Hemorrhagic fever with renal syndrome: four decades of research.

Hemorrhagic fever with renal syndrome is an acute infectious illness characterized by fever, hemorrhage, and renal failure. Research over the last 40 years has led to the discovery and characterization of the causative viruses, detailed knowledge of the epidemiology of the disease, development of sensitive diagnostic assays, and improvements in patient management, which in turn have led to significant reductions in mortality. Considerable progress has also been made in elucidating the pathophysiology of the disease, although much more needs to be learned. Recent data show that hemorrhagic fever with renal syndrome has a wider geographic occurrence than previously thought. This syndrome must be considered in the differential diagnosis of acute renal failure of unknown cause.