• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.366-372
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• 2018

Background: An inactivated Hantaan virus vaccine (iHV) has been broadly used as a preventive strategy for hemorrhagic fever with renal syndrome (HFRS) by the South Korean Army. After the vaccination program was initiated, the overall incidence of HFRS cases was reduced in the military population. While there are about 400 HFRS cases annually, few studies have demonstrated the efficacy of the iHV in field settings. Therefore, this study aimed to evaluate the iHV efficacy on HFRS severity. Methods: From 2009 to 2017, HFRS cases were collected in South Korean Army hospitals along with patients' vaccination history. HFRS patients were classified retrospectively into two groups according to vaccination records: no history of iHV vaccination and valid vaccination. Vaccine efficacy on the severity of acute kidney injury (AKI) stage and dialysis events were investigated. Results: The effects of the iHV on renal injury severity in between 18 valid vaccinated and 110 non-vaccinated patients were respectively evaluated. In the valid vaccination group, six of the 18 HFRS patients (33.3%) had stage 3 AKI, compared to 60 of the 110 (54.5%) patients in the non-vaccination group. The iHV efficacy against disease progression ($VE_p$) was 58.1% (95% confidence interval, 31.3% to 88.0%). Conclusion: The iHV efficacy against the progression of HFRS failed to demonstrate statistically significant protection. However, different severity profiles were observed between the iHV and non-vaccination groups. Additional studies with larger populations are needed to demonstrate the effectiveness of the iHV in patients with HFRS.

• 대한바이러스학회지
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• 제28권4호
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• pp.377-382
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• 1998

Hemorrhagic fever with renal syndrome (HFRS), scrub typhus, murine typhus and leptospirosis have been the principal acute febrile diseases in Korea. To evaluate the seroepidemiologic patterns of acute febrile illness, sera collected from 2,423 patients in 1996 were examined for antibodies against Hantaan virus, Orientia tsutsugamushi, Rickettsia typhi, and Borrelia burgdorferi by indirect immunofluorescent antibody technique (IFA) and macroscopic agglutination test for Leptospira interogans. Seropositive cases against Otsutsugamushi, Rickettsia typhi, Leptospira interogans and Hantaan virus were 192 (7.9%), 193 (8.0%), 12 (0.5%) and 324 (13.4%), respectively. Male was more affected in HFRS and murine typhus contrasting to scrub typhus and leptospirosis in female. Most positive cases occurred during October and November for scrub typhus, and during November and December for HFRS. These results showed similar patterns with previous epidemical data for recent couple of years, and possibly implied no significant changes occurred in ecologic situations for acute febrile diseases in Korea.

• 농촌의학ㆍ지역보건
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• 제19권2호
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• pp.119-128
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• 1994

This study was performed on 302 cases of leptospirosis, tsutsugamushi disease and hemorrhagic fever with renal syndrome(HFRS) which occurred in Chonnam(Do) in 1991 through 1993. The results were as follows : 1. 81.8% of the patients with Leptospirosis and 54.5% of the HFRS patients were men while 61.4% of the patients with tsutsugamushi disease were women. 2. Most patients lived in rural areas(Gun), their educational level was elementary School or lower and their occupations were either farmer or jobless. 3. Peak ages were 40s for leptospirosis(36.4%) and 50s for tsutsugamushi disease and HFRS(32.9% and 36.4% respectively). 4. The high incidence areas of tsutsugamushi disease were northern, eastern and a diagonal line, from northeast to southwest, of the Chonnam area, and these are consistent with a mountainous district. 5. In monthly distribution leptospirosis was higher in Sep. and Oct., and tsutsugamushi disease and HFRS were higher in Oct. and Nov. 6. The first case is occurring and the last case shows up later than in past years.

• 동의생리병리학회지
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• 제18권1호
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• pp.289-293
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• 2004

Hantaviruses are found worldwide and are known to cause two serious and often fatal human disease: hemorrhagic fever with renal syndrome(HFRS) and hantavirus pulmonary syndrome(HPS). The typical clinical prodrome consists of fever, chills, myalgia, headache, and gastrointestinal symptoms. Treatment usually involves maintenance of fluids, blood pressure, ventilation and electrolytes. We report a patient who had multisystem inflammatory symptom with Hantaan virus antibody positive accompanied by mild fever and myalgia. This case was diagnosed as HFRS. This patient was treated by Galgun hegi-tang. As a result of this treatment, symptoms were markedly improved.

