Hantavirus nephropathy in The Netherlands: clinical, histopathological and epidemiological findings

Until 1995, 39 cases of serologically confirmed hantavirusnephropathy in humans, caused by the Puumala type of Hantavirus, have been documented in the Netherlands. Thirty-two of these occurred in Twente, a small region in the eastern part of the country, in which the presence of Puumala-like Hantavirus in feral rodents has recently been demonstrated. Sixteen of the cases documented in humans occurred in 1993. Here we present an overview of clinical, histopathological and epidemiological findings of hantavirus infections. All the clinical and laboratory findings of the 39 documented cases were similar to those found in infections with the same virus in neighbouring countries. Complete recovery of renal function occurred in all patients. One patient developed a Guillain-Barré syndrome after having recovered from her renal failure. Histopathological examination of kidney biopsies collected from 13 of the patients in the acute stage, confirmed the presence of acute interstitial inflammation of differing severity in these individuals. A serological survey carried out amongst 4232 healthy blood donors in the endemic area showed a seroprevalence of 0.7%. This suggests that less severe or perhaps even subclinical infections occur.