Hantavirus Infection during Pregnancy
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REVIEW
Hantavirus Infection during Pregnancy Deng-Hui Lu1 • Hong Jiang1 • Jian-Qi Lian1 Received: 25 January 2020 / Accepted: 7 August 2020 Ó Wuhan Institute of Virology, CAS 2020
Abstract Hantavirus infection is a global health challenge, causing widespread public concern. In recent years, cases of hantavirus infection in pregnant women have been reported in many countries. The infected pregnant women and their fetuses appear to have more severe clinical symptoms and worse clinical outcomes. Hence, to study the prevalence of hantavirus infection in pregnant women, this study will focus on the epidemiological distribution of the virus, different virus species penetrating the placental barrier, and factors affecting the incidence and clinical outcome of the infection in pregnant women and their fetuses. In addition, this review will also discuss the diagnostic tools and treatments for pregnant patients and provide an overview of the relevant future research. Keywords Hantavirus Pregnancy Hantaan virus (HTNV) HPS HFRS
Introduction Hantaviruses are negative-sense, single-stranded, enveloped RNA viruses belonging to the family Hantaviridae. Since the first hantavirus was isolated in 1978, many countries and regions have reported a series of hantavirus infections continuously (Lee et al. 1978). Hantaviruses cause two clinical syndromes in humans; designated hemorrhagic fever with renal syndrome (HFRS), and hantavirus cardiopulmonary syndrome (HPS). HFRS mostly occur in Eurasian countries, caused by Hantaan virus (HTNV), Seoul virus (SEOV), Puumala virus (PUUV) and Dobrava virus (DOBV) (Avsic-Zupanc et al. 2019). The clinical features of HFRS are severe systemic manifestations, including fever, hemorrhage and acute renal failure. HPS is mainly a group of syndromes with respiratory system involvement, caused by Sin Nombre virus (SNV), Andes virus, and other viruses. The leading cause of death in HPS is acute progressive non-cardiogenic pulmonary edema and respiratory failure (Peters et al. 1999).
Hantaviruses are zoonotic viruses that can be carried by small rodents. Approximately 20,000 cases of hantavirusrelated diseases occur worldwide each year (Jiang et al. 2017). Furthermore, there is a clear indication that the incidence rate increases every year (Jiang et al. 2017; Watson et al. 2014). The mortality rates reported are 12% for HFRS and 60% for HPS (Zhang et al. 2010; Jonsson et al. 2010). Pregnant women are afflicted by inhalation of host secretions and excretions carrying the virus, or by exposure to rodent carriers (Pedrosa and Cardoso 2011). However, the cases of women infected with hantavirus during pregnancy are rarely reported even in areas where hantaviruses are concentrated, which poses certain difficulties for subsequent research and clinical management. Here, in order to contribute to the diagnosis, treatment, and prognosis prediction, we reviewed past cases of hantavirus infections in pregnant women.
Hantavir
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