Urinary genome detection and tracking of Hantaan virus from hemorrhagic fever with renal syndrome patients using multiplex PCR-based next-generation sequencing

Background

Hantavirus infection occurs through the inhalation of aerosolized excreta, including urine, feces, and saliva of infected rodents. The presence of Hantaan virus (HTNV) RNA or infectious particles in urine specimens of patient with hemorrhagic fever with renal syndrome (HFRS) remains to be investigated.

Methodology/Principal findings

We collected four urine and serum specimens of Republic of Korea Army (ROKA) patients with HFRS. We performed multiplex PCR-based next-generation sequencing (NGS) to obtain the genome sequences of clinical HTNV in urine specimens containing ultra-low amounts of viral genomes. The epidemiological and phylogenetic analyses of HTNV demonstrated geographically homogenous clustering with those in Apodemus agrarius captured in highly endemic areas, indicating that phylogeographic tracing of HTNV genomes reveals the potential infection sites of patients with HFRS. Genetic exchange analyses showed a genetic configuration compatible with HTNV L segment exchange in nature.

Conclusion/Significance

Our results suggest that whole or partial genome sequences of HTNV from the urine enabled to track the putative infection sites of patients with HFRS by phylogeographically linking to the zoonotic HTNV from the reservoir host captured at endemic regions. This report raises awareness among physicians for the presence of HTNV in the urine of patients with HFRS.

Hantavirus transmission to humans occurs via inhalation of aerosolized excreta, including urine, feces, and saliva of infected rodents. Currently, no report for the etiological evidence associated with urinary Hantaan virus (HTNV) from patients with hemorrhagic fever with renal syndrome (HFRS) is available. Here, we conducted multiplex PCR-based next-generation sequencing (NGS) using urine and serum specimens from four Republic of Korea Army (ROKA) patients with HFRS. The epidemiological and phylogenetic analyses using whole or partial genome sequences of HTNV from urine and serum demonstrated homogenous genetic clustering with HTNV from clinical specimens, circulating at highly endemic sites of patient infection. Among the sequences from ROKA patients, the genomic configuration of ROKA16-10 demonstrated occurrences of the genetic reassortment. Our results suggest that whole or partial genome sequences of HTNV from the urine enabled to track the putative infection sites of patients with HFRS by phylogeographically linking to the zoonotic HTNV from the reservoir host captured at endemic regions. This result provides new insights into presence of HTNV in the urine of patients with HFRS among physicians.

A novel genotype of Hantaan orthohantavirus harbored by Apodemus agrarius chejuensis as a potential etiologic agent of hemorrhagic fever with renal syndrome in Republic of Korea

BACKGROUND

Orthohantaviruses, causing hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome, pose a significant public health threat worldwide. Despite the significant mortality and morbidity, effective antiviral therapeutics for orthohantavirus infections are currently unavailable. This study aimed to investigate the prevalence of HFRS-associated orthohantaviruses and identify the etiological agent of orthohantavirus outbreaks in southern Republic of Korea (ROK).

METHODOLOGY/PRINCIPAL FINDINGS

We collected small mammals on Jeju Island during 2018-2020. We detected the Hantaan virus (HTNV)-specific antibodies and RNA using an indirect immunofluorescence assay test and reverse transcription-polymerase chain reaction on Apodemus agrarius chejuensis (A. chejuensis). The prevalence of anti-HTNV antibodies among rodents was 14.1%. A total of six seropositive mouse harbored HTNV RNA. The amplicon-based next-generation sequencing provided nearly full-length tripartite genomic sequences of six HTNV harbored by A. chejuensis. Phylogenetic and tanglegram analyses were conducted for inferring evolutionary relationships between orthohantaviruses with their reservoir hosts. Phylogenetic analysis showed a novel distinct HTNV genotype. The detected HTNV genomic sequences were phylogenetically related to a viral sequence derived from HFRS patient in southern ROK. Tanglegram analysis demonstrated the segregation of HTNV genotypes corresponding to Apodemus spp. divergence.

CONCLUSIONS/SIGNIFICANCE

Our results suggest that A. chejuensis-borne HTNV may be a potential etiological agent of HFRS in southern ROK. Ancestral HTNV may infect A. chejuensis prior to geological isolation between the Korean peninsula and Jeju Island, supporting the co-evolution of orthohantaviruses and rodents. This study arises awareness among physicians for HFRS outbreaks in southern ROK.

