Hantaan virus

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Hantaan virus
Virus classification OOjs UI icon edit-ltr.svg
(unranked): Virus
Realm: Riboviria
Kingdom: Orthornavirae
Phylum: Negarnaviricota
Class: Ellioviricetes
Order: Bunyavirales
Family: Hantaviridae
Genus: Orthohantavirus
Species:
Orthohantavirus hantanense
Virus:
Hantaan virus
Synonyms [1] [2]
  • Hantaan hantavirus
  • Hantaan orthohantavirus

Hantaan virus (HTNV) is the main cause of hemorrhagic fever with renal syndrome (HFRS) in East Asia. Hantaan virus is transmitted by the striped field mouse (Apodemus agrarius) In its natural reservoir, HTNV causes a persistent, asymptomatic infection and is spread through excretions, fighting, and grooming. Humans can become infected by inhaling aerosols that contain rodent saliva, urine, or feces, as well as through bites and scratches. In humans, infection causes such as fever and headache, as well as the appearance of spots on the skin, hepatitis, and renal symptoms such as kidney swelling, excess protein in urine, blood in urine, decreased urine production, and kidney failure. Rarely, HTNV infection affects the pituitary gland and can cause empty sella syndrome. The case fatality rate from infection is up to 6.3%.

Contents

The genome of HTNV is about 11.9 kilobases (kb) in length and segmented into three negative-sense, single-stranded RNA (-ssRNA) strands. The small strand encodes the viral nucleoprotein, the medium strand encodes the viral spike protein, which attaches to cell receptors for entry into cells, and the long strand encodes the viral RNA-dependent RNA polymerase (RdRp), which replicates and transcribes the genome. Genome segments are encased in nucleoproteins to form ribonucleoprotein (RNP) complexes that are surrounded by a viral envelope that contains spikes emanating from its surface.

Hantaan virus replicates first by binding to the surface of cells with its envelope spikes. Virus particles, called virions, are then taken into the cell by endosomes, where a drop in pH causes the viral envelope to fuse with the endosome, which releases viral RNA into the host cell. RdRp then transcribes the genome for translation by host cell ribosomes and produces copies of the genome for progeny viruses. New virions are assembled at the endoplasmic reticulum and bud from its surface to obtain their viral envelope. Progeny viruses are then transported by a cellular vesicle to the cell membrane, where they leave the cell by exocytosis.

HTNV was discovered in 1976 then isolated in 1978 after being extracted from striped field mice. The virus was subsequently linked to a past outbreak among soldiers in the Korean War who were stationed near the Hantan river and for that was named after the river. Hantaan virus was the first hantavirus to be discovered, and the group is named after the virus. The vast majority of HFRS cases occur in China, where Hantaan virus is responsible for up to 70% of cases. Cases of HFRS caused by Hantaan virus also occur in South Korea, Russia, and Vietnam.

Genome

The genome of Hantaan virus is about 11.8 thousand nucleotides in length and segmented into three negative-sense, single-stranded RNA (-ssRNA) strands. The segments form into circles via non-covalent bonding of the ends of the genome. [1] The small segment, about 1.7 kilobases (kb) in length, encodes the viral nucleoprotein. The medium segment, about 3.62 kb in length, encodes a glycoprotein precursor that is cleaved into the two spike proteins Gn and Gc during virion assembly. The large segment, about 6.53 kb in length, encodes the viral RNA-dependent RNA polymerase (RdRp), which is responsible for transcribing and replicating the genome. The ends of each segment contain untranslated terminal regions (UTRs) that are involved in the replication and transcription of the genome. [1] [3] [4]

Structure

Virions are mostly spherical or pleomorphic in shape and range from 80 to 160 nm in diameter. They contain a lipid envelope covered in spike proteins made of the two viral glycoproteins, Gn and Gc. The spike proteins extend about 10 nm out from the surface and are tetrameric, consisting of four copies each of Gn and Gc with helical symmetry, in which Gn forms the stalk of the spike and Gc the head. Spikes are arranged on the surface in a lattice pattern. Inside the envelope are the three genome segments, which are encased in nucleoproteins to form a ribonucleoprotein (RNP) complex. Attached to each RNP complex is a copy of RdRp. [1] [5] [6]

