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Kazasidis O, Geduhn A, Jacob J. High-resolution early warning system for human Puumala hantavirus infection risk in Germany. Sci Rep 2024; 14:9602. [PMID: 38671000 PMCID: PMC11053085 DOI: 10.1038/s41598-024-60144-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
The fluctuation of human infections by the Puumala orthohantavirus (PUUV) in Germany has been linked to weather and phenology parameters that drive the population growth of its host species. We quantified the annual PUUV-outbreaks at the district level by binarizing the reported infections in the period 2006-2021. With these labels we trained a model based on a support vector machine classifier for predicting local outbreaks and incidence well in advance. The feature selection for the optimal model was performed by a heuristic method and identified five monthly weather variables from the previous two years plus the beech flowering intensity of the previous year. The predictive power of the optimal model was assessed by a leave-one-out cross-validation in 16 years that led to an 82.8% accuracy for the outbreak and a 0.457 coefficient of determination for the incidence. Prediction risk maps for the entire endemic area in Germany will be annually available on a freely-accessible permanent online platform of the German Environment Agency. The model correctly identified 2022 as a year with low outbreak risk, whereas its prediction for large-scale high outbreak risk in 2023 was not confirmed.
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Affiliation(s)
- Orestis Kazasidis
- Institute for Epidemiology and Pathogen Diagnostics, Rodent Research, Julius Kühn Institute (JKI) - Federal Research Centre for Cultivated Plants, Toppheideweg 88, 48161, Münster, Germany.
| | - Anke Geduhn
- Laboratory for Health Pests and Their Control, German Environment Agency, Corrensplatz 1, 14195, Berlin, Germany
| | - Jens Jacob
- Institute for Epidemiology and Pathogen Diagnostics, Rodent Research, Julius Kühn Institute (JKI) - Federal Research Centre for Cultivated Plants, Toppheideweg 88, 48161, Münster, Germany
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Li Y, Miyani B, Faust RA, David RE, Xagoraraki I. A broad wastewater screening and clinical data surveillance for virus-related diseases in the metropolitan Detroit area in Michigan. Hum Genomics 2024; 18:14. [PMID: 38321488 PMCID: PMC10845806 DOI: 10.1186/s40246-024-00581-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/24/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Periodic bioinformatics-based screening of wastewater for assessing the diversity of potential human viral pathogens circulating in a given community may help to identify novel or potentially emerging infectious diseases. Any identified contigs related to novel or emerging viruses should be confirmed with targeted wastewater and clinical testing. RESULTS During the COVID-19 pandemic, untreated wastewater samples were collected for a 1-year period from the Great Lakes Water Authority Wastewater Treatment Facility in Detroit, MI, USA, and viral population diversity from both centralized interceptor sites and localized neighborhood sewersheds was investigated. Clinical cases of the diseases caused by human viruses were tabulated and compared with data from viral wastewater monitoring. In addition to Betacoronavirus, comparison using assembled contigs against a custom Swiss-Prot human virus database indicated the potential prevalence of other pathogenic virus genera, including: Orthopoxvirus, Rhadinovirus, Parapoxvirus, Varicellovirus, Hepatovirus, Simplexvirus, Bocaparvovirus, Molluscipoxvirus, Parechovirus, Roseolovirus, Lymphocryptovirus, Alphavirus, Spumavirus, Lentivirus, Deltaretrovirus, Enterovirus, Kobuvirus, Gammaretrovirus, Cardiovirus, Erythroparvovirus, Salivirus, Rubivirus, Orthohepevirus, Cytomegalovirus, Norovirus, and Mamastrovirus. Four nearly complete genomes were recovered from the Astrovirus, Enterovirus, Norovirus and Betapolyomavirus genera and viral species were identified. CONCLUSIONS The presented findings in wastewater samples are primarily at the genus level and can serve as a preliminary "screening" tool that may serve as indication to initiate further testing for the confirmation of the presence of species that may be associated with human disease. Integrating innovative environmental microbiology technologies like metagenomic sequencing with viral epidemiology offers a significant opportunity to improve the monitoring of, and predictive intelligence for, pathogenic viruses, using wastewater.