Orthohantaviruses infections in humans and rodents in Baoji, China

In recent years, hemorrhagic fever with renal syndrome (HFRS) incidence has been becoming a severe public health problem again due to its significant increase in Shaanxi Province, China. Baoji, located in the Guanzhong Plain in the central part of Shaanxi Province, has been severely affected by HFRS since its first emergence in 1955. To better understand the epidemiology of orthohantaviruses infection in humans and the causative agents carried by the rodents, the long-term incidence patterns were analyzed and a molecular epidemiological investigation of orthohantaviruses infection in humans and rodents was performed. During 1984-2019, 13,042 HFRS cases were registered in Baoji, including 275 death cases. Except the first high prevalence of HFRS in 1988-1993, another two epidemic peaks were observed in 1998-2003 and 2012, respectively, although vaccination project was started since 1996. During the same period, HFRS cases in Baoji mainly were recorded in winter suggesting they may be caused by Hantaan orthohantavirus (HTNV), while a small peak of HFRS was also found in summer with unknown reason. Nucleotide identity and phylogenetic analyses demonstrated that a novel clade of HTNV sequences recovered from HFRS cases were closely related to those from rodents, including species close contact with humans, suggesting a direct viral transmission from rodents to humans and the important role in the HTNV transmission the nontraditional rodent hosts may play. Moreover, two distant related Dabieshan orthohantavirus (DBSV) lineages were also identified in Niviventer niviventer in this area demonstrating its considerable genetic diversity. Our data indicated that continual spillover of HTNV from rodents to humans, contributing to the high prevalence of HFRS in humans in Baoji.

Hemorrhagic fever with renal syndrome accompanied by panhypopituitarism and central diabetes insipidus: a case report

Central diabetes insipidus (DI) was detected in a patient with hemorrhagic fever with renal syndrome (HFRS) who had been molecularly and serologically diagnosed with Hantaan virus infection. We recommend that clinicians differentiate central DI in HFRS patients with a persistent diuretic phase even when pituitary MRI findings are normal.

Genetic Diversity and Reassortment of Hantaan Virus Tripartite RNA Genomes in Nature, the Republic of Korea

Background

Hantaan virus (HTNV), a negative sense tripartite RNA virus of the Family Bunyaviridae, is the most prevalent hantavirus in the Republic of Korea (ROK). It is the causative agent of Hemorrhagic Fever with Renal Syndrome (HFRS) in humans and maintained in the striped field mouse, Apodemus agrarius, the primary zoonotic host. Clinical HFRS cases have been reported commonly in HFRS-endemic areas of Gyeonggi province. Recently, the death of a member of the ROK military from Gangwon province due to HFRS prompted an investigation of the epidemiology and distribution of hantaviruses in Gangwon and Gyeonggi provinces that border the demilitarized zone separating North and South Korea.

Methodology and Principal Findings

To elucidate the geographic distribution and molecular diversity of HTNV, whole genome sequences of HTNV Large (L), Medium (M), and Small (S) segments were acquired from lung tissues of A. agrarius captured from 2003–2014. Consistent with the clinical incidence of HFRS established by the Korea Centers for Disease Control & Prevention (KCDC), the prevalence of HTNV in naturally infected mice in Gangwon province was lower than for Gyeonggi province. Whole genomic sequences of 34 HTNV strains were identified and a phylogenetic analysis showed geographic diversity of the virus in the limited areas. Reassortment analysis first suggested an occurrence of genetic exchange of HTNV genomes in nature, ROK.

Conclusion/Significance

This study is the first report to demonstrate the molecular prevalence of HTNV in Gangwon province. Whole genome sequencing of HTNV showed well-supported geographic lineages and the molecular diversity in the northern region of ROK due to a natural reassortment of HTNV genomes. These observations contribute to a better understanding of the genetic diversity and molecular evolution of hantaviruses. Also, the full-length of HTNV tripartite genomes will provide a database for phylogeographic analysis of spatial and temporal outbreaks of hantavirus infection.

Hemorrhagic Fever with Renal Syndrome (HFRS) and Hantavirus Pulmonary Syndrome (HPS) are endemic zoonotic infectious diseases caused by hantaviruses that belong to the Family Bunyaviridae containing negative-sense tripartite RNA genomes. Hantaviruses pose a critical emerging public health threat, with up to 200,000 clinical cases reported annually worldwide with 1–36% case fatality rates. In humans, hantavirus-borne diseases are contracted by the inhalation of viruses aerosolized from rodent excreta. However, there is no effective therapeutic or vaccine to prevent from the disease. Whole genome sequences of Hantaan virus (HTNV) were acquired from lung tissues of Apodemus agrarius captured in HFRS-endemic areas of the Republic of Korea (ROK). Phylogenetic analyses demonstrated that sequences of the HTNV tripartite genomes clustered geographically, showing broad diversity of HTNV throughout the areas surveyed. Reassortment analysis first suggested a natural occurrence of the HTNV genetic exchange in the ROK. These observations contribute to a better understanding of the genetic diversity and molecular evolution of hantaviruses in HFRS-endemic regions. The complete sequences of HTNV genomes will provide a database for the phylogeographic analysis and surveillance of endemic hantavirus-borne diseases.

