Human infection with Seoul orthohantavirus in Korea, 2019

PLoS Negl Trop Dis. 2021 Feb 22;15(2):e0009168. doi: 10.1371/journal.pntd.0009168. eCollection 2021 Feb.

Abstract

Of various rodent-borne hantaviruses, Seoul orthohantavirus (SEOV) causes haemorrhagic fever with renal syndrome (HFRS), as does Hantaan orthohantavirus (HTNV). Given global-scale of cases of human infection with SEOV, it is of great clinical importance to distinguish SEOV from other HFRS-causing hantaviruses. In May 2019, a middle-aged patient who had lived in a suburban area of Chungcheong Province, Republic of Korea and enjoyed outdoor activities was transferred to Asan Medical Center in Seoul, Republic of Korea with HFRS; his symptoms included high fever and generalized myalgia. The rapid diagnostic test performed immediately after his transfer detected HTNV-specific antibodies, and the patient was treated accordingly. However, two consecutive IFAs performed at ten-day intervals showed no HTNV-specific immunoglobulin (Ig) G. During continuous supportive care, next-generation sequencing successfully identified viral genomic sequences in the patient's serum, which were SEOV and not HTNV. Phylogenetic analysis grouped the L, M, and S genes of this SEOV strain together with those of rat- or human-isolated Korean strains reported previously. Given global outbreaks and public health threats of zoonotic hantaviruses, a causative pathogen of hantavirus HFRS should be identified correctly at the time of diagnosis and by point-of-care testing.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Farmers
  • Genome, Viral
  • Hemorrhagic Fever with Renal Syndrome / diagnosis
  • Hemorrhagic Fever with Renal Syndrome / immunology
  • Hemorrhagic Fever with Renal Syndrome / virology*
  • Humans
  • Immunoglobulin G / blood
  • Male
  • Middle Aged
  • Phylogeny
  • Republic of Korea / epidemiology
  • Seoul virus / genetics
  • Seoul virus / immunology
  • Seoul virus / isolation & purification*

Substances

  • Immunoglobulin G

Grants and funding

This study was supported by grants from the National Research Foundation of Korea (NRF), funded by the Ministry of Science and ICT, Republic of Korea (Grant No. NRF-2017M3A9E4061995; M.-S.P.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.