Special Issue "Hantavirus Research in Finland"

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Animal Viruses".

Deadline for manuscript submissions: 31 December 2021.

Special Issue Editor

Prof. Dr. Jukka T. Mustonen
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Guest Editor
Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland

Special Issue Information

Dear Colleagues,

Puumala hantavirus (PUUV) infections are common in Finland, making this country the most endemic area of hantavirus infections per inhabitant. PUUV is the only human pathogenic hantavirus found in this country. The natural reservoir for PUUV is the bank vole (Myodes glareolus). Scientific research on the disease, previously described as nephropathia epidemica, started in Finland in the 1970s and PUUV was discovered in 1980. The structure of PUUV and serological diagnostics have been and are currently studied, as are the epidemiology, risk factors, and immune response of the infection, disease severity biomarkers, and host genetics. Other research topics include the pathogenesis of the main clinical manifestations, capillary leakage, thrombocytopenia, and acute kidney injury (AKI), as well as acute-phase complications and long-term prognosis of the infection. Studies on the pathogenesis and immune response may show the way towards optimal prophylaxis and treatment.

Studies on the dynamics and genetics of PUUV in bank vole populations have also been performed. Finnish scientists have worked together with many collaborators in European, Asian, and American countries. In these projects, hantaviruses other than PUUV have also been studied.

The present Special Issue includes reviews, original articles, and short communications about PUUV infections showing that the research continues actively in Finland.

Prof. Dr. Jukka T. Mustonen
Guest Editor

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Keywords

  • Puumala virus
  • hantavirus infections
  • bank vole

Published Papers (5 papers)

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Research

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Article
Hormonal Defects Are Common during Puumala Hantavirus Infection and Associate with Disease Severity and Biomarkers of Altered Haemostasis
Viruses 2021, 13(9), 1818; https://0-doi-org.brum.beds.ac.uk/10.3390/v13091818 - 13 Sep 2021
Viewed by 396
Abstract
Central and peripheral hormone deficiencies have been documented during and after acute hantavirus infection. Thrombocytopenia and coagulation abnormalities are common findings in haemorrhagic fever with renal syndrome (HFRS). The associations between coagulation and hormonal abnormalities in HFRS have not been studied yet. Forty-two [...] Read more.
Central and peripheral hormone deficiencies have been documented during and after acute hantavirus infection. Thrombocytopenia and coagulation abnormalities are common findings in haemorrhagic fever with renal syndrome (HFRS). The associations between coagulation and hormonal abnormalities in HFRS have not been studied yet. Forty-two patients diagnosed with Puumala virus (PUUV) infection were examined during the acute phase and on a follow-up visit approximately one month later. Hormonal defects were common during acute PUUV infection. Overt (clinical) hypogonadism was identified in 80% of the men and approximately 20% of the patients had overt hypothyroidism. At the one-month follow-up visit, six patients had central hormone deficits. Acute peripheral hormone deficits associated with a more severe acute kidney injury (AKI), longer hospital stay and more severe thrombocytopenia. Half of the patients with bleeding symptoms had also peripheral hormonal deficiencies. Patients with free thyroxine levels below the reference range had higher D-dimer level than patients with normal thyroid function, but no thromboembolic events occurred. Acute phase hormonal abnormalities associate with severe disease and altered haemostasis in PUUV infection. Full article
(This article belongs to the Special Issue Hantavirus Research in Finland)
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Article
The Clinical Presentation of Puumala Hantavirus Induced Hemorrhagic Fever with Renal Syndrome Is Related to Plasma Glucose Concentration
Viruses 2021, 13(6), 1177; https://0-doi-org.brum.beds.ac.uk/10.3390/v13061177 - 20 Jun 2021
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Abstract
Puumala hantavirus (PUUV) causes a hemorrhagic fever with renal syndrome characterized by thrombocytopenia, increased capillary leakage, and acute kidney injury (AKI). As glucosuria at hospital admission predicts the severity of PUUV infection, we explored how plasma glucose concentration associates with disease severity. Plasma [...] Read more.
Puumala hantavirus (PUUV) causes a hemorrhagic fever with renal syndrome characterized by thrombocytopenia, increased capillary leakage, and acute kidney injury (AKI). As glucosuria at hospital admission predicts the severity of PUUV infection, we explored how plasma glucose concentration associates with disease severity. Plasma glucose values were measured during hospital care in 185 patients with PUUV infection. They were divided into two groups according to maximum plasma glucose concentration: P-Gluc < 7.8 mmol/L (n = 134) and P-Gluc ≥ 7.8 mmol/L (n = 51). The determinants of disease severity were analyzed across groups. Patients with P-Gluc ≥7.8 mmol/L had higher hematocrit (0.46 vs. 0.43; p < 0.001) and lower plasma albumin concentration (24 vs. 29 g/L; p < 0.001) than patients with P-Gluc < 7.8 mmol/L. They presented with higher prevalence of pulmonary infiltrations and pleural effusion in chest radiograph, higher prevalence of shock and greater weight change during hospitalization. Patients with P-Gluc ≥ 7.8 mmol/L were characterized by lower platelet count (50 vs. 66 × 109/L; p = 0.001), more severe AKI (plasma creatinine 272 vs. 151 µmol/L; p = 0.001), and longer hospital treatment (8 vs. 6 days; p < 0.001) than patients with P-Gluc < 7.8 mmol/L. Plasma glucose level is associated with the severity of capillary leakage, thrombocytopenia, inflammation, and AKI in patients with acute PUUV infection. Full article
(This article belongs to the Special Issue Hantavirus Research in Finland)
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Review

