Epidemiology in Military and Veteran Populations Proceedings of the Second Biennial Conference, March 7, 1990 (1991) / Chapter Skim
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Hemorrhagic Fever with Renal Syndrome: Past Accomplishments and Future Challenges
Hemorrhagic Fever with Renal Syndrome: Past Accomplishments and Future Challenges
Pages 35-48
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From page 35... ...
This syndrome is caused by a newly recognized genus of viruses, the genus Hantavirus' of the family Bunyaviridae~, and these viruses are of special interest, as they clearly cause acute renal failure, and there is growing evidence that they may predispose a person to subsequent development of chronic renal disease. Human disease due to hantaviral infections first came to the attention of Western medicine during the Korean Conflict, when a mysterious "news disease, Korean hemorrhagic fever, was seen among the United Nations forces.
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From page 36... ...
Acute hantaviral infections cause a wide spectrum of illness, which typically includes abrupt onset, fever, renal dysfunction, and often hemorrhagic manifestations7. The name hemorrhagic fever with renal syndrome has been proposed by the World Health Organization to cover all human disease due to hantaviral infections8.
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From page 37... ...
This disease was first described in the medical literature during the 1930'st°~t, and the similarities between it and the Asian forms of hemorrhagic fever with renal syndrome have been known for some timely. Like Hantaan virus in Asia, Puumala virus, the cause of nephropathia epidemics, is also associated with a rodent host, in this case the bank vole, Clethrionomvs glareolust3~4.
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From page 38... ...
The story of Seoul virus begins in the early 1980's, and again, Ho Wang Lee and his Korean colleagues played a prominent role in its discoveryt9. With the aid of the serologic test developed for Hantaan virus, they diagnosed hemorrhagic fever with renal syndrome among patients who resided in the urban centers of Korea, far from the recognized endemic region of Korean hemorrhagic fever.
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From page 39... ...
When we attempted to match each seropositive by age and sex to five seronegative controls from this same population, we found that seropositive persons were significantly more likely to suffer from hypertension, chronic renal disease, or have a history of cerebrovascular accidents, although rates of diabetes were not significantly different (Table 2~. A nephrologist from Johns Hopkins Hospital then reviewed the charts for the primary diagnosis underlying their renal disease, without knowledge of their serological status.
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From page 40... ...
Finally, a serological survey targeted 402 patients utilizing chronic renal dialysis units in Baltimore (Table 1~. Individual identifiers and personal histories were not available for these sera, but the population age distribution and sex ratio were similar to those of the Johns Hopkins Hospital population.
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From page 41... ...
Hantaviral infections can be acquired either overseas, including as part of military service, or right here in the United States, from local infected rats; but regardless of the source of infection, there is growing evidence that some patients will progress to chronic renal disease and perhaps end-stage kidney failure. It has been estimated that the United States spends more than $30 billion a year for medical care for kidney and urologic diseases, and about $3 billion is Medicare payments for dialysis and transplantation for people with ends~ge kidney disease.
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From page 42... ...
1981. Intraspecific transmission of Hantaan virus, etiologic agent of Korean hemorrhagic fever, in the rodent Apodemus Uranus.
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From page 43... ...
Initial and long term evaluation of renal function in hemorrhagic fever with renal syndrome. 2nd Symposium on Arboviruses in the Mediterranean Countries, 24-29 September 1989, Dubrovaik, Yugoslavia, Abstract S16.
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From page 44... ...
, predominantly black patients seen at Johns Hopkins Hospital Patients using chronic renal dialysis units 2.4/1000 12/1000 20/1000
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From page 45... ...
35 (48%) ns Total 15 73 ~Chi square analysis.
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From page 46... ...
* Chi square analysis with 3 df.
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