New cases of suspected HFRS (Hantavirus infection) in south-eastern Poland

Introduction: HFRS – hemorrhagic fever with renal syndrome, found in Europe, is an acute viral zoonosis due to the hantavirus infection. The disease is characterized by the triad of symptoms: sudden, febrile onset, acute renal failure and haemorrhagic diathesis. The range of hantavirus infections in humans has not been yet established on the territory of Poland. The medical literature described 18 cases of seropositive HFRS in Poland – mainly in the district of Sanok, and single cases in the districts of: Brzozów, Dębica, Krosno, Lesko, Przemyśl and Stalowa Wola. Aim: The aim of the study was to verify the hypothesis, assuming that patients hospitalized in the Department of Nephrology, located in the Regional Hospital in Przemyśl were infected with hantavirus and had HFRS. Material and methods: Due to the fact that patients selected for the study were not tested serologically, verification was based on statistical comparison of the retrospectively selected group of patients suspected of HFRS with the seropositive group described in the study of Nowakowska, Heyman, Knap et al. in 2009, in terms of individual symptoms prevalence in conjunction with the structure of selected clinical and epidemiological parameters. Results: 26 individuals with renal failure and influenza-like episode of several-day fever of unknown origin were indentified on the base of the retrospectively analyzed records of the patients hospitalized in the Department of Nephrology in Przemyśl between 2001–2011. The significant differences in age, frequency of selected laboratory parameters (platelet count, serum electrolytes) and oliguria were not found in both compared groups. However, the study group included the higher percentage of men. Additionally, the differences in prevalence of symptoms (cough, diarrhea), which are not considered specific for HFRS were detected. Analogously to the reference group, seasonal morbidity was observed also in the study group, but the peak intensity was delayed for 4 weeks. Conclusions: The hypothesis cannot be rejected that, the group analyzed in the prestent study, hospitalized in the Department of Nephrology in the Regional Hospital in Przemyśl – is the sample of patients with HFRS (similarly to the group described by Nowakowska et al.). The cases described in this study can be considered as suspected of HFRS. It is justifiable to perform serological testing in these individuals.