• BMB Reports
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• 제43권8호
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• pp.535-540
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• 2010

Patients with hemorrhagic fever with renal syndrome (HFRS) often exhibit altered serum lipid and lipoprotein profile during the oliguric phase of the disease. Serum lipid and lipoprotein profiles were assessed during the oliguric and recovery phases in six male patients with HFRS. In the oliguric phase of HFRS, the apolipoprotein (apo) C-III content in high-density lipoproteins (HDL) was elevated, whereas the apoA-I content was lowered. The level of expression and activity of antioxidant enzymes were severely reduced during the oliguric phase, while the cholesteryl ester transfer protein activity and protein level were unchanged between the phases. In the oliguric phase, electromobility of $HDL_2$ and $HDL_3$ was faster than in the recovery phase. Low-density lipoprotein (LDL) particle size was smaller and the distribution was less homogeneous. Patients with HFRS in the oliguric phase had severely modified lipoproteins in composition and metabolism.

• 대한바이러스학회지
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• 제29권2호
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• pp.55-64
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• 1999

In Yugoslavia, hemorrhagic fever with renal syndrome (HFRS) is one of the important national health problem, but no vaccine has been used to prevent HFRS. Since first HFRS case in 1952, sporadic cases of HFRS occurred every year and over 4,000 registered cases with $1{\sim}16%$ mortality so far. We performed a prospective, randomized double-blind placebo-controlled trial to evaluate the effectiveness of $Hantavax^{TM}$ against HFRS in 3,900 healthy adults living in the endemic areas of Yugoslavia. 1,900 people were given 0.5 ml of Hantavax subcutaneously twice at one month interval and a booster shot at one year after. For controls other 2,000 healthy people were given 0.5 ml of physiolosical saline as a placebo. We investigated HFRS cases in both the vaccinated and nonvaccinated groups by monitoring the program for patient registration in the areas from 1996 to 1998, and the effect of vaccine was analyzed epidemiologically. No confirmed case of HFRS was observed among 1,900 Hantavax vaccinees, while 20 confirmed cases were observed among 2,000 nonvaccinated control group. There were no remarkable side effects among the vaccinees either locally or in general after inoculation of the vaccine. The Hantavax vaccine showed statistically significant protective efficacy against HFRS among Yugoslavian people.

• Journal of Microbiology and Biotechnology
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• 제12권1호
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• pp.53-58
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• 2002

To better understand the reservoir host range and distribution of hantaviruses in small mammal populations in Korea, a serological survey was conducted on 1,375 wild rodents and 62 insectivores captured in seven provinces during the six-year period, 1995 to 2000. As determined by the indirect immunofluorescent antibody (IFA) test, 90 ($13.1\%$) of 685 Apodemus agrarius, 47 ($13.6\%$) of 345 Apodemus peninsulae, and 4 ($6.5\%$) of 62 Crocidura laciura were seropositive against the Hantaan virus, while 38 ($13.5\%$) of 282 Eothenomys regulus were seropositive against the Puumala virus. Serological evidence for hantavirus infection was not found in 50 Microtus fortis, six Micromys minutus, six Mus musculus, and one Cricetulus triton. Our serological data indicate that hemorrhagic fever with renal syndrome (HFRS)-related hantaviruses are widely distributed in indigenous rodents in Korea. Particularly noteworthy was the high seropositivity rates among Apodemus peninsulae and Eothenomys regulus captured in certain mountainous regions, suggesting that HFRS may be under-reported among nearby residents or among individuals who might visit such areas for recreational or occupational purposes.

• Journal of Preventive Medicine and Public Health
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• 제32권3호
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• pp.269-275
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• 1999

