Analysis index

Antibody-demonstration: 1 ml serum

PCR: urine (External service

Immunoblot: Please refer to findings report     

PCR: negative

Suspicion of Hantavirus infection (fever, headaches, myalgia, proteinuria, increased serum creatinine with oliguria, thrombocytopenia)

The laboratory has to report any direct or indirect demonstration to the health department. The suspicion of virus-related hemorrhagic fever as well as disease and death are to be reported by the treating physician.

Hanta viruses are passed by asymptomatic, persistently infected rodents via their urine, saliva and feces. Human infection is by inhalation of virus-containing aerosols or via contract with infected dusts (for instance through open wounds). Direct transfer by a bite of an infected animal is possible. Incubation time is 5 – 60 days, usually 2 – 4 weeks. Initially, often nonspecific flu-like symptoms. Three-phased clinical picture in case of nephropathia epidemica:

Phase 1: Abrupt onset with high fever (> 39 °C), ague, myalgia, headaches, visual effects, pharyngeal exanthema for 3 – 4 days

Phase 2: Lumbago, abdominal pain, nausea, vomiting, diarrhea

Phase 3: Kidney insufficiency with oliguria, hematuria, and proteinuria

Differential diagnosis: Leptospirosis, other kidney diseases, other infections.

In Germany, approximately 98 % of infections are caused by the subtype Puumala, far less commonly by subtype Dobrava. 

IgM-antibodies can be detected 6 – 10 days after infection and persist 3 months to several years. IgG-antibodies are detectable shortly after IgM-antibodies occur, are usually positive at symptom onset and remain elevated lifelong. In approximately 2 % – 5 % of the German population antibodies against hanta viruses, indicating previous infection can be seen.

Further information can be found at www.rki.de

Labor Berlin – Charité Vivantes GmbH