Hemorrhagic fever with renal syndrome: comparison of clinical course in Sweden and in the Western Soviet Union.

The severity of the clinical course in 355 Swedish and 603 Soviet patients with serologically confirmed hemorrhagic fever with renal syndrome (HFRS) was compared retrospectively. The overall frequency of hemorrhagic manifestations including also benign bleeding such as ecchymoses was higher among Soviet than among Swedish patients (37% vs. 10%). However, severe hemorrhagic complications (gastrointestinal and renal tract bleeding) were equally common in both countries. There were 2 fatal Soviet cases, whereas none of the Swedish patients died. We conclude that the clinical presentation of HFRS in Sweden and in the Western Soviet Union shows many similarities but there seems to be a higher frequency of life threatening complications among the patients in the Western USSR.