Clinical course of hantavirus-induced nephropathia epidemica in children compared to adults in Germany—analysis of 317 patients

  • Fabian EchterdiekEmail author
  • Daniel Kitterer
  • M. Dominik Alscher
  • Vedat Schwenger
  • Bettina Ruckenbrod
  • Martin Bald
  • Joerg Latus
Original Article



Hantavirus infections are endemic worldwide, and its incidence in Europe has been steadily increasing. In Western Europe, hantavirus infections are typically caused by Puumala hantavirus and cause nephropathia epidemica (NE), a mild form of haemorrhagic fever with renal syndrome. Up to now, there is only little data about the course of acute NE in children, but it has been suggested that hantavirus infections take a lighter course in children when compared to adults. We performed a retrospective analysis of adults and children diagnosed with acute NE in two counties in South-Western Germany to investigate if there are differences in the course of the disease.


We reviewed the medical records of 295 adults and 22 children with acute NE regarding clinical presentation, laboratory findings, complications and outcome.


Acute kidney injury (AKI) and thrombocytopenia occurred at similar frequencies and severity in both groups. Sudden onset of fever and back/loin pain were two of the three most common symptoms in both adults and children. However, adults presented more frequently with arthralgia and visual disturbances, whereas abdominal pain and nausea/vomiting could be detected more often in children. No significant differences were found in the incidence of complications (haemodialysis, long-term outcome of kidney function, length of hospital stay).


The clinical course of acute NE was similar in adults and children with high frequency of AKI as well as thrombocytopenia, but with full recovery of all patients.


Hantavirus Nephropathia epidemica Acute kidney injury Haemodialysis Children 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the ethic committee of the University of Tübingen.


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Copyright information

© IPNA 2019

Authors and Affiliations

  1. 1.Department of NephrologyKlinikum StuttgartStuttgartGermany
  2. 2.Department of Internal Medicine, Division of NephrologyRobert-Bosch-HospitalStuttgartGermany
  3. 3.Olga Children’s Hospital, Department of Pediatric NephrologyKlinikum StuttgartStuttgartGermany

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