Life cycle

HTNV primarily infects endothelial cells and macrophages. [3] It enters cells by using β3-integrins as receptors. [5] Virions are taken into a cell via an endosome. Once pH is lowered, the viral envelope fuses with the endosome, which releases viral RNA into the host cell's cytoplasm. The small segment is transcribed by RdRp first, then the medium segment, and lastly the large segment. Once the genome has been transcribed, RdRp snatches caps from host messenger RNA (mRNA) to create viral mRNA that is primed for translation by host ribosomes to produce viral proteins. [5] [7]

For replication of the genome, a complementary positive-sense strand is produced by RdRp. Copies of the genome are made from this complementary strand. Progeny RNA strands are then encapsidated by nucleoproteins. [3] During replication, the glycoprotein is cleaved in the endoplasmic reticulum by the host signal peptidase during translation. This produces Gn at the N-terminus and Gc at the C-terminus of the protein. [5] Spike proteins are expressed on the surface of the endoplasmic reticulum. Viral RNPs are transported to the endoplasmic reticulum where they bud from the surface, thereby obtaining their envelope. Progeny viruses are then transported by a cellular vesicle to the cell membrane, where they leave the cell via exocytosis. [7] [8]

Evolution

The most common way that hantaviruses evolve is through mutations of individual nucleotides being inserted, deleted, or substituted. Because Hantaan virus has a segmented genome, it is possible for recombination and reassortment of segments to occur, whereby segments from different lineages mix in a single host cell and produce hybrid progeny. [3] In China, a recombinant strain of HTNV was discovered in which recombination had occurred with a different species of hantavirus. [3] In another instance, an isolate from brown rats (Rattus norvegicus) was found to have reassorted with a virus in another species, Seoul virus. [9]

Ecology

The striped field mouse, the natural reservoir of Hantaan virus. Mysz polna2.jpg
The striped field mouse, the natural reservoir of Hantaan virus.

Hantaan virus is transmitted by striped field mice (Apodemus agrarius). [3] [10] These mice mainly reside in rural areas, where they frequently use crop fields as a source of food. [10] Spillover events in which HTNV spreads from striped field mice to brown rats (Rattus norvegicus) are common. [9] Parasitic mites of striped field mice have been found to be infected Hantaan virus, which suggests that they can transmit the virus to mammals they parasitize. [11] Antibodies to Hantaan virus have been detected in cattle, deer, and rabbits, but the role of these animals as hosts is unknown. [3]

In its rodent hosts, HTNV causes a persistent and mainly asymptomatic infection. Rodent-to-rodent transmission occurs through contact with bodily fluids and through fighting and grooming. [5] [12] Transmission to humans occurs mainly through the inhalation of aerosols that contain rat saliva, urine, or feces. [4] [10] Transmission can also occur through consumption of contaminated food, bites, and scratches. [3] [10] Infections with Hantaan virus mainly occur in rural settings such as in residences near crop fields or in such fields. In China, cases most commonly occur during the autumn harvest season when farmers work on and sometimes sleep in crop fields. [10]

Disease

Hantaan virus infection can cause hemorrhagic fever with renal syndrome (HFRS). Symptoms usually occur 12–16 days after exposure and come in five phases: fever, hypotension, low urine production, high urine production, then recovery. [13] The disease is hallmarked by acute kidney disease with kidney swelling, excess protein in urine, and blood in urine. Early symptoms include fever, headache, lower back pain, nausea, vomiting, diarrhea, bloody stool, and the appearance of spots on the skin. During the hypotensive phase, there is a sudden lowering of blood pressure and shock due to microvascular leakage. Low urine production then occurs as a result of renal failure. As renal function recovers, urine production increases. [3] [8] The case fatality rate is up to 6.3%. [10] A rare complication of HTNV infection is impaired pituitary gland function. HTNV can cause bleeding and atrophy of the anterior pituitary lobe and empty sella syndrome. [14] In more mild cases, the different phases of illness may be hard to distinguish, [15] or some phases may be absent, while in more severe cases, the phases may overlap. [4]

Infection with Hantaan virus mainly occurs in China and South Korea, [16] but also in Russia and Vietnam. [3] The vast majority of HFRS cases in the world are in China, and Hantaan virus is responsible for up to 70% of cases. 9,000–12,000 cases occur each year in China, and about 400–600 per year in South Korea. [3] HTNV infection is diagnosed based on observation of symptoms and testing for hantavirus nucleic acid, proteins, or hantavirus-specific antibodies. Treatment is supportive in nature and includes intravenous hydration, electrolyte therapy, platelet transfusions, and, in cases of kidney injury or failure, intermittent dialysis and continuous renal replacement therapy. [3] [17] [18] [19] Avoiding or minimizing contact with rodents is key to prevent infection. In China and South Korea, bivalent vaccines for Seoul virus and Hantaan virus are available for use. [3] Repeated infections of hantaviruses have not been observed, so recovering from infection likely grants life-long immunity. [10] [20]

