Seoul virus, first identified in Korea in 1982,1 is one of multiple hantaviruses (family Bunyaviridae, genus Hantavirus) that cause hemorrhagic fever with renal syndrome (HFRS), mainly in Europe and Asia. Common clinical features include fever, myalgias, thrombocytopenia, leukocytosis, renal failure, and shock in the most severe cases.2 Elevation of liver enzymes is characteristic of HFRS caused by Seoul virus infection.3 Seoul virus is found worldwide and is transmitted by the brown Norway rat (Rattus norvegicus)1; humans can become infected and experience HFRS after exposure to aerosolized urine, droppings, or saliva from infected rodents. Only one confirmed case has been reported in the United States.4,5
Lee HW, Baek LJ, Johnson KM, 1982. Isolation of Hantaan virus, the etiologic agent of Korean hemorrhagic fever, from wild urban rats. J Infect Dis 146: 638–644.
Kim YS, Ahn C, Han JS, Kim S, Lee JS, Lee PW, 1995. Hemorrhagic fever with renal syndrome caused by the Seoul virus. Nephron 71: 419–427.
Glass GE, Watson AJ, LeDuc JW, Childs JE, 1994. Domestic cases of hemorrhagic fever with renal syndrome in the United States. Nephron 68: 48–51.
Woods C, Palekar R, Kim P, Blythe D, de Senarclens O, Feldman K, Farnon EC, Rollin PE, Albarino CG, Nichol ST, Smith M, 2009. Domestically acquired Seoul virus causing hemorrhagic fever with renal syndrome-Maryland, 2008. Clin Infect Dis 49: e109–e112.
Zhang YZ, Dong X, Li X, Ma C, Xiong HP, Yan GJ, Gao N, Jiang DM, Li MH, Li LP, Zou Y, Plyusnin A, 2009. Seoul virus and hantavirus disease, Shenyang, People's Republic of China. Emerg Infect Dis 15: 200–206.
LeDuc JW, 2007. Hantaviruses. Evans AS, Kaslow RA, eds. Viral Infections of Humans: Epidemiology and Control. New York: Plenum Publishing Corporation, 345–362.
Peters CJ, Mills JN, Spiropoulou C, Zaki SR, Rollin PE, 2006. Hantavirus infections. Guerrant LR, Walker DH, Weller PF, eds. Tropical Infectious Diseases: Principles, Pathogens and Practice. Philadelphia, PA: Elsevier Churchill Livingstone, 762–780.
Easterbrook JD, Kaplan JB, Vanasco NB, Reeves WK, Purcell RH, Kosoy MY, Glass GE, Watson J, Klein SL, 2007. A survey of zoonotic pathogens carried by Norway rats in Baltimore, Maryland, USA. Epidemiol Infect 135: 1192–1199.
Duchin JS, Koster FT, Peters CJ, Simpson GL, Tempest B, Zaki SR, Ksiazek TG, Rollin PE, Nichol S, Umland ET et al., 1994. Hantavirus pulmonary syndrome: a clinical description of 17 patients with a newly recognized disease. The Hantavirus Study Group. N Engl J Med 330: 949–955.
Khan AS, Khabbaz RF, Armstrong LR, Holman RC, Bauer SP, Graber J, Strine T, Miller G, Reef S, Tappero J, Rollin PE, Nichol ST, Zaki SR, Bryan RT, Chapman LE, Peters CJ, Ksiazek TG, 1996. Hantavirus pulmonary syndrome: the first 100 US cases. J Infect Dis 173: 1297–1303.
Easterbrook JD, Shields T, Klein SL, Glass GE, 2005. Norway rat population in Baltimore, Maryland, 2004. Vector Borne Zoonotic Dis 5: 296–299.
Zeier M, Handermann M, Bahr U, Rensch B, Muller S, Kehm R, Muranyi W, Darai G, 2005. New ecological aspects of hantavirus infection: a change of a paradigm and a challenge of prevention–a review. Virus Genes 30: 157–180.
Mills JN, Corneli A, Young JC, Garrison LE, Khan AS, Ksiazek TG, 2002. Hantavirus pulmonary syndrome–United States: updated recommendations for risk reduction. Centers for Disease Control and Prevention. MMWR Recomm Rep 51: 1–12.
Farnon EC, Rollin PE, 2009. Viral hemorrhagic fevers. Health Information for International Travel 2010—The Yellow Book. Atlanta, GA: U.S. Department of Health and Human Services, CDC.