[Hantavirus infections in Belgium]

Hantavirus disease is a recently recognised zoonosis. The main vectors are infected but healthy wild rodents or laboratory rats. Transmission to man occurs via contact with, or inhalation of aerosolised excretions. The target organs in man are the kidney (Old World) or the lung (New World), probably via a local hyperproduction of pro-inflammatory cytokines. To date, more than 33 different hantaviruses have been characterised, at least 14 of them being of clinical importance. Each serotype has its own rodent vector and its own geographical spread. In Europe, the red bank vole (Clethrionomys glareolus) is the main rodent vector, carrying the Puumala (PUU) serotype, which is the etiologic agent of a viral affection known as Nephropathia epidemica (NE). PUU infection has been recognised for the first time in Belgium in 1983. From this date on, approximately 500 cases have been diagnosed. In our regions, a diagnosis of hantavirus disease is mandatory when a febrile patient presents with lumbaches, headache, and an acute renal failure with proteinuria, and particularly with thrombocytopenia.