Clinical Updates
6 October 2011
Haemorrhagic fever with renal syndrome (HFRS) in Russia
In recent months, the Russian Federation has reported an increased number of cases of haemorrhagic fever with renal syndrome (HFRS). As of 27 September, 357 cases, including three deaths, have been reported since the beginning of 2011 in Udmurt (Udmurtskaya) Republic [1]. This compares with 281 cases reported during the entire year of 2010 [2], and is more than a five-fold increase in incidence. Nearly two-thirds of these cases have been reported in Izhevsk, the capital city of Udmurt Republic [1]. Cases have occurred in suburban areas, as well as in people undertaking activities in the forest environment e.g. gathering mushrooms and berries.
Other areas of Russia have also reported cases in 2011: Samara (Samarskaya) province, 56 cases and 20 deaths [3,4]; the Republic of Bashkortostan (309 cases); the Republic of Tatarstan (102) and in Krasnodar city, Southern Federal district (three cases) [5-7].
It is expected that additional cases will continue to occur as the usual peak season is in the summer-autumn period, from June to November [2].
The unusually high number of cases is thought to be due to an increase in the rodent population, the main reservoir for hantavirus which is the cause of HFRS [1].
Haemorrhagic fever with renal syndrome (HFRS)
Hantaviruses are a group of viruses belonging to the family Bunyaviridae. Rodents are the reservoir hosts. Humans can become infected with hantaviruses when they inhale virus particles from rodent excreta (urine, faeces or saliva).
Hantaviruses cause two major clinical syndromes, although there can be a spectrum of severity: HFRS and hantavirus pulmonary syndrome (HPS). Puumala hantavirus is the most common hantavirus infection in Europe and usually causes a mild form of HFRS.
HFRS is characterised by fever, headache, gastrointestinal symptoms and renal dysfunction. No specific treatment is available and most cases resolve spontaneously over two to three weeks.
Advice for travellers
The risk of HFRS in most travellers is low. However, those who may be in close proximity with rodents, such as travellers undertaking activities in rural areas, e.g. camping or hiking should take the following precautions:
- Wash hands thoroughly before eating.
- Avoid direct contact with rodents or their excreta.
- Inside areas frequented by rodents should be moistened and cleaned with disinfectant and then vacuumed whilst wearing a mask and gloves.
- Take measures to avoid attracting rodents, such as keeping food covered and not storing firewood inside.
Information on other specific health risks for travellers to Russia can be found on the NaTHNaC Country Information Page.
References
1. Rospotrebnadzor. Press release. Haemorrhagic fever with renal syndrome. Tips for gardeners. 27 September 2011. [In Russian]. [Accessed 6 October 2011]. Available at:
http://18.rospotrebnadzor.ru/epidemiologic_situation/72336/
2. Rospotrebnadzor. Press release. Haemorrhagic fever with renal syndrome in the Udmurt Republic. 22 August 2011. [In Russian]. [Accessed 6 October 2011]. Available at:
http://18.rospotrebnadzor.ru/epidemiologic_situation/51554/
3. Rospotrebnadzor.. Press release. The epidemiological situation in the Samara region in January-August 2011. 14 September 2011. [In Russian]. [Accessed 6 October 2011]. Available at: http://63.rospotrebnadzor.ru/directions/nadzor/epid/71409/
4. Rospotrebnadzor. Press release. On the epidemiology of haemorrhagic fever with renal syndrome (HFRS) in the Samara region and prevention measures. 12 September 2011. [In Russian]. [Accessed 6 October 2011]. Available at:
http://63.rospotrebnadzor.ru/s/63/files/directions/nadzor/epid/
5. Rospotrebnadzor. Press release.The situation on the incidence of haemorrhagic fever with renal syndrome in the Republic of Bashkortostan in the last 7 months of 2011. 15 September 2011. [In Russian]. [Accessed 6 October 2011]. Available at:
http://02.rospotrebnadzor.ru/epidemiologic_situation/glps/697
6. Rospotrebnadzor. Press release. About haemorrhagic fever with renal syndrome in the Republic of Tatarstan and its prevention measures. 16 August 2011. [In Russian]. [Accessed 6 October 2011]. Available at:
http://16.rospotrebnadzor.ru/directions/epidnadzor/69330/
7. Rospotrebnadzor. Press release. Infectious diseases in the Krasnodar Territory in the last 7 months of 2011. 16 August 2011. [In Russian]. [Accessed 6 October 2011]. Available at:
http://www.23.rospotrebnadzor.ru/epidemiologic_situation/69
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