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Biological Health Threat – Hantavirus (Epidemic hemorrhagic fever [HFRS]): Asia – China [Update]


Published Date: 2016-04-24 12:24:56
Subject: PRO/AH/EDR> Hantavirus update – Asia (02): China (ZJ)
Archive Number: 20160424.4179769

Date: Thursday 21 Apr 2016
Source: Quzhou Evening News [in Chinese, trans. Rapp.DS, edited]

Jiangshan Center for Disease Control said yesterday [20 Apr 2016] that a case of epidemic hemorrhagic fever [with renal syndrome, HFRS] was found in Jiangshan. The patient is receiving treatment under isolation. The confirmed patient stated that he had contact with dead rats on 5 Apr [2016] while doing farm work. After returning home that evening, he felt uncomfortable and developed a fever of 40.3 C [104 F] with lumbago and a reduction in urine output.

Epidemic hemorrhagic fever [HFRS] is caused by a virus (hantavirus). It is a disease that occurs in nature, and rodents are the main infectious source, passing via close contact and contact with diseased or dead animals or the corpse of patients, as well as the blood, secretions, faeces, vomit of patients or animals. It is transmitted through mucous membranes or broken skin. After infection, the main clinical manifestations are fever, bleeding, hyperemia, hypotensive shock, and renal damage. Classic symptoms are the 3 pains (headache, lumbago, orbital pain) and the 3 reds (face, neck and upper chest turn red).

“Surveillance of hemorrhagic fever over the past 2 years has shown that some wild rodents and house rats in Jiangshan are carriers of epidemic hemorrhagic fever. There was also a confirmed case in March of this year [2016].”

The Jiangshan Center for Disease Control reminds the public that once infectious hemorrhagic fever is confirmed, only treatment of symptoms is possible. Therefore, prevention is of utmost importance. Residents should undertake rodent extermination with appropriate rodent prevention measures at home. When working outside, socks should be worn, pants legs and cuffs strapped down to prevent bites from mites and other parasites. When contacting dead rodents, wear personal protection and handle them in a sterile fashion. Pay attention to food hygiene and safe storage of food to avoid accidentally consuming food contaminated by rodents or being bitten or scratched by rodents. Wounds should be cleaned promptly with prompt immunization for hemorrhagic fever. Diagnosis and treatment in hospitals should be sought as quickly as possible once symptoms appear.

[byline: Cheng Hanlu]

communicated by:
ProMED-mail rapporteur Dan Silver

[The specific hantavirus involved in this case is not stated. In Asia, the 5 recognized hantaviruses, with their main rodent reservoir species, are: Hantaan virus (_Apodemus agrarius_), Amur virus (_A. peninsulae_), Thailand virus (_Bandicota indica_), Seoul virus (widely distributed worldwide in _Rattus norvegicus_), and Muju virus (_Myodes regulus_). Hantaan virus and Seoul virus cause cases of HFRS frequently in China. A bunyavirus, severe fever with thrombocytopenia syndrome (SFTS) virus is unlikely, as during the winter season, ticks, the vectors of this virus, will not be active.

Hantaan virus has several (up to 5 have been reported) subtypes and is transmitted by the field mouse _Apodemus agrarius_, whereas Seoul virus is less variable and is transmitted by the rat _Rattus norvegicus_. A 3rd hantavirus that causes HFRS, Muju virus, has been reported from the Korean peninsula. Since Zhejiang province is coastal and the case occurred in a rural area, either Hantaan or Seoul virus could be involved. It has been reported that during 1990-1997, there were recorded in China nearly 400 000 cases of HFRS, of which 1.6 per cent were fatal.

An image of _Apodemus agrarius_ can be seen at and of _Rattus norvegicus_ at,I_RB27.jpg.

A HealthMap/ProMED-mail map showing the location of Hunan province in eastern China can be accessed at
Maps of China can be accessed at and – Mod.TY

A HealthMap/ProMED-mail map can be accessed at:]

See Also

Hantavirus update – Asia: China (HN) RFI 20160101.3905948

Hantavirus infection – China: (Shandong) 20111231.3727

Hantavirus infection – Taiwan ex China (Inner Mongolia) 20080119.0249

Hantavirus infection – China: background (02) 20001126.2056
Hantavirus infection – China (Chongqing) (02) 20001121.2020
Hantavirus infection – China (Chongqing): alert 20001117.2008
Hantavirus infection – China: background 20001118.2015
Hantavirus infection – China (Chongqing): alert 20001117.2008

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ProMED-mail is a program of the International Society for Infectious Diseases

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