1. 1 Institute for Clinical Microbiology and Immunology,St. Gallen, Switzerland 2 Swedish Institute for Infectious Disease Control, Karolinska Institutet, Stockholm, Sweden 3 University Childrens Hospital, Basel, Switzerland 4 Research Laboratory for Vector-Borne Diseases and National Reference Center for Hantavirus Infections, Queen Astrid Military Hospital, Brussels, Belgium FIRST HUMAN CASE OF HANTA VIRUS INFECTION IN SWITZERLAND Hantavirus: an ignored pandemic in Switzerland ? [Troillet N. Institut Central des Hopitaux Valaisans; Rev Med Suisse Romande 1997 Jan;117(1):3-11] Switzerland - a white spot for hantaviruses ? [Vaheri A. 2000, Haartman Institute, Helsinki, 2000;personal communication] Introduction to Hantaviruses Family Bunyaviridae, Genus Hantavirus, > 20 sero / genotypes, 100 nm, enveloped, negative sense, tri-segmented RNA Worldwide natural reservoir of hantaviruses pathogenic for humans : Rodentia (Order), Muridae (Family) with chronic persistent infection D. Schultze 1, Å. Lundkvist 2, U. Blauenstein 3, P. Heyman 4 Hantavirus serology Hantavirus foci peroxidase-stained in one well from a tissue culture plate [Niklasson et al. Am. J.Trop.Med.Hyg. 1991, 660-665] Summary  First documented case of Hantavirus infection in CH  First documented case of acute infection with serotype Tula virus, associated with symptoms uncommon for Hantavirus disease  Rare case of Hantavirus infection in context with a rodent bite  Awareness of Hantavirus diseases in Switzerland is warranted Summary  First documented case of Hantavirus infection in CH  First documented case of acute infection with serotype Tula virus, associated with symptoms uncommon for Hantavirus disease  Rare case of Hantavirus infection in context with a rodent bite  Awareness of Hantavirus diseases in Switzerland is warranted -Asymptomatic & non-specific mild infections outnumber symptomatic, characteristic infections Two broad clinical presentations : -HFRS - Hemorrhagic Fever with Renal Syndrome, Asia & Europe -Hantavirus Pulmonary Syndrome, North & South America 60'000 to 100'000 hospitalised cases of hantavirus disease / year Prologue August 2000 Kaiseraugst, nearby Basel: a 12 year old boy caught a small rodent, hours later rodent bit the boy Medical record Case report Clinical features of Hantavirus infections Acknowledgement This work was enabled by cooperation of the authors within the European Network of Viral Diseases (http://www.enivd.de) - Transmission of Hantaviruses to humans via - respiratory route (common) - bite (rare) - person-to-person (only Andes virus) Microtus arvalis, known to carry Tula virus 61st Annual Assembly of Swiss Society for Micro- biology, Luzern, 20-21 February 2002 Hantavirus serology indicates a recent infection with TULV: -high IgM index in acute-phase serum samples and a rise of IgG index (Hantavirus ELISA, MRL Diagnostics, USA) -confirmed by seroconversion of IgM in Tula virus (TULV) enzyme immuno assay* Definite diagnosis and serological typing of TULV by: -Tula virus -specific focus reduction neutralisation test (FRNT)** -on convalescent serum, 21 weeks after the rodent bite *Lundkvist Å et al. Virus Research (1996) 45:29-44. **Lundkvist Å et al. Journal of Medical Virology (1997) 53:51-59. The history of Tula virus [Plyusnin A et al. Journ Virol (1994) 68:7833-7839 / [Plyusnin A, Morzunov SP; Microbiology and Immunology (2001) 256: 47-75] 1994 Tula virus in Microtus arvalis, trapped 1987 in Tula, 100 km south of Moskow 1996/7 Tula virus in voles from Czech Rep, Slovakia & Austria 2001 Tula virus -genome sequences in rodents in CH Tula virus considered apathogenic to humans so far 2001 Tula virus -specific antibodies in one serum from a healthy blood donor from the Czech Republic