Classification

Hantaan virus is classified into the species Orthohantavirus hantanense in the genus Orthohantavirus, which is in the family Hantaviridae, the family that all hantaviruses belong to. Other members of Orthohantavirus hantanense include Amur virus and Soochong virus. The 76-118 isolate of Hantaan virus is the exemplar virus of the species. This taxonomy is shown hereafter: [1] [2] [21]

History

During the Korean War, around 3,200 cases of epidemic disease occurred from 1951 to 1954 among United Nations soldiers [22] stationed near the Hantan river in northern South Korea. [6] This disease received the name "Korean hemorrhagic fever". Infected people experienced typical symptoms of HFRS, including headache, fever, chills, anorexia, vomiting, as well as commonly hypotension and bleeding in the kidneys. The case fatality rate at first was over 10% but dropped to about 5%. Because of how severe the epidemic was, the US military established a hemorrhagic fever center close to where most cases occurred. Suspected cases were airlifted to the hospital for treatment. The disease at that time was named Korean hemorrhagic fever. [22]

In 1976, Ho-Wang Lee (Korean: 이호왕) [23] showed that antigens taken from the lungs of striped field mice were reactive to antibodies from sera of people who had Korean hemorrhagic fever. The virus couldn't be isolated in 1976 but testing showed that an infectious agent was responsible. [21] The virus was isolated for the first time in 1978 [3] and named "KHF strain 76-118". It was propagated in cell cultures for the first time in 1981 and renamed "Hantaan virus, strain 76-118" after the Hantan river. Around the same time, other viruses related to Hantaan virus that caused HFRS were discovered throughout Asia and Europe. This group of newly discovered were given the name "hantaviruses", taking the name of Hantaan virus. [21]

Hantaan virus was accepted as a species by the International Committee on Taxonomy of Viruses in 1987, [2] and with it the establishment a genus for hantaviruses. [24] It has undergone a series of changes to its species name, first changing to Hantaan hantanavirus, then Hantaan orthohantavirus, and most recently to the current Orthohantavirus hantanense. [2] In 1989, the method to diagnose Hantaan virus infection was developed by Lee and just a year later he developed a vaccine against it, which made him the first person in history to discover the cause of a viral disease, develop a method to diagnose it, and develop a vaccine against it. [23]

Related Research Articles

<i>Orthohantavirus</i> Genus of viruses

Orthohantavirus is a genus of viruses that includes all hantaviruses that cause disease in humans. Orthohantaviruses, hereafter referred to as hantaviruses, are naturally found primarily in rodents. In general, each hantavirus is carried by one rodent species and each rodent that carries a hantavirus carries one hantavirus species. Hantaviruses in their natural reservoirs usually cause an asymptomatic, persistent infection. In humans, however, hantaviruses cause two diseases: hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). HFRS is mainly caused by hantaviruses in Africa, Asia, and Europe, called Old World hantaviruses, and HPS is usually caused by hantaviruses in the Americas, called New World hantaviruses.

<span class="mw-page-title-main">Sin Nombre virus</span> Prototypical agent of hantavirus cardiopulmonary syndrome

Sin Nombre virus (SNV) is the most common cause of hantavirus pulmonary syndrome (HPS) in North America. Sin Nombre virus is transmitted mainly by the eastern deer mouse. In its natural reservoir, SNV causes an asymptomatic, persistent infection and is spread through excretions, fighting, and grooming. Humans can become infected by inhaling aerosols that contain rodent saliva, urine, or feces, as well as through bites and scratches. In humans, infection leads to HPS, an illness characterized by an early phase of mild and moderate symptoms such as fever, headache, and fatigue, followed by sudden respiratory failure. The case fatality rate from infection is high, at 30–50%.

<i>Bunyavirales</i> Order of RNA viruses

Bunyavirales is an order of segmented negative-strand RNA viruses with mainly tripartite genomes. Member viruses infect arthropods, plants, protozoans, and vertebrates. It is the only order in the class Ellioviricetes. The name Bunyavirales derives from Bunyamwera, where the original type species Bunyamwera orthobunyavirus was first discovered. Ellioviricetes is named in honor of late virologist Richard M. Elliott for his early work on bunyaviruses.

