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Published Date: 2011-12-31 22:11:38
Subject: PRO/AH/EDR> Hantavirus infection - China: (Shandong)
Archive Number: 20111231.3728

HANTAVIRUS INFECTION - CHINA (SHANDONG)
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Date: Sat 31 Dec 2011
Source: Xinhua News [edited]
http://news.xinhuanet.com/english/health/2011-12/31/c_131337160.htm

Rats are blamed for spreading the virus that caused 24 confirmed
deaths this year in Shandong province from viral hemorrhagic fever
(VHF), according to figures released by the provincial health bureau
Saturday[31 Dec 2011].

The bureau said most of the cases were recorded after October, and the
number of deaths are 11 more than last year [2010]. The bureau
recorded a total of 938 VHF infection cases this year [2011], which is
1.88 per cent lower than that of 2010. Among the 24 fatal cases, 13
were reported in Qingdao, a port city in Shandong.

Fan Tianli, a doctor at the Qingdao Hospital of Infectious Diseases,
said the VHF patients were all from rural areas. They had either
contact with infected rats, eaten food contaminated by rats, or been
stung [bitten] by mites that had also bitten rats, before showing
symptoms of fever and bleeding disorders.

The provincial health bureau has organized vaccinations in the
epidemic-affected areas and mobilized campaigns to kill rats.

The bureau's figures showed that 1.5 million people in Shandong have
received VHF vaccinations since 2008, which has been attributed to
effectively curbing the mass spread of the disease.

Outbreaks of VHF had been reported in the 1980s and 1990s in the
province, when more than 10 000 people were infected on average each
year, but no exact number of deaths was recorded.

Disease control experts say the epidemic is likely to break out in
winter and spring when rats lack food in the wild and turn to rural
homes and garbage heaps.

[Editor: Xiong Tong]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[The specific hantavirus involved in these hemorrhagic fever cases is
not given, but presumably is Hantaan or Seoul virus, or both. In the
published literature, the clinical disease is usually referred to as
hantavirus [infection] with renal syndrome (HFRS). In ProMED archive
no. 20001126.2056, Mod.CP commented that there are 2 common
hantaviruses that cause HFRS in East Asia (China), which are regarded
as distinct virus species, Hantaan virus and Seoul virus. Hantaan
virus has several (up to 5 now according to the article cited)
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 Shandong province
is coastal, and the cases are occurring in rural areas, either virus
could be involved. The report cited states that during 1990 - 1997,
there were recorded in China nearly 400 000 cases of HFRS, of which
1.6 percent were fatal.

An image of _Apodemus agrarius_ can be seen at
http://www.hlasek.com/foto/apodemus_agrarius_11035.jpg
and of _Rattus norveigicus_ at
http://www.discoverlife.org/im/I_RB/0000/320/Rattus_norvegicus,I_RB27.jpg

A HealthMap/ProMED-mail map showing the location of Shandong province
can be accessed at http://healthmap.org/r/1AYk. - Mod. TY]

See Also