Background : In April 6, 1990, a male researcher who has worked at a research unit at the Basic Research Building of Seoul National University(SNU) College of Medicine admitted to SNU Hospital due to persistent fever. He was diagnosed serologically as hemorrhagic fever with renal syndrome(HFRS). Another female researcher in the same unit was also diagnosed as HFRS at the same hospital several days later. Epidemic investigation of HFRS was conducted to determine the magnitude of the problems since these two cases were strongly suspected to have laboratory-acquired infections of HFRS. Methods : All researchers and employees working at the Basic Research Building(BRB) of SNU College of Medicine as of April 1, 1996 were recruited for the study, information on symptoms of HFRS and history of contact to experimental animals were collected by self-administered questionnaires and serological tests among study subjects were also conducted by indirect immunofluorescent antibody(IFA) to hantavirus. The experimental animals were also serologically tested for infection with hantavirus by IFA. Results : Among 218 surveyed, six researchers and an animal caretaker had hantavirus antibodies above 1:20 in IFA titer. Five of seven sero-positive subjects had antibodies above 1:640 in IFA titer and had shown clinical symptoms compatible to HFRS during Jan. 1 to Apr, 20, 1996. The sero-positive persons had handled animals more frequently than sero-negative persons (OR, 19,68; 95% Cl, 1.11-350.40) and handling animals at the animal quarter at School of Public Health(SPH) had shown consistently higher risk to get infected with hantavirus irrespective of types of animals handled (OR, 4.90-6.37). Sero-positivity of rats of the aniamal quarter at BRB was 30-60%, whereas 80% of rats at SPH tested were shown sero-positivity. Conclusion: There was a epidemic of HFRS in research units of a medical school during the period from Jan. through Apr, Further investigation is needed to determine the extent and the mode of transmission of the laboratory-acquired infection with hantavirus in other research facilities.

• 농촌의학ㆍ지역보건
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• 제44권1호
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• pp.1-10
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• 2019

이 연구는 국내의 대표적인 가을철 발열성 질환으로 고위험군 중 재배농업인을 대상으로 선택하여 가을철 발열성 질환에 감염실태와 위험요인, 인지도을 조사하여 질병에 대한 증거기반에 전략을 제공하고자 이 연구를 수행하게 되었다. 농업인 감염병 실태조사 방법은 지역사회에 일부 재배농업인 841명을 혈청학적 검사와 설문조사를 시행하였고, 혈청학적 기준은 수동혈구응집법과 면역크로마토그래피법으로 시행되었다. 혈청감염에 영향을 주는 일반적 특성으로는 쯔쯔가무시증이 나이가 증가할수록 혈청반응이 증가하였고, 렙토스피라증은 과거병력과 가족병력이 혈청반응이 유의하게 높았다. 그리고 신증후군출혈열은 종사기간이 증가할수록 혈청반응이 증가하였다. 또 다른 결과로는 혈청감염에 영향을 미치는 위험요인으로는 쯔쯔가무시증은 진드기에 물린 적이 있는 경우 혈청반응이 높았고, 렙토스피라증은 과수재배 관련된 일을 하는 경우 혈청반응이 높았다. 또한 신증후군출혈열은 비닐하우스 관련된 일을 한 적이 있는 경우 혈청반응이 높았다. 결론적으로 취악한 직업인 재배농업인 감염병에 대한 인식 형성 할 수 있도록 정부에서 효율적이고 효과적인 방법을 개발해야 할 것이다. 그리고 질병에 대한 조기 발견과 치료로 합병증 없이 건강한 삶을 살 수 있도록 주민들 인식에 영향을 줄 수 있는 교육과 홍보 그리고 질병 특성에 맞는 특정 예방 전략을 개발해야 할 것으로 생각한다.

• 대한바이러스학회지
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• 제29권1호
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• pp.23-31
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• 1999

Hantavirus is a genus of the Bunyaviridae family causing two serious diseases, hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). Puumala virus is a member of hantavirus originally found in Europe, and its natural reservoir is Clethrionomys glareolus. It is also associated with the human disease nephropathia epidemica, a milder form of HFRS. To identify the hantaviruses in bats, bats were collected from Jeong-Sun, Won-Joo, Chung-Ju and Hwa-Cheon area in Korea, and nested RT-PCR was performed with serotype specific primer from M segment. Interestingly, Puumala virus was detected in bats (Rhinolophus ferrum-equinum) only from Won-Joo. The 327 bp nested RT-PCR product, was sequenced. The sequence database search indicates that the sequence is homologous to the published sequence of Puumala viruses. The sequence similarities were ranged from 71% to 97%. The highest sequence similarity was 97% with Puumala virus Vranicam strain, and the lowest was 71% with Puumala virus K27 isolate. Puumala virus Vranicam strain was isolated from a bank vole (Clethrionomys glareolus) in Bosnia-Hercegovina. Puumala virus K27 was isolated from human in Russia. This analysis confirms that bats (Rhinolophus ferrum-equinum) in Korea are natural reservoir of Puumala virus.