<i>Lassa mammarenavirus</i> Type of viral hemorrhagic fever

Lassa mammarenavirus (LASV) is an arenavirus that causes Lassa hemorrhagic fever, a type of viral hemorrhagic fever (VHF), in humans and other primates. Lassa mammarenavirus is an emerging virus and a select agent, requiring Biosafety Level 4-equivalent containment. It is endemic in West African countries, especially Sierra Leone, the Republic of Guinea, Nigeria, and Liberia, where the annual incidence of infection is between 300,000 and 500,000 cases, resulting in 5,000 deaths per year.

Seoul virus (SEOV) is one of the main causes of hemorrhagic fever with renal syndrome (HFRS). Seoul virus is transmitted by the brown rat and the black rat. In its natural reservoirs, SEOV causes an asymptomatic, persistent infection and is spread through excretions, fighting, and grooming. Humans can become infected by inhaling aerosols that contain rodent saliva, urine, or feces, as well as through bites and scratches. In humans, infection leads to HFRS, an illness characterized by general symptoms such as fever and headache, as well as the appearance of spots on the skin and renal symptoms such as kidney swelling, excess protein in urine, blood in urine, decreased urine production, and kidney failure. The case fatality rate from infection is 1–2%.

Andes virus (ANDV) is the most common cause of hantavirus pulmonary syndrome (HPS) in South America. Andes virus is transmitted mainly by the long-tailed pygmy rice rat. In its natural reservoir, ANDV causes an asymptomatic, persistent infection and is spread through excretions, fighting, and grooming. Humans can become infected by inhaling aerosols that contain rodent saliva, urine, or feces, as well as through bites and scratches. In humans, infection leads to HPS, an illness characterized by an early phase of mild and moderate symptoms such as fever, headache, and fatigue, followed by sudden respiratory failure. The case fatality rate from infection is high, at about 40%.

Puumala virus (PUUV) is the main cause of hemorrhagic fever with renal syndrome (HFRS) in Europe and Russia. Puumala virus is transmitted by the bank vole. In its natural reservoir, PUUV causes a persistent infection with few symptoms and is spread through excretions, fighting, and grooming. Humans can become infected by inhaling aerosols that contain rodent saliva, urine, or feces, as well as through bites and scratches. In humans, infection is usually asymptomatic but can lead to a mild form of HFRS often called nephropathia epidemica (NE). Symptoms include fever and headache, impaired vision, as well as the appearance of spots on the skin and renal symptoms such as kidney swelling, excess protein in urine, blood in urine, decreased urine production, and kidney failure. The case fatality rate from infection is less than 1%.

Bayou virus (BAYV) is a species of Orthohantavirus comprising enveloped and spherical viruses. It was first identified in 1993 in Louisiana and later confirmed by other investigators. BAYV was recognized as a distinct form of hantavirus disease, now known as hantavirus pulmonary syndrome (HPS). It now represents the second most common hantavirus in the United States behind the Sin Nombre virus. In 1996, the marsh rice rat, which is seen in marshes in the southeast and mountain streams in the northeast, was identified as the natural reservoir of the virus. Due to the virus being first identified in Louisiana, this indicated the virus to be widespread throughout the Southeastern United States. This hantavirus disease is known as a severe and sometimes fatal respiratory disease, and HPS has a case-rate fatality of almost 50%.

Amur virus (AMRV) is a zoonotic negative-sense single-stranded RNA virus. It may be a member of the genus Orthohantavirus, but it has not be definitively classified as a species and may only be a strain. It has been identified as a causative agent of hemorrhagic fever with renal syndrome.

<span class="mw-page-title-main">1993 Four Corners hantavirus outbreak</span> 1993 disease outbreak

The 1993 Four Corners hantavirus outbreak was an outbreak of hantavirus disease that occurred in the Four Corners region of the US states in Arizona, Colorado, and New Mexico. The outbreak marked the discovery of hantaviruses in the Western Hemisphere that could cause disease and revealed the existence of a novel type of disease caused by hantaviruses: hantavirus pulmonary syndrome (HPS). Hantaviruses that cause disease in humans are native to rodents and, prior to the outbreak, were known to exist in Asia and Europe, but previously were only associated with a different disease called hemorrhagic fever with renal syndrome (HFRS).

Sangassou virus(SANGV) is single-stranded, negative-sense RNA virus species of the genus Orthohantavirus in the Bunyavirales order. It was first isolated in an African wood mouse (Hylomyscus simus) in the forest in Guinea, West Africa in 2010. It is named for the village near where the mouse was trapped. It is the first indigenous Murinae-associated African hantavirus to be discovered.