Co-circulation of Hantaan, Kenkeme, and Khabarovsk Hantaviruses in Bolshoy Ussuriysky Island, China

Hemorrhagic fever with renal syndrome (HFRS) was first recognized in far eastern Asia in the 1930s, and has been highly prevalent in this region ever since. To reveal the molecular epidemiology of hantaviruses in this region, a total of 374 small mammals (eight species of rodents and one species of shrew) were captured in the Chinese part of the Bolshoy Ussuriysky Island (Heilongjiang Province). Hantavirus sequences were recovered from three striped field mice (Apodemus agrarius), 11 Maximowicz's voles (Microtus maximowiczii), and one flat-skulled shrew (Sorex roboratus). Genetic and phylogenetic analysis revealed the presence of three viruses: Hantaan virus (HTNV), Khabarovsk virus (KHAV), and Kenkeme virus (KKMV). HTNV sequences recovered from A. agrarius were closely related to those identified in Apodemus mice from the surrounding areas, while a new lineage of KHAV was present in M. maximowiczii. Additionally, while the viral sequences recovered from one flat-skulled shrew were most closely related to KKMV, their divergence to the prototype strain suggests that they represent a new viral subtype. Overall, these results suggest that Bolshoy Ussuriysky Island harbors considerable hantavirus diversity.

Genetic analysis of hantaviruses and their rodent hosts in central-south China

Hantaan virus (HTNV) and Seoul virus (SEOV) are two major zoonotic pathogens of hemorrhagic fever with renal syndrome (HFRS) in Asia. Hubei province, which is located in the central-south China, had been one of the most severe epidemic areas of HFRS. To investigate phylogenetic relationships, genetic diversity and geographic distribution of HTNV and SEOV in their reservoir hosts, a total of 687 rodents were trapped in this area between 2000 and 2009. Sequences of partial S- and M-segments of hantaviruses and mitochondrial D-loop gene from 30 positive samples were determined. Our data indicated that SEOV and HTNV were co-circulating in Hubei. Phylogenetic analysis based on partial S- and M-segment sequences revealed two and three previously undefined lineages of SEOV, and a novel genetic lineage of HTNV, respectively. Four inter-lineage reassortment SEOVs carried by Rattus norvegicus and Apodemus agrarius were observed. It suggests that SEOV may cause spillover infections to A. agrarius naturally. The abundance of the phylogenetic lineages of SEOV suggested that central-south China was a radiation center for SEOVs.

Genotyping of hantaviruses occurring in Linyi, China, by nested RT-PCR combined with single-strand conformation polymorphism analysis

The hemorrhagic fever with renal syndrome (HFRS) incidence rate still holds in high level in some areas of the world, but a reliable and simple typing method that can be used in clinical diagnosis and epidemiologic surveys is not available. In this study, 48 serum samples were collected from patients with HFRS in Linyi area, China, that is seriously affected by this disease. The collected samples were analyzed by nested RT-PCR combined with single-strand conformation polymorphism (SSCP) for genotyping of hantaviruses (HV). Out of 48 serum samples, 41 samples were positive by the nested RT-PCR. According to the SSCP patterns, Seoul virus (SEOV) was found in 33 samples and Hantaan virus (HTNV) in 8 samples. The comparison of sequence identities of nested RT-PCR products of tested samples with reference isolates SEOV and HTNV supported the typing results. Thus, genotyping of HV by nested RT-PCR/SSCP is suitable in early diagnosis of HV infection and in epidemiologic surveys.

[Discovery, clinical and etiological characteristic of hemorrhagic fever with renal syndrome in the subtropical zone of Krasnodar region]

Twenty-six patients with hemorrhagic fever with renal syndrome (HFRS) were revealed as a result of serological examination of 582 patients with fever living around Sochi town. Etiologic role of Dobrava virus subtype as the cause of HFRS was assessed by immunofluorescent and ELISA assays, and neutralization test. The principal host of this virus and source of infection for humans is Caucasian forest mouse Apodemus ponticus. HFRS morbidity was sporadic and not dependent from patients' occupation and season. Comparative analysis of clinical and laboratory data from HFRS cases caused by DOB/Sochi and DOB/Lipetsk subspecies, as well as Puumala virus showed higher proportion of severe forms of disease in patients with HFRS from Sochi.

A new Hantaan-like virus in rodents (Apodemus peninsulae) from Northeastern China

Lung tissue samples of 76 Korean field mice (Apodemus peninsulae) collected from northeastern China bordering with Far East Russia and Korea were detected for hantavirus partial M-segment or entire S-segment sequences by RT-PCR and 481-nt mitochondrial DNA fragment of the rodents. Four A. peninsulae mice were found positive for partial M-segment of hantavirus. Sequence analyses of partial M-segment or/and entire S-segment of the hantaviruses revealed that three were closely related to Hantaan virus (HTNV) strain 76-118. One new variant of HTNV-like virus designated as "Jilin-AP06" was much different from other rodent-borne hantavirus from China, and clustered with Amur (AMR) virus strains, which represent a distinct genetic lineage. These findings imply that hantavirus Jililn-AP06 strain from A. peninsulae is a new record of rodent-borne AMR virus in China. A. peninsulae might be a natural carrier of two distinct hantaviruses, AMR virus and HTNV in China.

