PDF(Pubmed)
Abstract：
UNASSIGNED: In the United States (U.S.), hantavirus pulmonary syndrome (HPS) and non-HPS hantavirus infection are nationally notifiable diseases. Criteria for identifying human cases are based on clinical symptoms (HPS or non-HPS) and acute diagnostic results (IgM+, rising IgG+ titers, RT-PCR+, or immunohistochemistry (IHC)+). Here we provide an overview of diagnostic testing and summarize human Hantavirus disease occurrence and genotype distribution in the U.S. from 2008 to 2020.
UNASSIGNED: Epidemiological data from the national hantavirus registry was merged with laboratory diagnostic testing results performed at the CDC. Residual hantavirus-positive specimens were sequenced, and the available epidemiological and genetic data sets were linked to conduct a genomic epidemiological study of hantavirus disease in the U.S.
UNASSIGNED: From 1993 to 2020, 833 human hantavirus cases have been identified, and from 2008 to 2020, 335 human cases have occurred. Among New World (NW) hantavirus cases detected at the CDC diagnostic laboratory (representing 29.2% of total cases), most (85.0%) were detected during acute disease, however, some convalescent cases were detected in states not traditionally associated with hantavirus infections (Connecticut, Missouri, New Jersey, Pennsylvania, Tennessee, and Vermont). From 1993 to 2020, 94.9% (745/785) of U.S. hantaviruses cases were detected west of the Mississippi with 45.7% (359/785) in the Four Corners region of the U.S. From 2008 to 2020, 67.7% of NW hantavirus cases were detected between the months of March and August. Sequencing of RT-PCR-positive cases demonstrates a geographic separation of Orthohantavirus sinnombreense species [Sin Nombre virus (SNV), New York virus, and Monongahela virus]; however, there is a large gap in viral sequence data from the Northwestern and Central U.S. Finally, these data indicate that commercial IgM assays are not concordant with CDC-developed assays, and that \"concordant positive\" (i.e., commercial IgM+ and CDC IgM+ results) specimens exhibit clinical characteristics of hantavirus disease.
UNASSIGNED: Hantaviral disease is broadly distributed in the contiguous U.S, viral variants are localised to specific geographic regions, and hantaviral disease infrequently detected in most Southeastern states. Discordant results between two diagnostic detection methods highlight the need for an improved standardised testing plan in the U.S. Hantavirus surveillance and detection will continue to improve with clearly defined, systematic reporting methods, as well as explicit guidelines for clinical characterization and diagnostic criteria.
UNASSIGNED: This work was funded by core funds provided to the Viral Special Pathogens Branch at CDC.
UNASSIGNED: Epidemiological data from the national hantavirus registry was merged with laboratory diagnostic testing results performed at the CDC. Residual hantavirus-positive specimens were sequenced, and the available epidemiological and genetic data sets were linked to conduct a genomic epidemiological study of hantavirus disease in the U.S.
UNASSIGNED: From 1993 to 2020, 833 human hantavirus cases have been identified, and from 2008 to 2020, 335 human cases have occurred. Among New World (NW) hantavirus cases detected at the CDC diagnostic laboratory (representing 29.2% of total cases), most (85.0%) were detected during acute disease, however, some convalescent cases were detected in states not traditionally associated with hantavirus infections (Connecticut, Missouri, New Jersey, Pennsylvania, Tennessee, and Vermont). From 1993 to 2020, 94.9% (745/785) of U.S. hantaviruses cases were detected west of the Mississippi with 45.7% (359/785) in the Four Corners region of the U.S. From 2008 to 2020, 67.7% of NW hantavirus cases were detected between the months of March and August. Sequencing of RT-PCR-positive cases demonstrates a geographic separation of Orthohantavirus sinnombreense species [Sin Nombre virus (SNV), New York virus, and Monongahela virus]; however, there is a large gap in viral sequence data from the Northwestern and Central U.S. Finally, these data indicate that commercial IgM assays are not concordant with CDC-developed assays, and that \"concordant positive\" (i.e., commercial IgM+ and CDC IgM+ results) specimens exhibit clinical characteristics of hantavirus disease.
UNASSIGNED: Hantaviral disease is broadly distributed in the contiguous U.S, viral variants are localised to specific geographic regions, and hantaviral disease infrequently detected in most Southeastern states. Discordant results between two diagnostic detection methods highlight the need for an improved standardised testing plan in the U.S. Hantavirus surveillance and detection will continue to improve with clearly defined, systematic reporting methods, as well as explicit guidelines for clinical characterization and diagnostic criteria.