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Affiliation(s)
- Yabing Li
- Department of Civil and Environmental Engineering, Michigan State University, 1449 Engineering Research Ct, East Lansing, MI, 48823, USA
| | - Brijen Miyani
- Department of Civil and Environmental Engineering, Michigan State University, 1449 Engineering Research Ct, East Lansing, MI, 48823, USA
| | - Russell A Faust
- Oakland County Health Division, 1200 Telegraph Rd, Pontiac, MI, 48341, USA
| | - Randy E David
- School of Medicine, Wayne State University, Detroit, MI, 48282, USA
| | - Irene Xagoraraki
- Department of Civil and Environmental Engineering, Michigan State University, 1449 Engineering Research Ct, East Lansing, MI, 48823, USA.
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Kazasidis O, Jacob J. Machine learning identifies straightforward early warning rules for human Puumala hantavirus outbreaks. Sci Rep 2023; 13:3585. [PMID: 36869118 PMCID: PMC9984366 DOI: 10.1038/s41598-023-30596-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
Human Puumala virus (PUUV) infections in Germany fluctuate multi-annually, following fluctuations of the bank vole population size. We applied a transformation to the annual incidence values and established a heuristic method to develop a straightforward robust model for the binary human infection risk at the district level. The classification model was powered by a machine-learning algorithm and achieved 85% sensitivity and 71% precision, despite using only three weather parameters from the previous years as inputs, namely the soil temperature in April of two years before and in September of the previous year, and the sunshine duration in September of two years before. Moreover, we introduced the PUUV Outbreak Index that quantifies the spatial synchrony of local PUUV-outbreaks, and applied it to the seven reported outbreaks in the period 2006-2021. Finally, we used the classification model to estimate the PUUV Outbreak Index, achieving 20% maximum uncertainty.
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Affiliation(s)
- Orestis Kazasidis
- Julius Kühn Institute (JKI) - Federal Research Centre for Cultivated Plants, Institute for Plant Protection in Horticulture and Forests / Institute for Epidemiology and Pathogen Diagnostics, Rodent Research, Toppheideweg 88, 48161, Münster, Germany.
| | - Jens Jacob
- Julius Kühn Institute (JKI) - Federal Research Centre for Cultivated Plants, Institute for Plant Protection in Horticulture and Forests / Institute for Epidemiology and Pathogen Diagnostics, Rodent Research, Toppheideweg 88, 48161, Münster, Germany
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Prevalence of orthohantavirus in rodents: A systematic review and meta-analysis. Travel Med Infect Dis 2023; 51:102504. [PMID: 36402291 DOI: 10.1016/j.tmaid.2022.102504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Orthohantaviruses are zoonotic diseases transmitted mainly by rodents, particularly mice and rats, associated with multiple outbreaks in different continents. Despite its epidemiological relevance, there is a lack of systematic reviews and meta-analyses. OBJECTIVE To determine the combined global prevalence of Orthohantavirus infection in rodents. METHODS A systematic literature review was carried out in six databases (Web of Sciences, Scopus, PubMed, SciELO, Lilacs, Google Scholar) to evaluate the proportion of rodents infected with Orthohantavirus, defined by molecular and immunological techniques. The meta-analysis used a random effects model for the pooled prevalence and 95% confidence intervals (95%CI). Heterogeneity measures, Cochrane's Q, the I2 index and the tau-squared test were estimated. RESULTS A total of 35,706 rodents (229 studies) were evaluated for ELISA, in which 3360 were found positive, for seroprevalence of 4.9% (95%CI 4.3-5.4%) (τ2 = 0.001; Q = 4027.708; I2 = 94.339%, p < 0.001). For PCR (N = 8812, 91 studies) it was 3.2% (95%CI 2.5-3.9%) (τ2 = 0.001; Q = 397.483; I2 = 77.358%; p < 0.001). For IFA (N = 555, 7 studies) it was 18.8% (95%CI 9.4-28.2%) (τ2 = 0.011; Q = 51.239; I2 = 88.29%, p < 0.001). At the genus level, the studies evaluated Oligoryzomys (8.98%), Reithrodontomys (8.98%), Peromyscus (8.20%), Rattus (8.20%), and Akodon (6.64%). CONCLUSIONS The global prevalence of Orthohantavirus is worrisome, with an increase in its report in certain regions, including Latin America. In this context, rodents have a role as reservoirs. The data of the present meta-analysis showed considerable seroprevalences with great variations by years, countries and Orthohantavirus species.