Characterization of truncated hantavirus nucleocapsid proteins and their application for serotyping

Hemorrhagic fever with renal syndrome (HFRS) is a fulminant infectious disease characterized by fever, hemorrhage, renal impairment, and thrombocytopenia. Hantaviruses associated with this belong to different serotypes: Hantaan (HTN), Seoul (SEO), Dobrava/Belgrade (DOB), and Puumala (PUU). The first two, HTN and SEO, are endemic in China. To investigate the epidemiology of HFRS and virus transmission in China, we constructed prokaryotic plasmids encoding truncated recombinant HTN and SEO nucleocapsid proteins (NPs), which lacked 154 amino acid (aa), 99 aa, or 49 aa in the N-terminal region, respectively. After expression, the truncated rNPs were tested as serotyping antigens, particularly for use in the enzyme-linked immunosorbent assay (ELISA). In addition, 68 acute and 52 convalescent sera were collected from HFRS patients from Harbin, Lantian, and Kaifeng regions in China in 2004, which had hantavirus specific antibodies by IFA. A neutralization test was used to differentiate these, which showed that 73 were due to HTN infection, 33 to SEO infection, and 14 undetermined. By ELISA, the truncated rNPs, that lacked 99 (rNP100) or 49 (rNP50) N-terminal amino acids of the NPs of HTN and SEO, were able to differentiate HTNV and SEOV-specific immune sera, but the rNP155 could not. Particularly, the ELISAs based on the rNP50s had a result comparable to PRNT. Thus, the rNP50 is recommended as efficient serotyping antigen for hantavirus infection diagnosis by ELISA.

[Using geographic information system to study on the association between epidemic areas and main animal hosts of hemorrhagic fever with renal syndrome in China]

OBJECTIVE

To analyze the association between types of epidemic areas and proportion of main animal hosts of hemorrhagic fever with renal syndrome (HFRS) in China.

METHODS

Data on serotype of HFRS patients from 122 regions and species as well as number of animal hosts from 41 national surveillance sites were collected and managed. The map of the types of epidemic areas from 1991-1999 in China was produced using inverse distance weighted technique in the ArcGIS 8.1 software. The map of the proportion of host animals was then overlapped on it and the surveillance sites of HFRS were clustered in terms of the proportion of host animals.

RESULTS

Variance in spatial distribution of the types of epidemic areas was observed. Two epidemic area types, namely Hantaan-dominant mixed epidemic areas and Soul-dominant mixed epidemic areas seemed to have transferred from the north-east to south-west of China in turns. There were more species of HFRS animal hosts in fields than those of in residential areas. The diversity of rodent species in fields was higher than that of the residential areas which predominant harbored rodent species of 2-3 kinds. Types of surveillance sites classified by cluster analysis of proportion of main animal hosts were consistent with the serotypes of HFRS patients.

CONCLUSION

Through employment of spatial analysis technique based on GIS databases, the HFRS types of main epidemic area in China could be well predicted by surveillance data.

Microarray technology for identification and distinction of hantaviruses

DNA microarrays combine high-precision technology with advanced molecular biology to achieve high-throughput screening of DNA fragments. In this study, we investigated the potential of the cDNA microarray technique to identify and discriminate PCR derived amplicons from genetically highly similar viruses. The wide range of sequence variation among hantaviruses makes them suitable as a model for this purpose. The hantaviruses, carried by rodents, cause several hundred thousand cases of severe human disease every year in many parts of the world. A hantavirus-specific microarray, including DNA fragments from 12 viral isolates of six different hantaviruses, was designed. The S and M genome segments were represented by 500-nucleotide overlapping and 250-nucleotide non-overlapping fragments. A considerable ability to distinguish between different hantaviruses was demonstrated using a novel analysis method. Even different isolates of a single virus, were identified correctly despite 90% sequence similarity. The distinction ability was accompanied by a tolerance for smaller sequence differences, which makes the microarray suitable for testing samples containing unknown viruses. Viral genetic material found in samples from the lungs of bank voles caught in the wild was identified precisely, which demonstrated further the potential for this technology.

[Molecular characterization of hantavirus Shandong isolate JNL virus strain]

OBJECTIVE

To understand the molecular epidemiologic characteristics of hantavirus Shandong isolate JNL virus strain.

METHODS

The complete M and S gene of the JNL virus isolated from Shandong Province was amplified by RT- PCR, and the purified PCR product was cloned into T vector for sequencing.

RESULTS

The results revealed that the JNL M segment was 3615 bp in length, encoding 1135 amino acids, and the S segment was 1698 bp encoding 429 amino acids, JNL belongs to HTN virus. The comparison of homology with HTN and SEO types showed that the difference of M and S complete sequences between JNL and all other HTN virus strains reached 20.0%-20.6%, and 15.5%-16.0%, respectively. Phylogenetic tree also showed that the position of JNL is located at a different clade.

