Hemorrhagic fever with renal syndrome in the Dolenjska region of Slovenia - A 10-year survey

This report describes the first investigation of clinical findings for a la rger series of patients with hemorrhagic fever with renal syndrome (HFRS) w ho were infected with Dobrava virus. From 1985 to 1995, 38 patients with se rologically confirmed HFRS were hospitalized at the regional hospital in No vo mesto in the Dolenjska region of Slovenia. On the basis of results of se rological examination, 24 patients had Dobrava virus infection, and 14 pati ents had Puumala virus infection. Complete clinical data were available for 31 patients. Eleven patients underwent hemodialysis for treatment of acute oliguric or anuric renal failure. Four patients, all infested by Dobrava v irus, had signs of shock and severe bleeding. Three severely ill Dobrava vi rus-infected patients died of hemorrhagic complications. We have demonstrat ed that Dobrava and Puumala viruses coexist in a single region of endemicit y and are capable of causing HFRS with significant differences in severity.