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Monchatre-Leroy E, Sauvage F, Boué F, Augot D, Marianneau P, Hénaux V, Crespin L. Prevalence and Incidence of Puumala Orthohantavirus in its Bank Vole (Myodes glareolus) Host Population in Northeastern France: Between-site and Seasonal Variability. Epidemics 2022; 40:100600. [DOI: 10.1016/j.epidem.2022.100600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 05/02/2022] [Accepted: 06/14/2022] [Indexed: 11/03/2022] Open
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Razzauti M, Castel G, Cosson JF. Impact of Landscape on Host-Parasite Genetic Diversity and Distribution Using the Puumala orthohantavirus-Bank Vole System. Microorganisms 2021; 9:microorganisms9071516. [PMID: 34361952 PMCID: PMC8306195 DOI: 10.3390/microorganisms9071516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022] Open
Abstract
In nature, host specificity has a strong impact on the parasite's distribution, prevalence, and genetic diversity. The host's population dynamics is expected to shape the distribution of host-specific parasites. In turn, the parasite's genetic structure is predicted to mirror that of the host. Here, we study the tandem Puumala orthohantavirus (PUUV)-bank vole system. The genetic diversity of 310 bank voles and 33 PUUV isolates from 10 characterized localities of Northeast France was assessed. Our findings show that the genetic diversity of both PUUV and voles, was positively correlated with forest coverage and contiguity of habitats. While the genetic diversity of voles was weakly structured in space, that of PUUV was found to be strongly structured, suggesting that the dispersion of voles was not sufficient to ensure a broad PUUV dissemination. Genetic diversity of PUUV was mainly shaped by purifying selection. Genetic drift and extinction events were better reflected than local adaptation of PUUV. These contrasting patterns of microevolution have important consequences for the understanding of PUUV distribution and epidemiology.
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Affiliation(s)
- Maria Razzauti
- CBGP, INRAE, CIRAD, IRD, Montpellier SupAgro, Université Montpellier, 34000 Montpellier, France;
- Correspondence:
| | - Guillaume Castel
- CBGP, INRAE, CIRAD, IRD, Montpellier SupAgro, Université Montpellier, 34000 Montpellier, France;
| | - Jean-François Cosson
- UMR BIPAR, Animal Health Laboratory, ANSES, INRAE, Ecole Nationale Vétérinaire d’Alfort, Université Paris-Est, 94700 Maisons-Alfort, France;
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Laporta GZ, Ilacqua RC, Bergo ES, Chaves LSM, Rodovalho SR, Moresco GG, Figueira EAG, Massad E, de Oliveira TMP, Bickersmith SA, Conn JE, Sallum MAM. Malaria transmission in landscapes with varying deforestation levels and timelines in the Amazon: a longitudinal spatiotemporal study. Sci Rep 2021; 11:6477. [PMID: 33742028 PMCID: PMC7979798 DOI: 10.1038/s41598-021-85890-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 03/08/2021] [Indexed: 01/31/2023] Open
Abstract
