Hantavirus Infection in Turkey

Kemirgenler tarafından taşınan Bunyaviridae ailesinde yer alan, Hantavirüsler, insanda iki farklı klinik tabloya neden olur: “Renal Sendromlu Hemorajik Ateş” (HFRS) ve “Hantavirüs Pulmoner Sendrom” (HPS). Enfekte kemirgenin salgıları ile temasla veya virüs içeren aerosollerin solunum yolu ile alınması ile bulaşır. Dünyanın farklı bölgelerinde farklı virüs alt tipleri hastalığa neden olur. HPS’de en sık SinNombre, Andes, Laguna, Negra ve New York türleri etkendir. HFRS’de Dobrava, Puumala, Hantaan, Saaremaa ve Seoul türleri neden olur. Bolca yağış alan ve büyük rodent popülasyonuna sahip ormanlık bölgelerde daha sık görülmektedir. HPS Amerika’da HFRS ise Asya ve Avrupa’da daha sık görülmektedir. Dünyada Hantavirüs enfeksiyonlarının sayısı her geçen gün artmaktadır. Türkiye’de yapılan seroepidemiyolojik çalışmalar ile varlığı bilinen Hantavirüs’ebağlı klinik olgular ilk defa 2009 yılında ülkenin kuzey-batı bölgesinde meydana gelen salgınla tespit edilmiştir. Günümüze kadar bildirilen olgu sayısı 28’e ulaşmıştır. Burada Türkiye’de bugüne kadar görülen Hantavirus olguları gözden geçirilerek hastalıkla ilgili farkındalığın arttırılması amaçlanmıştır

Anahtar Kelimeler:

Renal Sendromlu Hemorajik Ateş, HFRS, Hantavirus kardiyopulmoner sendrom, Yeniden önem kazanan enfeksiyon hastalıkları, Türkiye

Hantavirus Infection in Turkey

The Hantaviruses within the Bunyaviridia family carried by rodents cause two different diseases in humans: Hemorrhagic Fever with renal syndrome (HFRS) and Hantavirus Pulmonary Syndrome (HPS). It is transmitted through contact with the secretion of infected rodents or through the inhalation of aerosols containing the virus. In different parts of the world, various virus subtypes cause the disease. In HPS, mostly Sin Nombre, Andes, Laguna, Negra and New York types are causative agents, whereas in HFRS the agents are Dobrava, Puumala, Hantaan, Saaremaa and Seoul. It is more frequently observed in forest areas receiving heavy rain and having a large rodent population. While HPS is seen in America, HFRS is mostly seen in Asia and Europe. The number of Hantavirus infections have been on the rise in the world day by day. Clinic cases associated with Hantavirus known to exist by seroepidemiological trials conducted in Turkey were defined for the first time in 2009 with an outbreak occurred in the north-west region of the country. The number of cases reported so far has reached 28. Here, it is aimed to review the Hantavirus cases occurred in Turkey up to the present and increase awareness about the disease.

Keywords:

Hemorrhagic Fever with renal syndrome HFRS, Hantavirus Pulmonary Syndrome, HPS, Emerging infectious diseases, Turkey,

