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Seroepidemiological study in a Puumala virus outbreak area in South-East Germany

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Abstract

Puumala virus (PUUV) is the cause of the majority of haemorrhagic fever with renal syndrome cases in Germany. In 2004, a nephropathia epidemica outbreak was recorded in Lower Bavaria, South-East Germany. For a seroepidemiological study in this region including the resident population at four locations (n = 178) and soldiers from one location (n = 208) indirect immunoglobulin M (IgM) and immunoglobulin G (IgG) enzyme-linked immunosorbent assays (ELISAs) and immunoblot tests based on a yeast-expressed PUUV nucleocapsid protein were established. The validation using human serum panels originating from Germany revealed a diagnostic sensitivity and specificity of 98/100% for the IgM ELISA, 99/99% for the IgG ELISA, 99/100% for the IgM immunoblot test and 100/96% for the IgG immunoblot test. Using the novel IgG assays as well as a commercial IgG ELISA and an immunofluorescence assay for the resident population an average prevalence of 6.7% (12 of 178) with a range of 0% (0 of 21) to 11.9% (7 of 59) was observed. Positive serological results were equally distributed between males and females with an average age of 63 for males and 52 for females. The seroprevalence in the soldier group was found to be about 1% with one positive male of 203 (age 46 years) and one positive female of five (age 47 years). In conclusion, the PUUV seroprevalence in the residents of the outbreak region in Lower Bavaria was found to be up to fivefold higher than the average hantavirus seroprevalence of the German population.

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Acknowledgments

We thank Rasa Petraityte, Rita Vorobjoviene, Ausra Razanskiene, Kestutis Sasnauskas (Vilnius), Claudia Dettmer (Wusterhausen) for support and Bernd Köllner for helpful discussions. Human sera for test establishment and validation were kindly provided by Hans Quast (Schledehausen), Regina Allwinn, Holger F. Rabenau (Frankfurt), Silvia Dorn (Neuried) and Petra Emmerich (Hamburg). TULV, strain Moravia, and PUUV, strain CG18-20, were obtained from Alexander Plyusnin (Helsinki) and the WHO collaboration centre (Seoul). We also thank the soldiers of the Mobile Medical Biological Reconnaissance and Verification Unit from the Bundeswehr Institute of Microbiology (Munich) as well as Rainer Stern (Geiersthal), Wolfgang Blank (Kirchberg), Irmengard Schoder (Schöfweg) and Karl-Heinz Haberer (Spiegelau) who conducted the serosurvey. The excellent technical assistance of Peter Klein, Anne Grumbach and Astrid Thomas is acknowledged. The work was supported by Research-Project M/SAB1/5/A017 for the Bundeswehr Medical Service. Jonas Schmidt-Chanasit acknowledges support by Förderverein of the Friedrich-Loeffler-Institut and Paul und Ursula Klein-Stiftung.

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Authors and Affiliations

  1. Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, OIE Collaborating Centre for Zoonoses in Europe, Institute for Novel and Emerging Infectious Diseases, Südufer 10, 17493, Greifswald, Insel Riems, Germany

    Marc Mertens, Jana Blumhardt, Ina Römer, Martin H. Groschup & Rainer G. Ulrich

  2. Bundeswehr Institute of Microbiology, 80937, Munich, Germany

    Roman Wölfel, Gerhard Dobler & Sandra S. Essbauer

  3. Institute of Epidemiology, 16868, Wusterhausen, Germany

    Katrin Ullrich & Jonas Schmidt-Chanasit

  4. Institute for Animal Experimentation, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Kumiko Yoshimatsu

  5. Labor Enzenauer und Kollegen, Abteilung Serologie, Osnabrück, Germany

    Jutta Esser

  6. Institute of Medical Virology, Hospital of the Johann Wolfgang Goethe University, 60596, Frankfurt am Main, Germany

    Jonas Schmidt-Chanasit

  7. Department of Virology, Bernhard-Nocht-Institute for Tropical Medicine, 20359, Hamburg, Germany

    Jonas Schmidt-Chanasit

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  1. Marc Mertens
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  2. Roman Wölfel
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  3. Katrin Ullrich
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  6. Ina Römer
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  7. Jutta Esser
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  8. Jonas Schmidt-Chanasit
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  9. Martin H. Groschup
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  10. Gerhard Dobler
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  11. Sandra S. Essbauer
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  12. Rainer G. Ulrich
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Correspondence to Rainer G. Ulrich.

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Mertens, M., Wölfel, R., Ullrich, K. et al. Seroepidemiological study in a Puumala virus outbreak area in South-East Germany. Med Microbiol Immunol 198, 83–91 (2009). https://doi.org/10.1007/s00430-009-0106-9

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