Hantavirus RNA in saliva from patients with hemorrhagic fever with renal syndrome.
Bottom Line: PUUV RNA was detected in saliva from 10 patients (range 1,530-121,323 PUUV RNA copies/mL) by quantitative reverse transcription-PCR.The PUUV S-segment sequences from saliva and plasma of the same patients were identical.Our data show that hantavirus RNA could be detected in human saliva several days after onset of disease symptoms and raise the question whether interhuman transmission of hantavirus may occur through saliva.
Affiliation: Umeå University, Umeå, Sweden.
Hantaviruses cause 2 zoonotic diseases, hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome. Infection is usually initiated after inhalation of virus-contaminated rodent excreta. In addition to the zoonotic infection route, growing evidence suggests person-to-person transmission of Andes virus. For this reason, we studied whether saliva from HFRS patients contained hantavirus. During an outbreak in northern Sweden of nephropathia epidemica (NE), a milder form of hemorrhagic fever with renal syndrome, we collected saliva and plasma from 14 hospitalized NE patients with verified Puumala virus (PUUV) infection. PUUV RNA was detected in saliva from 10 patients (range 1,530-121,323 PUUV RNA copies/mL) by quantitative reverse transcription-PCR. The PUUV S-segment sequences from saliva and plasma of the same patients were identical. Our data show that hantavirus RNA could be detected in human saliva several days after onset of disease symptoms and raise the question whether interhuman transmission of hantavirus may occur through saliva.
Related in: MedlinePlus
Mentions: To study in more detail whether the RNA we detected in saliva was truly specific, we sequenced regions of RT-PCR products. Sequencing of amplification products from saliva and plasma from 3 NE patients—patient 1 (GenBank accession nos. EU337014 and EU337015), patient 2 (GenBank accession nos. EU177629 and EU177630), and patient 4 (GenBank accession nos. EU337016 and EU337017)—demonstrated a PUUV S-segment sequence that was identical for each saliva/plasma pair (data not shown). When we compared the sequences for patients 1 and 4, we found 24 mismatches in the 292-nt S-segment sequence, which clearly demonstrated that they were derived from different strains (Figure). The observed nucleotide mismatches did not result in different amino acid sequences. The sequence from patient 2 was from another S-segment region. All PUUV sequences from the NE patients were most closely related to PUUV strains from the disease-endemic region in northern Sweden and grouped with the northern branch of PUUV strains (19,20).