Clinical aspects of nephropathia epidemica (Puumala virus infection) in Europe: A review

Nephropathia epidemica (NE) is a prevalent zoonosis throughout Europe and i s caused by the Puumala type of hantavirus, The incidence of NE varies in a cyclic fashion, with peaks occurring every 3rd to 4th year, coinciding wit h peaks in vole populations. The clinical course of NE is generally milder than haemorrhagic fever with renal syndrome caused by hantaviruses in other parts of the world, Typically, NE has a sudden onset with fever, headache, backpain and gastrointestinal symptoms. However, severe complications, e.g , gastrointestinal haemorrhage, occur and fatal cases have been reported. R enal involvement is prominent and manifests as initial oliguria and later a s marked polyuria. Tests of renal function show pronounced glomerular and t ubular involvement. Vaccine against Puumala virus infection as well as spec ific treatment for NE are still lacking.