CONCLUSIONS

HTN virus Shandong local isolate JNL strain is a new specific HTN subtype virus.

[Molecular analysis of hantavirus isolated from Shandong province]

OBJECTIVE

To compare the molecular characteristics of hantaviruses isolated from Shandong province by using PCR typing and nucleotide sequencing.

METHODS

Total cellular RNA was extracted from hantaviruses infected Vero E6 cells, viral cDNA was amplified by polymerase chain reaction. PCR products of partial M Segments of 4 strains of hantaviruses were sequenced. Cross neutralization tests were performed.

RESULTS

Four strains of hantavirus isolated from Rottus in Shandong province were SEO like viruses. The homology between Shandong isolates and other SEO like viruses was high at both amino acid and nucleotide levels. The homology among those 4 strains of hantaviruses was 98%.

CONCLUSIONS

The SEO like hantaviruses were more conserved than other hantaviruses. The homology of SEO like hantaviruses isolated from Shandong province was as high as 98% at nucleotides level, though they were isolated at more than 10-year intervals.

[Serum antibody response and Hantavirus RNA sequencing in patients with hemorrhagic fever renal syndrome in Yantai areas]

OBJECTIVE

To understand antibody responses to and RNA sequences of Hantavirus in patients with hemorrhagic fever renal syndrome (HFRS) in Yantai areas and to demonstrate the type of the prevalent viruses caused HFRS.

METHODS

Serum specimens collected at acute and convalescent stages from 90 patients with HFRS and IgM and IgG antibodies against Hantavirus were detected with ELISA, and cross plaque reduction neutralizing tests were performed to detect neutralizing antibody. Viral RNA was extracted from the patients? sera by using Trizol method and nested PCR was utilized to amplify the specific segments of the viral cDNA and the products of the PCR were TA cloned and then the nucleotide sequences were determined.

RESULTS

The IgM antibody was positive in 82.2% (88/107) of the patients while the IgG antibody was positive in 85.7% (66/77) of the patients. Both the serologic and sequence analyses demonstrated that the epidemic of HFRS in Yantai areas was caused by mixed types of Hantavirus. The prevalent strains of Hantavirus had higher homology with the strains isolated in Korea than with those isolated previously in China.

CONCLUSIONS

The serologic and sequencing analyses indicated that the epidemic of HFRS in Yantai areas was caused by mixed types of Hantavirus dominated by type SEO.

[Discovery of two sub-types of Hantanvirus in Anhui mountain areas]

OBJECTIVE

To investigate the existence of hemorrhagic fever with renal syndrome (HFRS) foci in high mountains and forest areas.

METHODS

A survey was conducted in the areas of 1 400 meter altitude in Dabie mountain and of 1,600 meter altitude in Wannan mountain in the mid 1990's using methods related to epidemiology, geographic-epidemiology, serum epidemiology, pathogenic and molecular epidemiology.

RESULTS

Two strains of HFRS viruses were isolated from pulmonary tissues of Rattus niviventer and both of them were identified as A types. The analysis of the nuclei sequence showed that there were significant differences between both sub types and HTN 76-118.

CONCLUSION

It was confirmed that there were HFRS foci in the areas with 2 strains possible new sub-types of HFRS.

Truncated hantavirus nucleocapsid proteins for serotyping Hantaan, Seoul, and Dobrava hantavirus infections

Truncated recombinant nucleocapsid proteins (rNPs) of Hantaan virus (HTNV), Seoul virus (SEOV), and Dobrava virus (DOBV) were expressed by a baculovirus system. The truncated rNPs, which lacked 49 (rNP50) or 154 (rNP155) N-terminal amino acids of the NPs of HTNV, SEOV, and DOBV, were able to differentiate HTNV-, SEOV-, and DOBV-specific immune sera. Recombinant NP50s retained higher reactivities than rNP155s and were proven useful for enzyme-linked immunosorbent assay (ELISA). The ELISAs based on the rNP50s of HTNV, SEOV, and DOBV successfully differentiated three groups of patient sera, previously defined by neutralization tests: 17 with HTNV infection, 12 with SEOV infection, and 20 with DOBV infection. The entire rNP of Puumala virus (PUUV) distinguished PUUV infection from the other types of hantavirus infection. Serotyping with these rNP50s can be recommended as a rapid and efficient system for hantavirus diagnosis.

Clinical characterization of Dobrava hantavirus infections in Germany

There is increasing evidence that Dobrava (DOBV) but not Hantaan (HTNV) hantavirus is a hemorrhagic fever with renal syndrome (HFRS) causing agent in Central Europe. However, only single clinical cases of HFRS due to acute DOBV infection have been described so far. We report on three male patients from a non-endemic hantavirus focus in Northern Germany who suffered from mild to moderate HFRS strongly resembling nephropathia epidemica. Serotyping by detection of hantavirus species-specific neutralizing antibodies revealed acute infections by the HTNV-related hantavirus DOBV in all three cases. Since DOBV infections in the Balkans frequently present as severe HFRS, our cases suggest that Central-European DOBV infections have a different, less severe clinical outcome. These differences in DOBV virulence towards humans might be due to the existence of different genetic lineages of DOBV.

