This study presents data on 33,000 serum samples studied from July 1989 to
June 1996 in Finland, with 6,701 serologically confirmed Puumala virus (PUU
) infections. In addition, a PUU serosurvey of 8,000 sera from Finland is p
resented. On average, 957 PUU infections were detected annually. resulting
in an incidence of 19/100,000; mortality was less than 0.1%. The infection
mas most common in the district or Ita-Savo with an incidence of 90/100,000
. The seasonal peak was in November-December; however, the urban population
had its incidence peak in August. Local epidemics mirrored bank vole densi
ties, with 3-4-y cycles. Males contracted the disease at a mean age of 40 y
, females at 44 y (male:female ratio 2:1). The disease was relatively rare
in children and elderly people. The nationwide PUU antibody prevalence for
women entering Finnish maternity clinics was 3%, suggesting 5% for the tota
l population. The highest prevalences (7% for young women) were encountered
in eastern Finland. In the district with the highest clinical alert, appro
ximately 30% of all PUU infections a ere estimated to lead to clinical dise
ase with serological confirmation.