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Epidemic Hemorrhagic Fever with Renal Syndrome in Yugoslavia, 1986

Ana Gligi, Mirceta Obradovi, Rade Stojanovi, Novica Vujoevi, Angelina Ovcari, Marina Fruic, Clarence J. Gibbs, Jr., Charles H. Calisher AND D. Carleton Gajdusek

An epidemic of hemorrhagic fever with renal syndrome (HFRS) occurred in Yugoslavia May–November 1986; all Republics and Provinces were involved. Serum samples were received from 260 of 276 persons with symptoms clinically compatible with a diagnosis of HFRS. Presumptive infection with a hantavirus was determined serologically for 161 of these. Many patients with serious clinical pictures, including severe renal insufficiency and shock, were hospitalized; 11 died. Indirect fluorescent antibody tests with antigens of 4 hantaviruses (Hantaan, Fojnica, Puumala, and the Vranica strain of Puumala virus) showed that > 1 serotype was circulating during this epidemic. Hantavirus antigens were detected in the lungs of 86 of 302 (28.5%) wild-caught small mammals.