Genetic diversity of Apodemus agrarius-borne hantaan virus in Korea

Hantaan (HTN) virus, the etiologic agent of clinically severe hemorrhagic fever with renal syndrome (HFRS), was first isolated in 1976 from lung tissues of striped field mice (Apodemus agrarius) captured in Songnae-ri, Kyungki-do, Korea. To clarify the genetic diversity and phylogenetic relationship among Korean strains of HTN virus, viral sequences of the partial S and M segments were amplified from lung tissues of 24 seropositive striped field mice captured between 1989 and 1998 at 11 sites in South Korea. The 771-nucleotide (nt) S segment sequences (coordinates 432 to 1202) of HTN virus strains from Yangju-kun differed by 10 to 40 nt (1.3 to 5.2%) from virus strains from Pocheon-kun, Songnae-ri and Nonsan-kun. Similar degrees of genetic variation were found in the G1 and G2 glycoprotein-encoding M segment. Phylogenetic trees, based on the partial S and M segments and generated by the maximum parsimony and neighbor-joining methods, demonstrated that virus strains from various geographic regions in South Korea showed a tendency to form two phylogenetic subgroups and were evolutionarily distinct from HTN virus strains from the People's Republic of China.

[Study on the genetic difference of SEO type Hantaviruses]

OBJECTIVE

To understand the genetic type of Hantaviruses and the difference between them caused by rodents in Beijing and to furhter explore the source of the infectious factors.

METHODS

Hantavirus RNA, isolated from lungs of rodents captured in Beijing and positive with Hantavirus antigens with frozen sectioning and Immunofluorescent assay, were reverse-transcribed and amplified with PCR with Hantavirus-specific primers.

RESULTS

Five of the PCR amplifications were discovered and sequenced with 300 bp sequence data of M segments (from 2003 - 2302nt according cDNA of seoul 8039 strain). Nucleotide sequence homology showed that they were sequences of SEO-type Hantavirus. Compared with SEO type Hantavirus, the nucleotide sequence homology of these samples was more than 94% while the homology of amonia acid sequence was more than 98%. When compared with HNT type Hantavirus, the homology of nucleotide sequence became less than 72% with the homology of amonia acid sequence less than 81%. Similar to other Hantavirus of SEO type, their nucleotide sequences and deduced amino acid sequences were highly preserved. Phylogenetic tree analysis showed that the five viruses could be divided into at least 4 branches.

CONCLUSION

It was quite likely that there were at least two sub-type SEO viruses with 4 branches that were circulating in Beijing.

Detection of Hantaan and Seoul viruses by reverse transcriptase-polymerase chain reaction (RT-PCR) and restriction fragment length polymorphism (RFLP) in renal syndrome patients with hemorrhagic fever

BACKGROUND

Hemorrhagic fever with renal syndrome (HFRS), also called Korean hemorrhagic fever (KHF), is the most common cause of acute renal failure in the Far East. Two serotypes of hantavirus, Hantaan and Seoul viruses are known pathogens for HFRS in Korea.

PURPOSE

To elucidate the diagnostic applicability for the serotype diagnosis in HFRS patients, we used nested reverse transcriptase-PCR and restriction fragment length polymorphism (nRT-PCR/RFLP) to screen 2 prototype viruses, 11 virus isolates from HFRS patients, and 69 specimens obtained from 31 HFRS patients.

METHODS

The nRT-PCR was performed using primers specific for the G1 segments of the Hantaan (HF3 1140-1163, HB14 1363-1342) and Seoul (SF2 809-832, SB3 1200-1177) viruses. The initial PCR products were then further amplified using nested primers for the Hantaan (HF4 1141-1164, HB13 1360-1339) and Seoul (SF7 863-884, SB1 1165-1142 ) viruses. Amplified segments were then digested with restriction enzymes specific for either Hantaan (C1a I) or Seoul (Sac I) virus sequences.

RESULTS

In all cultured viruses, the serotypes identified by nRT-PCR/RFLP were consistent with those of PRNT. nRT-PCR/RFLP results indicated the presence of Hantaan virus in 10 patients and of Seoul virus in 15 patients. In 3 patients, both Hantaan- and Seoul-specific amplified bands were visualized in serially collected samples, and in 4 patients no amplicon was detected. Among 69 specimens, 55 were positive; these positive specimens were obtained between days 3 and days 33 of illness. The positive rate was not affected by the clinical phase, day of illness, or severity of HFRS.

