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Journal of Clinical Microbiology, September 2007, p. 3008-3014, Vol. 45, No. 9
0095-1137/07/$08.00+0     doi:10.1128/JCM.02573-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Hantavirus Disease Outbreak in Germany: Limitations of Routine Serological Diagnostics and Clustering of Virus Sequences of Human and Rodent Origin{triangledown}

Stefan Schilling,1,{dagger} Petra Emmerich,1 Boris Klempa,2 Brita Auste,2 Ebbo Schnaith,3 Herbert Schmitz,1 Detlev H. Krüger,2* Stephan Günther,1 and Helga Meisel2

Department of Virology, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg,1 Institute of Virology, Helmut-Ruska-Haus, Charité University Hospital, Berlin,2 Laboratory Schubach and Associates, Passau, Germany3

Received 22 December 2006/ Returned for modification 7 March 2007/ Accepted 1 July 2007

In Europe, hemorrhagic fever with renal syndrome results mainly from infection with Puumala virus (PUUV) or Dobrava virus. For 31 patients from a hantavirus disease outbreak in Lower Bavaria, a district in southeast Germany, serodiagnosis was undertaken by enzyme-linked immunosorbent assay, immunofluorescence assay, and immunoblot analysis. In a few of these cases, however, PUUV-specific typing of antibodies by these standard assays failed and a virus neutralization assay under biosafety level 3 conditions was required to verify the infection by this virus type. PUUV RNA was amplified by reverse transcription-PCR from acute-phase sera of three patients and was found to be very closely related to virus sequences obtained from bank voles (Clethrionomys glareolus) trapped in the same area. These findings link the outbreak with a novel PUUV lineage, "Bavaria," circulating in the local rodent population. The Bavaria lineage associated with the outbreak is only distantly related to other PUUV lineages from Germany.

* Corresponding author. Mailing address: Institut für Medizinische Virologie, Helmut-Ruska-Haus, Charité—Universitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany. Phone: 49-30-450 525 092. Fax: 49-30-450 525 907. E-mail: detlev.kruger{at}charite.de

{triangledown} Published ahead of print on 11 July 2007.

{dagger} Present address: Center of Internal Medicine, Division of Infectious Diseases, University Hospital Frankfurt/Main, 60590 Frankfurt/Main, Germany.

Journal of Clinical Microbiology, September 2007, p. 3008-3014, Vol. 45, No. 9
0095-1137/07/$08.00+0     doi:10.1128/JCM.02573-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.





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