The relationship between deforestation and malaria is a spatiotemporal process of variation in Plasmodium incidence in human-dominated Amazonian rural environments. The present study aimed to assess the underlying mechanisms of malarial exposure risk at a fine scale in 5-km2 sites across the Brazilian Amazon, using field-collected data with a longitudinal spatiotemporally structured approach. Anopheline mosquitoes were sampled from 80 sites to investigate the Plasmodium infection rate in mosquito communities and to estimate the malaria exposure risk in rural landscapes. The remaining amount of forest cover (accumulated deforestation) and the deforestation timeline were estimated in each site to represent the main parameters of both the frontier malaria hypothesis and an alternate scenario, the deforestation-malaria hypothesis, proposed herein. The maximum frequency of pathogenic sites occurred at the intermediate forest cover level (50% of accumulated deforestation) at two temporal deforestation peaks, e.g., 10 and 35 years after the beginning of the organization of a settlement. The incidence density of infected anophelines in sites where the original forest cover decreased by more than 50% in the first 25 years of settlement development was at least twice as high as the incidence density calculated for the other sites studied (adjusted incidence density ratio = 2.25; 95% CI, 1.38-3.68; p = 0.001). The results of this study support the frontier malaria as a unifying hypothesis for explaining malaria emergence and for designing specific control interventions in the Brazilian Amazon.
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Affiliation(s)
- Gabriel Z Laporta
- Setor de Pós-Graduação, Pesquisa e Inovação, Centro Universitário Saúde ABC (FMABC), Fundação ABC, Santo André, SP, Brazil.
| | - Roberto C Ilacqua
- Setor de Pós-Graduação, Pesquisa e Inovação, Centro Universitário Saúde ABC (FMABC), Fundação ABC, Santo André, SP, Brazil
| | - Eduardo S Bergo
- Superintendência de Controle de Endemias (SUCEN), Secretaria de Estado da Saúde de São Paulo, Araraquara, SP, Brazil
| | - Leonardo S M Chaves
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo (FSP-USP), São Paulo, SP, Brazil
| | - Sheila R Rodovalho
- Unidade Técnica de Doenças Transmissíveis e Análise de Situação em Saúde, Pan American Health Organization (PAHO/WHO), Brasília, DF, Brazil
| | - Gilberto G Moresco
- Coordenação-Geral de Vigilância de Zoonoses e Doenças de Transmissão Vetorial, Secretaria de Vigilância em Saúde, Ministério da Saúde (MS), Brasília, DF, Brazil
| | | | - Eduardo Massad
- Escola de Matemática Aplicada, Fundação Getúlio Vargas, Rio de Janeiro, RJ, Brazil
| | - Tatiane M P de Oliveira
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo (FSP-USP), São Paulo, SP, Brazil
| | - Sara A Bickersmith
- New York State Department of Health, The Wadsworth Center, Slingerlands, NY, USA
| | - Jan E Conn
- New York State Department of Health, The Wadsworth Center, Slingerlands, NY, USA
- Department of Biomedical Sciences, School of Public Health, State University of New York, Albany, NY, USA
| | - Maria Anice M Sallum
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo (FSP-USP), São Paulo, SP, Brazil.
