Skip to main content
SpringerLink
Log in

Hantavirus infections in Greece – an update

  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

Hantaviruses are emerging viruses spread worldwide and cause hemorrhagic fever with renal syndrome (HFRS) or hantavirus pulmonary syndrome (HPS). Two pathogenic hantaviruses are present in Greece: Dobrava/Belgrade virus (DOBV) and Puumala virus (PUUV). The predominant one is DOBV, carried in Greece by the rodent Apodemus flavicollis. Most human infections are sporadic, but epidemic outbreaks were also described. The severity of the disease ranges from a mild or moderate form to severe and fatal cases. Several endemic foci for HFRS have been identified. Phylogenetic analysis of hantavirus sequences revealed a stable geographical distribution.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hjelle B, Glass GE. Outbreak of hantavirus infection in the four corners region of the United States in the wake of the 1997–1998 El Niño-Southern oscillation. J Infect Dis 2000; 181: 1569–1573.

    Google Scholar 

  2. Bugert JJ, Welzel TM, Zeier M, Darai G. Hantavirus infection-haemorrhagic fever in the Balkans — potential nephrological hazards in the Kosovo war. Nephrol Dial Transplant 1999; 14: 1843–1844.

    Google Scholar 

  3. Schmaljohn C. Molecular biology of hantaviruses. In: Elliott R (ed.), The Bunyaviridae, New York: Plenum Press, 1996: 63–90.

    Google Scholar 

  4. Nichol ST, Spiropoulou CF, Morzunov S, et al. Genetic identification of a hantavirus associated with an outbreak of acute respiratory illness. Science 1993; 262: 914–917.

    Google Scholar 

  5. Schmaljohn C, Hjelle B. Hantaviruses: A global disease problem. Emerg Infect Dis 1997; 3: 95–104.

    Google Scholar 

  6. Lundkvist A, Apekina N, Myasnikov Y, Vapalahti O, Vaheri A, Plyusnin A. Dobrava hantavirus outbreak in Russia. Lancet 1997; 350: 781–782.

    Google Scholar 

  7. Lundkvist A, Vasilenko V, Golovljova I, Plyusnin A, Vaheri A. Human Dobrava hantavirus infections in Estonia. Lancet 1998; 352: 369.

    Google Scholar 

  8. Meisel H, Lundkvist A, Gantzer K, Bar W, Sibold C, Kruger DH. First case of infection with hantavirus Dobrava in Germany. Eur J Clin Microbiol Infect Dis 1998; 17: 884–885.

    Google Scholar 

  9. Mentel R, Bordihn N, Wegner U, Wendel H, Niklasson B. Hantavirus Dobrava infection with pulmonary manifestation. Med Microbiol Immunol (Berl) 1999; 188: 51–53.

    Google Scholar 

  10. Sibold C, Meisel H, Lundkvist A, et al. Short report: Simultaneous occurrence of Dobrava, Puumala, and Tula Hantaviruses in Slovakia. Am J Trop Med Hyg 1999; 61: 409–411.

    Google Scholar 

  11. Plyusnin A, Vapalahti O, Vasilenko V, Henttonen H, Vaheri A. Dobrava hantavirus in Estonia: Does the virus exist throughout Europe? Lancet 1997; 349: 1369–1370.

    Google Scholar 

  12. Plyusnin A, Nemirov K, Apekina N, Plyusnina A, Lundkvist A, Vaheri A. Dobrava hantavirus in Russia. Lancet 1999; 353: 207.

    Google Scholar 

  13. Nemirov K, Vapalahti O, Lundkvist A, et al. Isolation and characterization of Dobrava hantavirus carried by the striped field mouse (Apodemus agrarius) in Estonia. J Gen Virol 1999; 80: 371–379.

    Google Scholar 

  14. Sibold C, Ulrich R, Labuda M, et al. Dobrava hantavirus causes hemorrhagic fever with renal syndrome in central Europe and is carried by two different Apodemus mice species. J Med Virol 2001; 63: 158–167.

    Google Scholar 

  15. Eltari E, Nuti M, Hasko I, Gina A, Haemorrhagic fever with renal syndrome in a case in northern Albania. Lancet 1987; 2(8569): 1211.

    Google Scholar 

  16. Verbev P, Gabev E. Haemorrhagic nephroso-nephritis in Bulgaria. J Hyg Epidemiol Microbiol Immunol 1963; 7: 136–144.

    Google Scholar 

  17. Chumakov M, Shindarov L, Gavrilovskaya I, Vasilenko Sv, Gorbachkova E, Katzarov G. Seroepidemiology of haemorrhagic fever with renal syndrome in Bulgaria. Acta Virol 1988; 32: 261–266.

