Nephropathia epidemica in Norway: antigen and antibodies in rodent reservoirs and antibodies in selected human populations.

Nephropathia epidemica (NE) antigen was detected by IFAT (indirect fluorescent antibody technique) in the lungs of 14 of 97 bank voles (Clethrionomys glareolus) collected in three endemic areas. The distribution of antigen positive voles within an endemic location was scattered. Antibodies to Korean hemorrhagic fever (KHF) virus antigens were detected by IFAT in 12 of 14 NE antigen positive bank voles and in 15 of 83 that were antigen negative. NE antigen positive voles exhibited higher antibody titres. Antibodies to KHF were demonstrated in sera from C. rutilus and C. rufocanus collected more than 200 km north of the distribution area for C. glareolus. It appears likely that these vole species can serve as virus vectors for NE cases occurring north of the bank vole area. NE antibodies cross-reacting with KHF virus seem to diminish with time after infection in some NE patients, while for others such cross-reacting antibodies were detected up to 12 years after the disease. Antibodies to KHF were detected in eight of 106 healthy forestry workers with no clinical history of NE. No serological cross-reactions were detected between NE/KHF antigens and representative Bunyaviridae present in Norway. NE/KHF-like viruses appear widespread in Norway, both within and outside of the distribution area of the bank vole.