UNASSIGNED: This work was funded by core funds provided to the Viral Special Pathogens Branch at CDC.
摘要：
■在美国（美国），汉坦病毒肺综合征（HPS）和非HPS汉坦病毒感染是国家法定报告的疾病。识别人类病例的标准基于临床症状（HPS或非HPS）和急性诊断结果（IgM，IgG+滴度上升，RT-PCR+,或免疫组织化学（IHC）+）。在这里，我们提供了诊断测试的概述，并总结了2008年至2020年美国汉坦病毒病的发生和基因型分布。
■国家汉坦病毒登记处的流行病学数据与CDC进行的实验室诊断测试结果合并。对残留的汉坦病毒阳性标本进行测序，和可用的流行病学和遗传数据集进行了汉坦病毒病的基因组流行病学研究在美国
■从1993年到2020年，已经确定了833例人类汉坦病毒病例，从2008年到2020年，发生了335例人类病例。在CDC诊断实验室检测到的新世界（NW）汉坦病毒病例中（占总病例的29.2％），大多数(85.0%)是在急性疾病期间检测到的，然而,在传统上与汉坦病毒感染无关的州检测到一些恢复期病例(康涅狄格州，密苏里州,新泽西,宾夕法尼亚,田纳西州,和佛蒙特州）。从1993年到2020年，在密西西比州以西发现了94.9％（745/785）的美国汉坦病毒病例，在美国四角地区发现了45.7％（359/785）。从2008年到2020年，在3月至8月之间检测到67.7％的NW汉坦病毒病例。对RT-PCR阳性病例的测序表明，正坦病毒synnombreense种[SinNombre病毒（SNV），纽约病毒,和莫农加希拉病毒]；然而，美国西北部和中部的病毒序列数据存在很大差距，这些数据表明，商业IgM测定与CDC开发的测定不一致，和“一致阳性”(即，商业IgM和CDCIgM结果）标本表现出汉坦病毒病的临床特征。
■汉塔病毒病广泛分布在美国病毒变体被定位到特定的地理区域，在大多数东南州很少发现汉坦病毒病。两种诊断检测方法之间的不一致结果凸显了美国汉坦病毒监测和检测将继续改进的标准化测试计划的必要性，系统报告方法，以及临床特征和诊断标准的明确指南。
■这项工作由提供给CDC病毒特殊病原体分支的核心资金资助。
■国家汉坦病毒登记处的流行病学数据与CDC进行的实验室诊断测试结果合并。对残留的汉坦病毒阳性标本进行测序，和可用的流行病学和遗传数据集进行了汉坦病毒病的基因组流行病学研究在美国
■从1993年到2020年，已经确定了833例人类汉坦病毒病例，从2008年到2020年，发生了335例人类病例。在CDC诊断实验室检测到的新世界（NW）汉坦病毒病例中（占总病例的29.2％），大多数(85.0%)是在急性疾病期间检测到的，然而,在传统上与汉坦病毒感染无关的州检测到一些恢复期病例(康涅狄格州，密苏里州,新泽西,宾夕法尼亚,田纳西州,和佛蒙特州）。从1993年到2020年，在密西西比州以西发现了94.9％（745/785）的美国汉坦病毒病例，在美国四角地区发现了45.7％（359/785）。从2008年到2020年，在3月至8月之间检测到67.7％的NW汉坦病毒病例。对RT-PCR阳性病例的测序表明，正坦病毒synnombreense种[SinNombre病毒（SNV），纽约病毒,和莫农加希拉病毒]；然而，美国西北部和中部的病毒序列数据存在很大差距，这些数据表明，商业IgM测定与CDC开发的测定不一致，和“一致阳性”(即，商业IgM和CDCIgM结果）标本表现出汉坦病毒病的临床特征。
■汉塔病毒病广泛分布在美国病毒变体被定位到特定的地理区域，在大多数东南州很少发现汉坦病毒病。两种诊断检测方法之间的不一致结果凸显了美国汉坦病毒监测和检测将继续改进的标准化测试计划的必要性，系统报告方法，以及临床特征和诊断标准的明确指南。
■这项工作由提供给CDC病毒特殊病原体分支的核心资金资助。