    Google Scholar 

  18. Manasia M, Olinic N, Zagreanu I, Serban A. Hemorrhagic fever with renal syndrome: Report of 11 observations. Int Urol Nephrol 1977; 9: 177–184.

    Google Scholar 

  19. Heneberg D, Heneberg N, Sebek Z. Experiences in the study of natural foci of Zoonoses in Yugoslavia. Med Glas 1970; 24: 297–305.

    Google Scholar 

  20. Gaon J, Karlovac M, Gresikova M, et al. Epidemiological features of hemorrhagic fever. Folia Med Sar 1968; 3: 23–43.

    Google Scholar 

  21. Vesenjak-Hirjan J, Hrabar A, Vince-Ribaric V, Borcic B, Brudnjak Z. An outbreak of hemorrhagic fever with a renal syndrome in the Plitvice Lakes area (preliminary report). Folia Parasitol (Praha) 1971; 18: 275–279.

    Google Scholar 

  22. Gligic A, Obravodovic M, Stojanovic R, et al. Epidemic hemorrhagic fever with renal syndrome in Yugoslavia, 1986. Am J Trop Med Hyg 1989; 41: 102–108.

    Google Scholar 

  23. Gligic A, Stojanovic R, Obradovic M, et al. Hemorrhagic fever with renal syndrome in Yugoslavia: Epidemiologic and epizootiologic features of a nationwide outbreak in 1989. Eur J Epidemiol 1992; 8: 816–825.

    Google Scholar 

  24. Avsic-Zupanc T, Cizman B, Gligic A, Hoofd G, van der Groen G. Evidence for hantavirus disease in Slovenia, Yugoslavia. Acta Virol 1989; 33: 327–337.

    Google Scholar 

  25. Hukic M, Kurt A, Torstensson S, Lundkvist A, Wiger D, Niklasson B. Haemorrhagic fever with renal syndrome in north-east Bosnia. Lancet 1996; 347(8993): 56–57.

    Google Scholar 

  26. Lundkvist A, Hukic M, Hörling J, Gilljam M, Nichol S, Niklasson B. Puumala and Dobrava viruses cause haemorrhagic fever with renal syndrome (HFRS) in Bosnia-Herzegovina: Evidence of highly cross-neutralizing antibody responses in early patient sera. J Med Virol 1997; 53: 51–59.

    Google Scholar 

  27. Lee HW, Antoniadis A. Serological evidence for Korean haemorrhagic fever in Greece. Lancet 1981; 1(8224): 832.

    Google Scholar 

  28. Lee HW, Baek LJ, Johnson KM. Isolation of Hantaan virus, the etiologic agent of Korean hemorrhagic fever, from wild urban rats. J Infect Dis 1982; 146: 638–644.

    Google Scholar 

  29. Antoniades A, Pyrpasopoulos M, Sion M, Daniel S, Peters CJ. Two cases of hemorrhagic fever with renal syndrome in northern Greece. J Infect Dis 1984; 149: 1011–1013.

    Google Scholar 

  30. Antoniadis A, Le Due JW, Acritidis N, Alexiou-Daniel S, Kyparissi A, Saviolakis GA. Hemorrhagic fever with renal syndrome in Greece: Clinical and laboratory characteristics. Rev Infect Dis 1989; 11: 5891–5896.

    Google Scholar 

  31. Antoniadis A, Le Due JW, Daniel-Alexiou S. Clinical and epidemiological aspects of hemorrhagic fever with renal syndrome (HFRS) in Greece. Eur J Epidemiol 1987; 3: 295–301.

    Google Scholar 

  32. Avsic-Zupanc T. Hantaviruses and hemorrhagic fever with renal syndrome in the Balkans. In: Saluzzo JF, Dodet B (eds), Factors in the Emergence and Control of Rodent-borne Viral Diseases (Hantaviral and Arenal Diseases), Éditíons scientifiques et médicales Elsevier SAS, 1999; 93–98.

  33. Eboriadou M, Kalevrosoglou I, Varlamis G, Mitsiakos G, Papa A, Antoniadis A. Hantavirus nephropathy in a child. Nephrol Dial Transplant 1999; 14: 1040–1041.

    Google Scholar 

  34. Papadimitriou MG, Antoniadis A. Hantavirus nephropathy in Greece. Lancet 1994; 343: 1038.

    Google Scholar 

  35. Elisaf M, Antoniadis A, Siamopoulos K. Mild human infections of HFRS in northwestern Greece. J Virol Dis 1993; 1: 28–30.

