Pinhal virus, a new arenavirus isolated from calomys tener in Brazil

Arenavirus Sabiá was originally isolated from a fatal human infection in Brazil, and after the occurrence of the second fatal human case in São Paulo state, epidemiologic and virologic studies were performed in the area where the patient lived, aiming at the identification of the Sabiá natural rodent reservoir. A broadly cross-reactive enzyme-linked immunosorbent assay (ELISA) was used to screen for antibody-positive samples. Antibodies to arenavirus were detected in two of the 55 samples of Calomys tener, and from these results, samples of rodents were analyzed by a broad RT-PCR assay. RT-PCR amplification detected arenavirus sequences in five of the 55 C. tener samples, and sequencing showed that this virus is a distinct form of Sabiá virus. Thus, we describe here the evidence for the circulation of a new arenavirus in Brazil (proposed name Pinhal virus) and its genetic characterization compared to other arenaviruses. This study also suggests C. tener as a probable rodent reservoir for this virus and associates this new virus with the lineage C of New World arenaviruses. Although we have defined some characteristics of this virus, so far, there is no evidence of its involvement in human disease.

[Emerging viral zoonoses: hantavirus infections]. / Zoonosis virales emergentes: las infecciones por hantavirus.

Hantaviruses are rodent-borne agents belonging to the Bunyaviridae family. These viruses, which are found throughout Europe, Asia and the Americas, are maintained by different species of rodents, in which they produce chronic, inapparent infections. Humans become infected through contact with urine, saliva or faeces from infected rodents, mainly via the aerosol route. In humans, clinical disease occurs in the form of two major syndromes: haemorrhagic fever with renal syndrome (HFRS) or hantavirus pulmonary syndrome (HPS). Haemorrhagic fever with renal syndrome mainly occurs in Europe and Asia and HPS has only ever been reported in the Americas. Person-to-person transmission of hantaviruses, although uncommon, was described during an outbreak of HPS in southern Argentina. Most epidemics of HFRS and HPS occur in areas with large populations of rodents that have a relatively high prevalence of infection.

[Isolation of lymphocytic choriomeningitis virus from human individuals]. / Aislamiento del virus de la coriomeningitis linfocitaria de seres humanos.

The activity of lymphocytic choriomeningitis virus (LCMv) in Argentina has been previously reported on the basis of serological evidence in rodents and humans and the isolation of only one strain of LCMv from a Mus domesticus captured in the province of Córdoba. The aim of this paper was to register patients with serological diagnosis of LCM, to isolate and to identify human strains of LCMv in Argentina. During the last 19 years, 15 cases were diagnosed as LCM by immunoflourescent indirect assay (IFI) and enzyme-linked immunosorbent assay (ELISA) but when neutralizing assay (NT) was incorporated, eight cases were classified as confirmed, three as probable and four as negative. The geographic distribution of the cases included three provinces: Córdoba, Buenos Aires and Santa Fe. Viral isolation was attempted in five patients classified as confirmed and only two resulted positive (P5226 and P8573). They were identified as LCMv by IFI and NT. The coexistence of LCMv with other arenaviruses, such as Junin and Oliveros viruses, in the same area, raises the probability of interactions between them, which could modify the virulence and/or pathogenicity for humans associated to genomic changes. Future studies of antigenic, genomic and virulence variability of different Argentine strains of LCMv, as well as the systematic search for human infection, will contribute to define the importance of this viral agent in our country and to implement control measures.

Aislamiento del virus de la coriomeningitis linfocitaria de seres humanos. / [Isolation of lymphocytic choriomeningitis virus from human individuals]

The activity of lymphocytic choriomeningitis virus (LCMv) in Argentina has been previously reported on the basis of serological evidence in rodents and humans and the isolation of only one strain of LCMv from a Mus domesticus captured in the province of Córdoba. The aim of this paper was to register patients with serological diagnosis of LCM, to isolate and to identify human strains of LCMv in Argentina. During the last 19 years, 15 cases were diagnosed as LCM by immunoflourescent indirect assay (IFI) and enzyme-linked immunosorbent assay (ELISA) but when neutralizing assay (NT) was incorporated, eight cases were classified as confirmed, three as probable and four as negative. The geographic distribution of the cases included three provinces: Córdoba, Buenos Aires and Santa Fe. Viral isolation was attempted in five patients classified as confirmed and only two resulted positive (P5226 and P8573). They were identified as LCMv by IFI and NT. The coexistence of LCMv with other arenaviruses, such as Junin and Oliveros viruses, in the same area, raises the probability of interactions between them, which could modify the virulence and/or pathogenicity for humans associated to genomic changes. Future studies of antigenic, genomic and virulence variability of different Argentine strains of LCMv, as well as the systematic search for human infection, will contribute to define the importance of this viral agent in our country and to implement control measures.

Genetic diversity of the Junin virus in Argentina: geographic and temporal patterns.