CONCLUSIONS

nRT-PCR/RFLP is a rapid and convenient method for serotype diagnosis in most HFRS patients. It could also allow detection of genetic variation of hantavirus within the same serotype.

Antigenic characterization of Hantaan and Seoul virus nucleocapsid proteins expressed by recombinant baculovirus: application of a truncated protein, lacking an antigenic region common to the two viruses, as a serotyping antigen

Hantaan virus (HTN) and Seoul virus (SEO) are members of the genus Hantavirus in the family Bunyaviridae and are causative agents of hemorrhagic fever with renal syndrome. The complete and truncated nucleocapsid proteins (NP) of HTN and SEO were expressed by a recombinant baculovirus system. Antigenic characterization of the NP using monoclonal antibodies (MAbs) indicated that the binding sites for the serotype-specific MAbs were located between amino acids (aa) 155 and 429. A Western blot assay indicated that the serotype-specific epitopes were conformation dependent. An indirect immunofluorescence antibody (IFA) assay with the truncated NP (aa 155 to 429) was able to distinguish convalescent-phase sera from HTN and SEO patients. However, the antibody titers with the truncated NP were lower than those with the whole NP. The truncated NP of SEO (aa 155 to 429) could be used as an enzyme-linked immunosorbent assay (ELISA) antigen, but the truncated NP from HTN lost its reactivity when used for ELISA. The IFA assay using baculovirus-expressed truncated NP as an antigen is a rapid, simple, and safe test for distinguishing between HTN and SEO infections by serotype.

[Serotyping of hemorrhagic fever with renal syndrome in Hubei province]

Ninety-two serum specimens, positive for antibodies against hemorrhagic fever with renal syndrome (HFRS) virus in initial screening with immunofluorescence assay technic (IFAT), were serotyped with micro cell pathogenic effects neutralization test based on preliminary epidemiological classification of epidemic foci of HFRS throughout the province to find out serological evidence of HFRS typing in Hubei Province. It was found that 48 of the specimens were belonged to Type I (HTN) accounting for 52.18 percent, 29 Type II (SEO) for 31.52 percent, and 15 undefined for 16.30 percent. Hubei Province was classified serologically as a mixed prevalent area with Type I as its major component, but all serotypes in different sub-areas have their own features and those in the old epidemic foci were more complex. It indicated that it was better to use a bivalent HFRS virus vaccine, or a single-valent vaccine consistent with local serotype. Serotyping of local HFRS conformed basically to that of epidemiological classification. Local HFRS should be serotyped periodically due to continuous changes in types of foci. Attention to reactions of vaccine immunization should be paid during observation of the effectiveness of the vaccine.

Genetic and phylogenetic analyses of hantaviral sequences amplified from archival tissues of deer mice (Peromyscus maniculatus nubiterrae) captured in the eastern United States

The S and M segments of a hantavirus, enzymatically amplified from tissues of Cloudland deer mice (Peromyscus maniculatus nubiterrae) captured during 1985 in West Virginia, diverged from strains of Four Corners virus from the southwestern United States by more than 16% and 6% at the nucleotide and amino acid levels, respectively. Phylogenetic analysis suggested that this virus strain (designated Monongahela) forms a possible evolutionary link between the Four Corners and New York hantaviruses.

[Study on the geographic distribution and serological typing of HFRS in Hebei Province]

Surveillance on the HFRS had been carried out during the period of 1986-1993. Rodent density ranged from 4.6%-12.2% with R.norvegicus exceeding 60% in all kinds of rodents. HV antigen carrier rate of R.norvegicus was 1.3%-7.5%, much higher than that among other rodents. A significantly positive correlation had been observed between the HFRS morbidity and the R.norvegicus density. Of 129 specimens from HFRS patients, 89% belonged to the type of SEOV. In the eastern and centre Parts of Hebei plain, HTNV occupied 1.6%. A total number of 9,609 HFRS patients had been identified during the period of 1980-1993. The plain area in Hebei province was recognized as the major epidemic area. The key measure for decreasing the HFRS morbidity was deratizationin in the residential area in January and February and immunization with HFRS inactivated vaccine.

[Genetic differentiation of hantaviruses using the polymerase chain reaction and sequencing]

Thirty-two hantavirus strains and 8 samples of lung tissue from rodents collected in different regions of Russia have been examined by molecular biological methods. Two methodological approaches have been employed for the study of genetic relationships between the viruses: nested PCR assay and common RT-PCR with subsequent direct sequencing of 200 and 365 base pair of G2 protein encoding regions of M-segment, respectively, and the resultant sequences were compared with those of the prototype hantavirus. The study revealed a mosaic pattern of distribution of different hantavirus genotypes on the territory of Russia.