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Review
Coagulopathy in Acute Puumala Hantavirus Infection
Viruses 2021, 13(8), 1553; https://0-doi-org.brum.beds.ac.uk/10.3390/v13081553 - 06 Aug 2021
Viewed by 527
Abstract
Puumala hantavirus (PUUV) causes a hemorrhagic fever with renal syndrome (HFRS), also called nephropathia epidemica (NE), which is mainly endemic in Europe and Russia. The clinical features include a low platelet count, altered coagulation, endothelial activation, and acute kidney injury (AKI). Multiple connections [...] Read more.
Puumala hantavirus (PUUV) causes a hemorrhagic fever with renal syndrome (HFRS), also called nephropathia epidemica (NE), which is mainly endemic in Europe and Russia. The clinical features include a low platelet count, altered coagulation, endothelial activation, and acute kidney injury (AKI). Multiple connections between coagulation pathways and inflammatory mediators, as well as complement and kallikrein–kinin systems, have been reported. The bleeding symptoms are usually mild. PUUV-infected patients also have an increased risk for disseminated intravascular coagulation (DIC) and thrombosis. Full article
(This article belongs to the Special Issue Hantavirus Research in Finland)
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Review
Hantavirus Research in Finland: Highlights and Perspectives
Viruses 2021, 13(8), 1452; https://0-doi-org.brum.beds.ac.uk/10.3390/v13081452 - 26 Jul 2021
Viewed by 558
Abstract
Finland has the highest incidence of hantavirus infections globally, with a significant impact on public health. The large coverage of boreal forests and the cyclic dynamics of the dominant forest rodent species, the bank vole Myodes glareolus, explain most of this. We review [...] Read more.
Finland has the highest incidence of hantavirus infections globally, with a significant impact on public health. The large coverage of boreal forests and the cyclic dynamics of the dominant forest rodent species, the bank vole Myodes glareolus, explain most of this. We review the relationships between Puumala hantavirus (PUUV), its host rodent, and the hantavirus disease, nephropathia epidemica (NE), in Finland. We describe the history of NE and its diagnostic research in Finland, the seasonal and multiannual cyclic dynamics of PUUV in bank voles impacting human epidemiology, and we compare our northern epidemiological patterns with those in temperate Europe. The long survival of PUUV outside the host and the life-long shedding of PUUV by the bank voles are highlighted. In humans, the infection has unique features in pathobiology but rarely long-term consequences. NE is affected by specific host genetics and risk behavior (smoking), and certain biomarkers can predict the outcome. Unlike many other hantaviruses, PUUV causes a relatively mild disease and is rarely fatal. Reinfections do not exist. Antiviral therapy is complicated by the fact that when symptoms appear, the patient already has a generalized infection. Blocking vascular leakage measures counteracting pathobiology, offer a real therapeutic approach. Full article
(This article belongs to the Special Issue Hantavirus Research in Finland)
Review
Central Nervous System and Ocular Manifestations in Puumala Hantavirus Infection
Viruses 2021, 13(6), 1040; https://0-doi-org.brum.beds.ac.uk/10.3390/v13061040 - 31 May 2021
Cited by 1 | Viewed by 776
Abstract
Puumala hantavirus (PUUV), carried and spread by the bank vole (Myodes glareolus), causes a mild form of hemorrhagic fever with renal syndrome (HFRS) called nephropathia epidemica (NE). Acute high fever, acute kidney injury (AKI), thrombocytopenia, and hematuria are typical features of [...] Read more.
Puumala hantavirus (PUUV), carried and spread by the bank vole (Myodes glareolus), causes a mild form of hemorrhagic fever with renal syndrome (HFRS) called nephropathia epidemica (NE). Acute high fever, acute kidney injury (AKI), thrombocytopenia, and hematuria are typical features of this syndrome. In addition, headache, blurred vision, insomnia, vertigo, and nausea are commonly associated with the disease. This review explores the mechanisms and presentations of ocular and central nervous system involvement in acute NE. Full article
(This article belongs to the Special Issue Hantavirus Research in Finland)
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