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Kim WK, Cho S, Lee SH, No JS, Lee GY, Park K, Lee D, Jeong ST, Song JW. Genomic Epidemiology and Active Surveillance to Investigate Outbreaks of Hantaviruses. Front Cell Infect Microbiol 2021; 10:532388. [PMID: 33489927 PMCID: PMC7819890 DOI: 10.3389/fcimb.2020.532388] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022] Open
Abstract
Emerging and re-emerging RNA viruses pose significant public health, economic, and societal burdens. Hantaviruses (genus Orthohantavirus, family Hantaviridae, order Bunyavirales) are enveloped, negative-sense, single-stranded, tripartite RNA viruses that are emerging zoonotic pathogens harbored by small mammals such as rodents, bats, moles, and shrews. Orthohantavirus infections cause hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome in humans (HCPS). Active targeted surveillance has elucidated high-resolution phylogeographic relationships between patient- and rodent-derived orthohantavirus genome sequences and identified the infection source by temporally and spatially tracking viral genomes. Active surveillance of patients with HFRS entails 1) recovering whole-genome sequences of Hantaan virus (HTNV) using amplicon (multiplex PCR-based) next-generation sequencing, 2) tracing the putative infection site of a patient by administering an epidemiological questionnaire, and 3) collecting HTNV-positive rodents using targeted rodent trapping. Moreover, viral genome tracking has been recently performed to rapidly and precisely characterize an outbreak from the emerging virus. Here, we reviewed genomic epidemiological and active surveillance data for determining the emergence of zoonotic RNA viruses based on viral genomic sequences obtained from patients and natural reservoirs. This review highlights the recent studies on tracking viral genomes for identifying and characterizing emerging viral outbreaks worldwide. We believe that active surveillance is an effective method for identifying rodent-borne orthohantavirus infection sites, and this report provides insights into disease mitigation and preparedness for managing emerging viral outbreaks.
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Affiliation(s)
- Won-Keun Kim
- Department of Microbiology, College of Medicine, Hallym University, Chuncheon, South Korea.,Institute of Medical Science, College of Medicine, Hallym University, Chuncheon, South Korea
| | - Seungchan Cho
- Department of Microbiology, Korea University College of Medicine, Seoul, South Korea
| | - Seung-Ho Lee
- Department of Microbiology, Korea University College of Medicine, Seoul, South Korea
| | - Jin Sun No
- Department of Microbiology, Korea University College of Medicine, Seoul, South Korea
| | - Geum-Young Lee
- Department of Microbiology, Korea University College of Medicine, Seoul, South Korea
| | - Kyungmin Park
- Department of Microbiology, Korea University College of Medicine, Seoul, South Korea.,BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul, South Korea
| | - Daesang Lee
- 4th R&D Institute, Agency for Defense Development, Daejeon, South Korea
| | - Seong Tae Jeong
- 4th R&D Institute, Agency for Defense Development, Daejeon, South Korea
| | - Jin-Won Song
- Department of Microbiology, Korea University College of Medicine, Seoul, South Korea.,BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul, South Korea
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Spatial and Temporal Evolutionary Patterns in Puumala Orthohantavirus (PUUV) S Segment. Pathogens 2020; 9:pathogens9070548. [PMID: 32650456 PMCID: PMC7400055 DOI: 10.3390/pathogens9070548] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/24/2020] [Accepted: 06/28/2020] [Indexed: 12/12/2022] Open
Abstract
The S segment of bank vole (Clethrionomys glareolus)-associated Puumala orthohantavirus (PUUV) contains two overlapping open reading frames coding for the nucleocapsid (N) and a non-structural (NSs) protein. To identify the influence of bank vole population dynamics on PUUV S segment sequence evolution and test for spillover infections in sympatric rodent species, during 2010–2014, 883 bank voles, 357 yellow-necked mice (Apodemus flavicollis), 62 wood mice (A. sylvaticus), 149 common voles (Microtus arvalis) and 8 field voles (M. agrestis) were collected in Baden-Wuerttemberg and North Rhine-Westphalia, Germany. In total, 27.9% and 22.3% of bank voles were positive for PUUV-reactive antibodies and PUUV-specific RNA, respectively. One of eight field voles was PUUV RNA-positive, indicating a spillover infection, but none of the other species showed evidence of PUUV infection. Phylogenetic and isolation-by-distance analyses demonstrated a spatial clustering of PUUV S segment sequences. In the hantavirus outbreak years 2010 and 2012, PUUV RNA prevalence was higher in our study regions compared to non-outbreak years 2011, 2013 and 2014. NSs amino acid and nucleotide sequence types showed temporal and/or local variation, whereas the N protein was highly conserved in the NSs overlapping region and, to a lower rate, in the N alone coding part.