Hantaan virus persistently infects marmoset B-lymphoblastoid cell line

To investigate lymphoid cell Hantavirus (HV) interaction, we examined the replication of the HV strains, Hantaan 76-118 (HTN), SR-11, and B-1 with the B95a, LYM-1, CGM1, JM, Jurkat, MOLT-4, AT(L)5KY, BW5147, L1210, and Vero/E6 cells. HV-growth was determined by immunofluorescence and focus-forming assays. LYM-1 and Vero/E6 supported the growth of all HV strains, and B95a only HTN, while remaining cells did not sustain these strains. This is the first report to indicate the HV-replication in lymphoid cell lines. B95a and LYM-1 cells may be useful for revealing the mechanism of HV-infection in animals.

A vaccinia virus-vectored Hantaan virus vaccine protects hamsters from challenge with Hantaan and Seoul viruses but not Puumala virus

To investigate the ability of a vaccinia virus-vectored vaccine expressing the M and the S segments of Hantaan (HTN) virus (C. S. Schmaljohn, S. E. Hasty, and J. M. Dalrymple, Vaccine 10:10-13, 1992) to elicit a protective immune response against other hantaviruses, we vaccinated hamsters with the recombinant vaccine and challenged them with HTN, Seoul (SEO), or Puumala (PUU) virus. Neutralizing antibodies to HTN virus were found in all vaccinated hamsters both before and after challenge. Neutralizing antibody titers to SEO virus were present at low levels or were undetectable after two immunizations with the vaccine but were positive in all vaccinated hamsters after challenge with SEO virus and were also positive in control animals that were not challenged. Neutralizing antibodies to PUU virus were observed only in hamsters previously challenged with PUU virus. To assay for virus in the blood and tissues of the hamsters, we developed a nested reverse transcriptase (RT)-PCR with cross-reactive outer primers and serotype-specific inner primers. The RT-PCR specifically detected as little as 1 PFU of virus in serum containing high-titer neutralizing antibodies and was more sensitive than immunofluorescent antibody staining for detecting virus in lung and kidney specimens of infected hamsters. By using the RT-PCR, we found that vaccinated hamsters, challenged with HTN or SEO virus, neither were viremic nor had evidence of virus in their lungs or kidneys. In contrast, vaccinated hamsters challenged with PUU virus were viremic and had PUU virus-specific nucleic acid in their organs.

Rapid differentiation between Hantaan and Seoul viruses by polymerase chain reaction and restriction enzyme analysis

The majority of causative strains of hemorrhagic fever with renal syndrome (HFRS) are known as Hantaan and Seoul viruses in Korea. The clinical manifestations may be indistinguishable between both viruses, although the clinical course of Hantaan virus infection is more severe than that of the Seoul virus. Therefore, the differentiation of Hantaan or Seoul virus may be important for predicting the prognosis. The primers were selected from the published sequences of the S segments of Hantaan virus strain 76-118 and Seoul virus strain SR-11, which made it possible to obtain the same size of 403 bp amplified product by reverse transcriptase polymerase chain reaction (RT-PCR) and nested PCR from both viral strains. The differentiation of the amplified products was carried out by restriction enzyme digestion. With HindIII, the 403 bp amplified product from Hantaan virus strain 76-118 was cleaved into two segments of 175 bp and 228 bp. By contrast, the 403 bp product from Seoul virus strain SR-11 was not cut by HindIII. With HinfI, the 403 bp amplified product from Hantaan virus strain 76-118 was divided into two bands of 280 bp and 60 bp on the electrophoresis. In the case of the digestion of 403 bp PCR product from Seoul virus strain SR-11 with HinfI, more than four bands (155 bp, 115 bp, 60 bp, and 32/29 bp) were observed on the 2% agarose gel electrophoresis. This rapid technique may be useful for the differential diagnosis of Asian HFRS in Korea.

Serological relationships among viruses in the Hantavirus genus, family Bunyaviridae

We examined the serological relationships among 32 hantavirus isolates collected from numerous geographic regions and hosts. We prepared rat immune sera to each virus and used these sera in hemagglutination inhibition (HAI) tests, enzyme-linked immunosorbent assays (ELISA), and plaque-reduction neutralization tests to establish the antigenic relationships among the isolates. Our studies included viruses that had been partially characterized previously, as well as isolates for which little or no serological data were available. Our results indicate that, in addition to the four established serological groups of hantaviruses, represented by Hantaan, Seoul, Puumala, and Prospect Hill viruses, there exist at least two other distinct groups of hantaviruses. These groups are represented by Thailand 749 virus, an isolate from Bandicota in Thailand, and by Thottapalayam virus, an isolate from Suncus in India. To compare more closely the antigenic relationships of the isolates to prototype Hantaan virus, we examined the reactivities of Hantaan G1- or G2-specific monoclonal antibodies with the envelope proteins of a number of the isolates. We found that several epitopes defined by monoclonal antibodies to the G2 protein were highly conserved as detected by HAI tests and ELISA. Almost all of the isolates could be neutralized by at least one G2-specific monoclonal antibody. In contrast, epitopes defined by G1 monoclonal antibodies were conserved only among Hantaan-like viruses.