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Stock I. Hantavirus infections; Med. Monatsschr Pharm, 2008 Apr;31(4):127-36
Lisa A. Beltz. A Guide to Diseaes, Causative Agents, and sur- veillance. Emerg Infect Dis 2011; 431-450
Vaheri A, Henttonen H, Voutilainen L, Mustonen J, Sironen T, Vapalahti O.; Hantavirus infections in Europe and their impact on public health, Rev. Medical Vir. 2013;23(1):35-49
http://www.cdc.gov/hantavirus/
Uğur K, Yılmaz G, Volkan S, Sökel S, Kaya S, Köksal İ, Evalu- ation of clinical and laboratory predictors of fatality in patients with Hantavirus infection; . J Microbiol Infect Dis, 2012;2 (4): 155-159
Laakkonen J, Kallio-Kokko H, Oktem MA, et al. Serological survey for viral pathogens in Turkish rodents. J Wildl Dis 2006; 42(3): 672-6.
Oktem MA. Hantavirus infections and tick-borne encephalitis virus infections. ANKEM 2009;23(Suppl 2):245-8.
Kavukcu S, Turkmen M, Sahman S, Soylu A, Camsan T. What is the risk of nephropathy associated with Hantavirus in Ae- gean region. Turk Neph Dial Transpl 1997;3-4:131-5.
Ertek M, Buzgan T. An outbreak caused by hantavirus in the Black Sea region of Turkey, January-May 2009. Euro Surveill 2009; 14(20).pii:19214
Kaya S, Yılmaz G, Erensoy S, Yağçı Çağlayık D, Uyar Y, Köksal I. Hantavirus infection: two case reports from a prov- ince in the Eastern Black Sea Region, Turkey. MikrobiyolBul 2010; 44(3): 479-87.
Çakır D, Çelebi S, Korukluoğlu G, Bozdemir ŞE, Çetin BŞ, Hacımustafaoğlu M. Haemorrhagic Fever with Renal Syn- drome by Hantavirus. Ankem Derg 2012; 26(4): 198-202.
Atalay YO, Dere K, Şen H, Küçükodacı Z, Önem Y, Özkan S. HantaviralHaemorrhagic Fever with Renal Syndrome: A case report and review. Yoğun Bakım Derg 2012; 10(4): 210-6.
Öncül A, Koçulu S, Çağlayık DY, Uyar Y. Hantavirus infection with a mild course in a patient from Giresun province: A case report. Turk Hij Den BiyolDerg 2011; 68(4): 209-14.
Sarıgüzel N, Hofmann J, Canpolat AT, et al. Dobrava hanta- virus infection complicated by panhypopituitarism, Istanbul, Turkey, 2010. Emerg Infect Dis 2012; 18(7): 1180-3.
Sünbül M, Yılmaz H, Çetinkaya H, et al. Two cases of hanta- virus infection in Crimean-Congo hemorrhagic fever endemic region. J Microbiol Infect Dis 2012; 2(3): 117-20.
Oncul O, Atalay Y, Onem Y, Turhan V, Acar A, Uyar Y. Hanta- virus infection in Istanbul, Turkey. Emerg Infect Dis 2011; 17(2): 303-4.
Öngürü P, Yılmaz S, Akıncı E, et al. Hemorrhagic Fever with renal syndrome: Two case reports. Turk Hij Den BiyolDerg 2011; 68(1): 35-9.
Gözel MG, Engin A, Elaldı N, Bakır M, Dökmetaş İ, Uyar Y. First cases of hemorrhagic fever with renal syndrome from the Middle Anatolia Region of Turkey and the first case of Hantavirus and Crimean-Congo hemorrhagic fever virus co- infection in a patient. Turk Klin J Med Sci 2013; 33(1): 224-8.
Özkan O, Tükek T, Yıldız E, Velioğlu EA, Gürsu M, Öztürk S. Hantavirus infections and renal manifestations: case report and update. Turk Neph Dial Transpl 2013; 22(1): 129-32.
Kaya S, Prognostic Factors in Hantavirus Infections. Mikrobi- yol Bul. 2014; 48(1): 179-187
http://www.merckmanuals.com/professional/infectious_dis- eases/arboviridae_arenaviridae_and_filoviridae/hantavirus_ infection.html
Huggins JW, Hsiang CM, Cosgriff TM, et al. Prospective, double blind, concurrent, placebo-controlled clinicaltrial of intravenous ribavirin therapy of hemorrhagic fever with renal syndrome. J Infect Dis 1991; 164(6):1119-27.
Rusnak JM, Byrne WR, Chung KN, et al. Experience with in- travenous ribavirin in the treatment of hemorrhagicfever with renal syndrome in Korea. Antiviral Res 2009; 81(1): 68-76.