A serotypic study of hemorrhagic fever with renal syndrome in rural China.

Apodemus agrarius was trapped in the fields and Rattus norvegicus was trapped within the houses in the villages of Jiande County, a region in the Zhejiang Province of China endemic for hemorrhagic fever with renal syndrome (HFRS). Antibodies to hantaviruses were detected in three (16.7%) of 18 A. agrarius and 12 (13.5%) of 89 R. norvegicus, whereas hantavirus antigens were detected in the lung tissues of four (22.2%) of 18 and nine (10.1%) of 89 of these rodents, respectively. Three hantaviruses, one from A. agrarius and two from R. norvegicus, were isolated and found to be antigenically similar to Hantaan and Seoul serotype viruses, respectively. A serologic study of 437 clinically defined HFRS patients conducted in Jiande County in 1988 revealed that the ratio of Hantaan (72.5%) to Seoul (26.8%) serotype virus infections was 2.7:1. Two epidemic seasons were found, with a major peak in November and a minor peak in June, and both were associated with Hantaan serotype virus infections that coincided with two seasonal peaks of the A. agrarius population and local agricultural activities in the fields. Seoul serotype virus infections occurred with a small peak during the months of December through May, in which in-house activities were dominant. All data suggested that Jiande County was an area endemic for HFRS, predominantly of the Hantaan virus serotype, combined with Seoul serotype virus infections.