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Selected Publication:
Fabian, E.
Klinische Präsentation von Puumalavirusinfektionen in der Steiermark im "Peakjahr" 2012 verglichen mit 2007-2011
[ Diplomarbeit ] Medical University of Graz; 2013. pp. 215
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- Authors Med Uni Graz:
- Advisor:
- Zollner-Schwetz Ines
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- Abstract:
- In 2012, an outbreak of hantavirus infections was observed in Styria. Never before, so many cases of Nephropathia epidemica (NE) have been recorded in Austria. The aim of this study was to investigate differences in epidemiology, clinical presentation, laboratory results, treatment and outcome between the peak year 2012 and the ¿normal¿ years 2007-2011. Therefore a retrospective analysis of clinical data was performed. Inclusion criteria were confirmed diagnosis by Reagena® point of care test and/or ELISA testing by the Medical University of Vienna, Department of Virology, age older than 18 years, and hospitalization or consultation of a physician at the Department of Internal Medicine, Medical University of Graz. The period of investigation was January, 1st, 2007 until December 31st, 2012. Group 1 (2007-2011) included 40 patients, group 2 (2012) was formed out of 42 patients. In 2012, patients were diagnosed significantly faster than in the past years. Furthermore, worsening of general condition and arthromyalgia were significantly more frequent in group 1 (2007-2011) than in group 2. In contrast, in 2012 more patients were found to suffer from back pains than in 2007-2011. Petechial bleeding were found to be more frequent in in 2007-2011. For laboratory results, first measured levels of haemoglobin, haematocrit and ALT were significantly higher in group 1. Concerning the maximum/minimum pathologic levels of laboratory results, we found tendencies showing lower levels of thrombocytes in group 1 as well as higher levels of CRP and urea in the years 2007-2011. The AST, in contrary, showed a tendency of higher levels in 2012. Patients needed dialysis significantly more often in 2007-2011 than in 2012. Clinical presentation of hantavirus disease shows slight variations in the different years, as patients suffered more frequently from arthomyalgia in 2007-2011 and from lumbago in 2012. Possible explanations for a faster diagnosis and the low rate of patients being put on dialysis in 2012 are a heightened public awareness of physicians as well as patients, leading to faster diagnosis and treatment making dialysis unnecessary, or that course of illness was less severe in 2012. The latter presumption is supported by the fact that in 2012, less patients developed petechial bleeding, suggesting a less severe course of illness.