Background. Endemic outbreaks of hantaviruses pose a critical public health threat worldwide. Hantaan orthohantavirus (HTNV) causes hemorrhagic fever with renal syndrome (HFRS) in humans. Using comparative genomic analyses of partial and nearly complete sequences of HTNV from humans and rodents, we were able to localize, with limitations, the putative infection locations for HFRS patients. Partial sequences might not reflect precise phylogenetic positions over the whole-genome sequences; finer granularity of rodent sampling reflects more precisely the circulation of strains. Methods. Five HFRS specimens were collected. Epidemiological surveys were conducted with the patients during hospitalization. We conducted active surveillance at suspected HFRS outbreak areas. We performed multiplex polymerase chain reaction-based next-generation sequencing to obtain the genomic sequence of HTNV from patients and rodents. The phylogeny of human- and rodent-derived HTNV was generated using the maximum likelihood method. For phylogeographic analyses, the tracing of HTNV genomes from HFRS patients was defined on the bases of epidemiological interviews, phylogenetic patterns of the viruses, and geographic locations of HTNV-positive rodents. Results. The phylogeographic analyses demonstrated genetic clusters of HTNV strains from clinical specimens, with HTNV circulating in rodents at suspected sites of patient infections. Conclusions. This study demonstrates a major shift in molecular epidemiological surveillance of HTNV. Active targeted surveillance was performed at sites of suspected infections, allowing the high-resolution phylogeographic analysis to reveal the site of emergence of HTNV. We posit that this novel approach will make it possible to identify infectious sources, perform disease risk assessment, and implement preparedness against vector-borne viruses.
Bibliographical noteFunding Information:
the National Research Foundation of Korea (NRF) funded by the Ministry of Science and Information and Communication Technology (ICT) (NRF-2017M3A9E4061992) and the Armed Forces Health Surveillance Branch, Global Emerging Infections Surveillance and Response System (P0025-15-ME).
Acknowledgments. The authors thank Dr Nicholas Di Paola for his contribution to the editing of the manuscript. Financial support. This work was supported by the Agency for Defense Development (UD160022ID); the Research Program To Solve Social Issues of
© The Author(s) 2019.
- Active targeted surveillance
- Hemorrhagic fever with renal syndrome
- Next-generation sequencing
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases