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There was an unexpected error. Message not sent. Hantaan virus HTNV was used as Sequences were submitted to GenBank under accession nos. Bulgarian sequences cluster with respective sequences retrieved from Apodemus flavicollis mouse tissues or from HFRS cases from central and southeastern Europe.
The genetic difference at nucleotide level among the Bulgarian strains is 1. Further studies on patients and small mammals in Bulgaria will elucidate the hantavirus epidemiology in this Balkan region.
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Figure Figure. We thank N. Kalvatchev and E. Papadimitriou for excellent technical assistance. Anna Papa and Iva Christova. A global perspective on hantavirus ecology, epidemiology, and disease. Groschup, A. Balkema-Buschmann, R. Klempa, B. Auste, D. The Study. Figure 1 Figure 1. Figure 2 Figure 2. Hemorrhagic fever with renal syndrome in the Dolenjska region of Slovenia—a year survey. Clin Infect Dis. Hantavirus infections and their prevention. Microbes Infect. Emerg Infect Dis. J Med Virol.
Central European Dobrava hantavirus isolate from striped field mouse, Apodemus agrarius. J Clin Microbiol. Serological divergence of Dobrava and Saaremaa hantaviruses: evidence for two distinct serotypes. Epidemiol Infect. PubMed Google Scholar. First case of infection with hantavirus Dobrava in Germany. First molecular identification of human Dobrava virus infection in Central Europe. London: Academic Press; Bulgaria is a country in southeastern Europe with 8 million inhabitants.
Both diseases have been subject to mandatory reporting since Diagnosis was based on clinical symptoms and serologic test results. We report 3 HFRS cases, 2 of which were fatal. Apart from serologic diagnosis, genetic detection of hantaviruses was also achieved, resulting in gaining insight into the genetic relationships of hantavirus sequences from Bulgaria with respective sequences retrieved in neighboring countries.
On September 2, , high fever, chills, headache, and myalgia developed in a year-old man who lived in Simitli town Blagoevgrad Province, southwestern Bulgaria. Five days after symptom onset, he was admitted to the regional hospital of Blagoevgrad. His condition rapidly deteriorated. Clinical signs were pharyngeal hyperemia, oliguria, and febrile toxic syndrome. The patient became hypotensive, reporting abdominal pain in the liver and spleen. Laboratory findings showed the following: leukocyte count An echograph showed enlarged kidneys, liver, spleen, and pancreas, and abdominal and bilateral pleural effusions.
Urine analysis disclosed proteinuria and microscopic hematuria. The patient was admitted with acute renal failure and multiple organ insufficiency. Despite multiple blood transfusions and hemodialysis, he died 14 days after hospitalization. On April 9, , a year-old man, a resident of Kirkovo village Kardjali Province, southern Bulgaria , was admitted to the regional hospital in Kardjali City with a 7-day history of fever, weakness, and myalgia in the lower extremities and a 4-day history of abdominal pain and diarrhea.
At admission, physical examination showed skin petechiae, subconjunctival and gingival hemorrhages, and oliguria.
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