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Balčiauskas L, Balčiauskienė L. On the Doorstep, Rodents in Homesteads and Kitchen Gardens. Animals (Basel) 2020; 10:E856. [PMID: 32429138 PMCID: PMC7278421 DOI: 10.3390/ani10050856] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/08/2020] [Accepted: 05/13/2020] [Indexed: 01/04/2023] Open
Abstract
Scarcely investigated in terms of small mammals, kitchen gardens and homesteads form a subset of environments. Using results of snap trapping, we present the first data on small mammal species diversity, gender and age structure, relative abundance, body fitness, and reproduction parameters in these commensal habitats (kitchen gardens, homestead gardens, houses, and outbuildings). We expected that (i) house mice should be the dominant species in buildings, while striped field mice should be dominant in gardens, (ii) body condition should be the highest in buildings, (iii) body condition should increase in the autumn, irrespective of the habitat, and (iv) breeding failures in the form of disrupted pregnancies should be observed. Not all of the predictions were confirmed. From the seven recorded species, gardens and outbuildings were dominated by yellow-necked mice, while bank voles dominated in buildings where food was available. The number of recorded species and diversity index increased during the autumn months. The body condition was highest in rodents that were trapped in gardens. It decreased towards winter, with the exception of the striped field mouse. Breeding disturbances were recorded in all of the most numerous species, comprising 16.7-100% of all observed pregnancies.
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Binder F, Drewes S, Imholt C, Saathoff M, Below DA, Bendl E, Conraths FJ, Tenhaken P, Mylius M, Brockmann S, Oehme R, Freise J, Jacob J, Ulrich RG. Heterogeneous Puumala orthohantavirus situation in endemic regions in Germany in summer 2019. Transbound Emerg Dis 2019; 67:502-509. [PMID: 31674714 DOI: 10.1111/tbed.13408] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/10/2019] [Accepted: 10/25/2019] [Indexed: 12/19/2022]
Abstract
Puumala orthohantavirus (PUUV) causes most human hantavirus disease cases in Europe. PUUV disease outbreaks are usually synchronized Germany-wide driven by beech mast-induced irruptions of its host (bank vole, Myodes glareolus). Recent data indicate high vole abundance, high PUUV prevalence and high human incidence in summer 2019 for some regions, but elsewhere values were low to moderate. This significant lack of synchrony among regions in Germany is in contrast to previous studies. Health institutions need to be informed about the heterogeneous distribution of human PUUV infection risk to initiate appropriate actions.
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Affiliation(s)
- Florian Binder
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany
| | - Stephan Drewes
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany
| | - Christian Imholt
- Julius Kühn-Institut, Federal Research Centre for Cultivated Plants, Institute for Plant Protection in Horticulture and Forests, Vertebrate Research, Münster, Germany
| | - Marion Saathoff
- Lower Saxony State Office for Consumer Protection and Food Safety, Veterinary Task-Force, Department of Pest Control, Oldenburg, Germany
| | - Diana Alexandra Below
- Julius Kühn-Institut, Federal Research Centre for Cultivated Plants, Institute for Plant Protection in Horticulture and Forests, Vertebrate Research, Münster, Germany
| | - Elias Bendl
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany
| | - Franz J Conraths
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Greifswald-Insel Riems, Germany
| | | | - Maren Mylius
- The Governmental Institute of Public Health of Lower Saxony, Hannover, Germany
| | | | - Rainer Oehme
- State Health Office Baden-Württemberg, Stuttgart, Germany
| | - Jona Freise
- Lower Saxony State Office for Consumer Protection and Food Safety, Veterinary Task-Force, Department of Pest Control, Oldenburg, Germany
| | - Jens Jacob
- Julius Kühn-Institut, Federal Research Centre for Cultivated Plants, Institute for Plant Protection in Horticulture and Forests, Vertebrate Research, Münster, Germany
| | - Rainer G Ulrich
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany
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