Hantavirus hemorrhagic fever with renal syndrome (HFRS) is a hemorrhagic fever caused by hantaviruses. Symptoms occur usually occur 12–16 days after exposure to the virus and come in five distinct phases: febrile, hypotensive, low urine production (oliguric), high urine production (diuretic), and recovery. Early symptoms include headache, lower back pain, nausea, vomiting, diarrhea, bloody stool, the appearance of spots on the skin, bleeding in the respiratory tract, and renal symptoms such as kidney swelling, excess protein in urine, and blood in urine. During the hypotensive phase, blood pressure lowers due to microvascular leakage. Renal failure then causes the diuretic phase, before recovering and increasing urine production as disease progression improves. The severity of symptoms varies depending on which virus causes HFRS and ranges from a mild illness to severe. The case fatality rate likewise varies by virus, at less than 1% up to 15%.

<span class="mw-page-title-main">Hantavirus pulmonary syndrome</span> Viral pulmonary disease of humans

Hantavirus pulmonary syndrome (HPS), also called hantavirus cardiopulmonary syndrome (HCPS), is a severe respiratory disease caused by hantaviruses. The main features of illness are microvascular leakage and acute respiratory distress syndrome. Symptoms occur anywhere from 1 to 8 weeks after exposure to the virus and come in three distinct phases. First, there is prodromal phase with flu-like symptoms such as fever, headache, muscle, shortness of breath, as well as low platelet count. Second, there is cardiopulmonary phase during which people experience elevated or irregular heart rate, cardiogenic shock, and pulmonary capillary leakage, which can lead to respiratory failure, low blood pressure, and buildup of fluid in the lungs and chest cavity. The final phase is recovery, which typically takes months, but difficulties with breathing can persist for up to two years. The disease has a case fatality rate of 30–60%.

Dobrava-Belgrade virus (DOBV) is the main cause of hemorrhagic fever with renal syndrome (HFRS) in southern Europe. In its natural reservoirs, DOBV causes a persistent, asymptomatic infection and is spread through excretions, fighting, and grooming. Humans can become infected by inhaling aerosols that contain rodent saliva, urine, or feces, as well as through bites and scratches. In humans, infection causes such as fever and headache, as well as the appearance of spots on the skin and renal symptoms such as kidney swelling, excess protein in urine, blood in urine, decreased urine production, and kidney failure. Acute respiratory distress syndrome occurs in about 10% of cases.

Soochong virus (SOOV) is a zoonotic negative sense single-stranded RNA virus. It may be a member of the genus Orthohantavirus, but it has not be definitively classified as a species and may only be a strain. It is one of four rodent-borne Hantaviruses found in the Republic of Korea. It is the etiologic agent for Hantavirus hemorrhagic fever with renal syndrome (HFRS). The other species responsible for HFRS in Korea are Seoul virus, Haantan virus, and Muju virus.

Prospect Hill virus is a single-stranded, negative-sense Hantaan-like zoonotic RNA virus isolated from meadow voles and microtine and other cricetid rodents in the United States. It has a widespread distribution in Pennsylvania, Maryland, West Virginia, Minnesota and California. The overall risk of infection in humans is low. It was first isolated from a meadow vole found in Prospect Hill, Maryland for which it is named.

Nova virus is a single-stranded, negative-sense, enveloped RNA virus with a trisegmented genome. It belongs to one of the most divergent lineages of the hantavirus group, which consists of zoonotic viruses belonging to the family Bunyaviridae. As of now, no human cases of infection have been reported.

Thailand virus (THAIV) is a single-stranded, enveloped, negative-sense RNA orthohantavirus.

Gou virus (GOUV) is a single-stranded, negative-sense, enveloped novel RNA orthohantavirus. It is one of the known hantaviruses responsible for hantavirus hemorrhagic fever with renal syndrome in humans.

Hantavirus vaccine is a vaccine that protects in humans against hantavirus infections causing hantavirus hemorrhagic fever with renal syndrome (HFRS) or hantavirus pulmonary syndrome (HPS). The vaccine is considered important as acute hantavirus infections are responsible for significant morbidity and mortality worldwide. It is estimated that about 1.5 million cases and 46,000 deaths occurred in China from 1950 to 2007. The number of cases is estimated at 32,000 in Finland from 2005 to 2010 and 90,000 in Russia from 1996 to 2006.

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