Acute Hantavirus Nephropathy in Belgium : Preliminary Results of a Sero-Epidemiological Study

Abstract

Hantavirus (HV) has recently been recognized as a cause of acute renal failure (ARF) in different countries of Europe, particularly in Belgium and France. This disease (HV-disease), hitherto unknown to the Western world, is marked by aspecific viral symptoms and minor thrombocytopenia at the onset, followed by a variable degree of ARF, most often with a self-limiting course of 2 to 6 weeks. This so-called HV-nephropathy is characterized by severe loin pain, oliguria, a heavy but transient proteinuria, and mostly a minor hematuria. On renal biopsy, acute interstitial nephritis with minimal glomerular hypercellurarity is found, whereas immunofluorescence shows no or very few and aspecific immuno­deposits. In the European patients, very faint or no hemorrhagic symptoms seem to appear, and the overall mortality is lower than 1 %. This is in contrast to the hemorrhagic forms with high mortality ( up to 20 %) in the Far East, where the disease was known for a long time under various denominations and had been considered as a viral “hemorrhagic fever”. Transmission of the virus occurs through exposure to infected rodents, probably by inhalation of contaminated aerosols ( droplets of urine and/or saliva from apparently healthy rodents, who act as carriers). Diagnosis can only be ascertained by specific anti-HV serology. In this paper, we want to give an historical background of this “new” disease and illustrate it with 2 case-reports and the first preliminary results of a sero-epidemiological study in Belgium.