The following background data are abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2] Primary references available on request.
Time and Place:
Although sporadic cases of Hantavirus infection have been reported in Germany since 1983, the disease became officially reportable only in 2001.
- During 2005 to 2007, highest rates were reported in Baden-Wuerttemberg, Bavaria, North Rhine Westphalia, and Lower Saxony.
- During 2001 to 2006, rates in Baden Wurttemberg were 0.55 to 1.12 per 100,000, as compared to national rates of 0.17 to 0.54 per 100,000
- Recent cases have been described in Wurzburg, Thuringia, Octenwald and Rhon.
- Risk factors for infection include occupational exposure (construction workers), residence <100 m from forested areas, and exposure to mice.
- Yearly rates are affected by bank vole habitats (beech forest, seed plants), vole food supply (beechnut mast), climate factors (winter and spring temperatures), and human population density (Baden-Wurttemberg, 2001 to 2007).
Hantavirus Infection in Germany – Incidence and rates per 100,000 (see following graph)
40 cases were reported during 1977 to 1992; 1,320 during 2001 to 2006.
– 1,487 cases were reported during 2001 to 2006, including 670 in Baden Wurttemberg.
– 853 cases were reported during October 2011 to April 2012, including 580 (68%) in Baden-Wurttemberg.
- The annual disease rate in Reutlingen is estimated at 6.5 per 100,000 (1995 to 1999).
1.83% in southern and western regions, and 0.8% in the eastern region.
0.9% of persons in Mecklenburg-Vorpommern (1994 to 1998)
6.7% of persons in Lower Bavaria, following an outbreak (2009 publication)
2.1% of forest workers in Baden Wurttemberg – 9% in Reutlingen and Tubingen (2001 publication)
8.2% of male and 15.6% of female forestry workers in Brandenburg – most toward Tula virus or Dobrava-Belgrade virus (2011 publication)
10% of hunters in Styria and Burgenland (2003 publication)
9.6% of captive monkeys in Gottingen (2006)
1988 – An American soldier acquired HFRS (nonfatal) in Germany.
2006 – A German traveler acquired HFRS (nonfatal) in Serbia.
2012 – A German tourist in Ireland was found to have Hantavirus infection.
- Puumala-like antigen is found in 12.2% of red bank voles (Myodes (Clethrionomys) glareolus) – the principal reservoir. Highest reservoir rates (22%) have been recorded in Ulm.
- Apodemus agrarius (striped field mouse) has been identified as a reservoir host of the Dobrava-Belgrade virus in three federal states.
- Tula virus has been identified in the Asian water vole (Arvicola amphibius), Microtus arvalis and M. agrestis.
- The muskrat (Ondatra zibethicus) has been implicated as a disease reservoir in northwestern Brandenburg and northeastern Saxony-Anhalt.
Puumala strain predominates, but antibody toward Hantaan strain is found in the south and east.
- Three cases of infection by Dobrava virus have been confirmed in a non-endemic focus in Northern Germany.
- The local reservoir is Apodemus agrarius.
- Infection by Tula virus has been confirmed in humans and rodents (Arvicola amphibius, Microtus arvalis and M. agrestis) in the northeast.
– A syndrome suggestive of American Hantavirus Respiratory Distress syndrome has been ascribed to local viral strains in Westfahlen.
1990 – An outbreak (16 cases, 0 fatal) of HFRS was reported among American soldiers in Germany.
2004 – An outbreak (38 cases) of Puumala virus infections in Lower Bavaria was associated with increased populations of bank voles (Myodes (Clethrionomys) glareolus).
2005 – An outbreak (89 cases) of Puumala virus infections was reported in Cologne, including 41 cases in the city center.
2007 – An outbreak (1,687 cases) of Puumala virus infection was reported, with most cases in rural areas in Baden-Wuerttemberg.
2010 – An outbreak (2,017 cases) was reported, including 736 cases in Baden-Wurttemberg during a 6-month period.
1. Berger SA. Infectious Diseases of Germany, 2012. 510 pages, 147 graphs, 2,68 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-germany/
2. Berger SA. Old-World Hantaviruses: Global Status, 2012. 64 pages, 49 graphs, 641 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/old-world-hantaviruses-global-status/