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Seroprevalence of hantavirus infections in Switzerland in 2009: difficulties in determining prevalence in a country with low endemicity


Engler, O; Klingstrom, J; Aliyev, E; Niederhauser, C; Fontana, S; Strasser, M; Portmann, J; Signer, J; Bankoul, S; Frey, F; Hatz, C; Stutz, A; Tschaggelar, A; Mütsch, Margot (2013). Seroprevalence of hantavirus infections in Switzerland in 2009: difficulties in determining prevalence in a country with low endemicity. Eurosurveillance, 18(50):20660.

Abstract

In several European countries, diagnosis of nephropathia epidemica, a mild form of haemorrhagic fever with renal syndrome (HFRS) caused by Puumala-virus infection, has increased over the past 10–20 years. In Switzerland, despite its geographical proximity to regions with epidemic outbreaks in Germany and France, infections are detected only sporadically. To estimate the actual prevalence and potential risk factors of human hantavirus infections in Switzerland, a seroepidemiological study was performed in 2009 on serum samples from 4,559 blood donors and 1,810 military personnel. Sera were screened using commercial Puumala IgG and hantavirus IgG enzyme-linked immunosorbent assays indicating a seroprevalence of 1% and 9%, respectively. Subsequently, the samples were analysed by immunofluorescence assay and immunoblot assay, showing a much lower prevalence, of 0.4% and 0.3%, respectively. Two of the serum samples achieved an 80% reduction in plaque-forming units in a neutralisation test. Statistical evaluation of questionnaires only identified an association of age (above 50 years) with hantavirus seropositivity when adjusted for sex (odds ratio: 2.36; 95% confidence interval: 1.10–5.05). This study provides baseline data (0.3–0.4%) for future monitoring of hantavirus seroprevalence in Switzerland and highlights the challenges in estimating the seroprevalence of these viruses in a country with very low endemicity.

Abstract

In several European countries, diagnosis of nephropathia epidemica, a mild form of haemorrhagic fever with renal syndrome (HFRS) caused by Puumala-virus infection, has increased over the past 10–20 years. In Switzerland, despite its geographical proximity to regions with epidemic outbreaks in Germany and France, infections are detected only sporadically. To estimate the actual prevalence and potential risk factors of human hantavirus infections in Switzerland, a seroepidemiological study was performed in 2009 on serum samples from 4,559 blood donors and 1,810 military personnel. Sera were screened using commercial Puumala IgG and hantavirus IgG enzyme-linked immunosorbent assays indicating a seroprevalence of 1% and 9%, respectively. Subsequently, the samples were analysed by immunofluorescence assay and immunoblot assay, showing a much lower prevalence, of 0.4% and 0.3%, respectively. Two of the serum samples achieved an 80% reduction in plaque-forming units in a neutralisation test. Statistical evaluation of questionnaires only identified an association of age (above 50 years) with hantavirus seropositivity when adjusted for sex (odds ratio: 2.36; 95% confidence interval: 1.10–5.05). This study provides baseline data (0.3–0.4%) for future monitoring of hantavirus seroprevalence in Switzerland and highlights the challenges in estimating the seroprevalence of these viruses in a country with very low endemicity.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:20 Jan 2014 13:38
Last Modified:07 Dec 2017 08:06
Publisher:Centre Europeen pour la Surveillance Epidemiologique du SIDA
ISSN:1025-496X
Free access at:Official URL. An embargo period may apply.
Official URL:http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20660
PubMed ID:24342520

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