    Google Scholar 

  36. Siamopoulos KC, Elisaf M, Antoniadis A, Moutsopoulos HM. Hemorrhagic fever with renal syndrome in an endemic area of Greece. Am J Nephrol 1992; 12: 170–173.

    Google Scholar 

  37. Antoniadis A, Stylianakis A, Papa A, et al. Direct genetic detection of Dobrava virus in Greek and Albanian patients with hemorrhagic fever with renal syndrome. J Infect Dis 1996; 174: 407–410.

    Google Scholar 

  38. Papa A, Johnson AM, Stockton PC, et al. Retrospective serological and genetic study of the distribution of hantaviruses in Greece. J Med Virol 1998; 55: 321–327.

    Google Scholar 

  39. Papa A, Spiropoulou C, Nichol S, Antoniadis A. Tracing Dobrava hantavirus infection. J Infect Dis 2000; 181: 2116–2117.

    Google Scholar 

  40. Papa A, Mills JN, Kouidou S, Ma B, Papadimitriou E, Antoniadis A. Preliminary characterization and natural history of hantaviruses in rodents in northern Greece. Emerg Infect Dis 2000; 6: 654–655.

    Google Scholar 

  41. Papa A, Pliakogiannis Th, Lundkvist A, Antoniadis A. First case of Puumala virus infection in Greece. Infection 2000; 28: 334–335.

    Google Scholar 

  42. Elisaf M, Stefanaki S, Repanti M, Korakis H, Tsianos E, Siamopoulos KC. Liver involvement in hemorrhagic fever with renal syndrome. J Clin Gastroenterol 1993; 17: 33–37.

    Google Scholar 

  43. Plyusnin A, Vapalahti O, Lundkvist A, Henttonen H, Vaheri A. Hantaviruses in Europe: An overview. In: Saluzzo JF, Dodet B (eds), Factors in the Emergence and Control of Rodent-borne Viral Diseases (Hantaviral and Arenal Diseases). Éditions scientifiques et médicales Elsevier SAS, 1999: 85–91.

  44. Ondrias JC. The taxonomy and geographical distribution of the rodents of Greece. Sangetierkunkliche Mitteilungen 1966; 14 (Sonderheft): 1–136.

    Google Scholar 

  45. LeDuc JW, Antoniades A, Siamopoulos K. Epidemiological investigations following an outbreak of hemorrhagic fever with renal syndrome in Greece. Am J Trop Med Hyg 1986; 35: 654–659.

    Google Scholar 

  46. Vohralik V, Sofianidou Th. Small mammals (Insectivora, Rodentia) of Thrace, Greece. Acta Univ Carolinae Biol 1992; 36: 341–369.

    Google Scholar 

  47. Avsic-Zupanc T, Nemirov K, Petrovec M, et al. Genetic analysis of wild-type Dobrava hantavirus in Slovenia: Co-existence of two distinct genetic lineages within the same natural focus. J Gen Virol 2000; 81: 1747–1755.

    Google Scholar 

  48. Avsic-Zupanc T, Xiao S-Y, Gligic A, van der Groen G, LeDuc JW. Characterization of Dobrava virus: A hantavirus from Slovenia. J Med Virol 1992; 38: 132–137.

    Google Scholar 

  49. Gligic A, Dimkovic N, Xiao SY, et al. Belgrade virus: A new hantavirus causing severe hemorrhagic fever with renal syndrome in Yugoslavia. J Infect Dis 1992; 166: 113–120.

    Google Scholar 

  50. Taller AM, Xiao SY, Godec MS, et al. Belgrade virus, a cause of hemorrhagic fever with renal syndrome in the Balkans, is closely related to Dobrava virus of field mice. J Infect Dis 1993; 168: 750–753.

    Google Scholar 

  51. Felsenstein J. PHYLIP (Phylogeny Inference Package), version 3.5c, 1993.

Download references

Author information

Authors and Affiliations

  1. Department of Microbiology (WHO Collaborating Centre for Reference and Research on Arboviruses and Haemorrhagic Fever Viruses), School of Medicine, Aristotelian University of Thessaloniki, Thessaloniki, Greece

    A. Papa & A. Antoniadis

Authors
  1. A. Papa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Antoniadis
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Papa, A., Antoniadis, A. Hantavirus infections in Greece – an update. Eur J Epidemiol 17, 189–194 (2001). https://doi.org/10.1023/A:1017987104363

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1017987104363

Search

Navigation