection rates are in workers who have contact with mice. [CCDM, p. 240-3; ID, p. 2023-9, 2140-4] |
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| Latency/Incubation |
Few days to 2 months; usually 2-4 weeks; |
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| Diagnostic |
Specific antibodies by ELISA or IFA; |
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| ICD-9 Code |
078.6 |
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| Scope |
Primarily in Asia (China and South Korea) and Europe (Russia and the Balkans); Seoul virus is found worldwide. |
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| Reference Link |
Health Canada - HFRS |
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| Related Information in Haz-Map |
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| Symptoms/Findings |
Symptoms/Findings associated with this disease:
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| Job Tasks |
High risk job tasks associated with this disease:
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