RNA was purified from 39 strains of cell-cultured Junin virus (JUN) from central Argentina, which included both human- and rodent-derived isolates (a total of 26 and 13, respectively), as well as from 2 laboratory JUN strains, XJ Cl3 and XJ #44. JUN-specific primers were used to amplify a 511-nucleotide (nt) fragment of the nucleocapsid protein gene and a 495-nt fragment of the glycoprotein 1 (GP1) gene. Genetic diversity among JUN strains studied was up to 13% at the nt level and up to 9% at the amino acid (aa) level for the GP1 gene and up to 9% (nt) and 4% (aa) for the NP gene. Phylogenetic analyses of both genes revealed three distinct clades. The first clade was composed of the JUN strains from the center of the endemic area and included the majority of JUN strains analyzed in the current study. The second clade contained 4 JUN strains isolated between 1963 and 1971 from Cordoba Province, the western-most edge of the known endemic area. The third clade contained 4 JUN strains that originated from Calomys musculinus trapped in Zarate, the northeastern edge of the known endemic area. Certain JUN sequences, which were obtained from GenBank and identified as XJ, XJ #44, and Candid #1 strains, appeared to form a separate clade. Over 400 nt of the GP1 and GP2 genes were additionally sequenced for 7 JUN strains derived from patients with different clinical presentations and outcomes of Argentine hemorrhagic fever. Analysis of the corresponding aa sequences did not allow us to attribute any particular genetic marker to the changing severity or clinical form of the human disease.

Hantavirus reservoir hosts associated with peridomestic habitats in Argentina.

Five species of sigmodontine rodents have been identified in Argentina as the putative reservoirs of six circulating hantavirus genotypes. Two species of Oligoryzomys are associated with the genotypes causing hantavirus pulmonary syndrome, Oligoryzomys flavescens for Lechiguanas and O. longicaudatus for Andes and Oran genotypes. Reports of human cases of hantavirus pulmonary syndrome prompted rodent trapping (2,299 rodents of 32 species during 27,780 trap nights) at potential exposure sites in three disease-endemic areas. Antibody reactive to Sin Nombre virus was found in six species, including the known hantavirus reservoir species. Risk for peridomestic exposure to host species that carry recognized human pathogens was high in all three major disease-endemic areas.

Hantavirus infection in children in Argentina.

Clinical hantavirus infection was diagnosed in five Argentine children ages 5 to 11 years by immunoglobulin M (IgM)- capture enzyme-linked immunosorbent assay using Sin Nombre virus (SNV) antigens. Death in three of the children was associated with absence of detectable IgG to SNV antigens. An additional two cases in healthy children were studied: one, a breast-fed 15-month-old whose mother died of suspected hantavirus pulmonary syndrome (HPS) 8 months previously, had hantavirus IgG (> 1:6400); a second, whose mother survived HPS during month three of pregnancy, apparently had maternal antibodies no longer detectable 1 year after birth.

Genetic diversity and epidemiology of hantaviruses in Argentina.

Phylogenetic analysis of a 292-nucleotide (nt) fragment of the hantavirus M genome segment from 36 rodent and 13 human samples from three known foci of hantavirus infection in Argentina was conducted. A 1654-nt fragment of the M genome segment was analyzed for 1 representative of 7 genetically distinct hantavirus lineages identified. Additionally, the nt sequence of the complete M genome segments of Lechiguanas, Oran, and Hu39694 hantavirus genotypes was determined. nt sequence comparisons reveal that 7 hantavirus lineages from Argentina differ from each other by 11.5%-21.8% and from Sin Nombre, Bayou, and Black Creek Canal viruses by 23.8%-26.5%. Phylogenetic analyses demonstrate that they form a unique, separate branch within the clade containing other New World sigmodontine-borne hantaviruses. Most Oligoryzomys-borne hantavirus genotypes clearly map together. The Oligoryzomys-borne genotypes Lechiguanas, Oran, and Andes appear to be associated with human disease. Oligoryzomys longicaudatus was identified as the likely rodent reservoir for Andes virus.

Protective efficacy of a live attenuated vaccine against Argentine hemorrhagic fever. AHF Study Group.

Argentine hemorrhagic fever (AHF), caused by the arenavirus Junin, is a major public health problem among agricultural workers in Argentina. A prospective, randomized, double-blind, placebo-controlled, efficacy trial of Candid 1, a live attenuated Junin virus vaccine, was conducted over two consecutive epidemic seasons among 6500 male agricultural workers in the AHF-endemic region. Twenty-three men developed laboratory-confirmed AHF during the study; 22 received placebo and 1 received vaccine (vaccine efficacy 95%; 95% confidence interval [CI], 82%-99%). Three additional subjects in each group developed laboratory-confirmed Junin virus infection associated with mild illnesses that did not fulfill the clinical case definition for AHF, yielding a protective efficacy for prevention of any illness associated with Junin virus infection of 84% (95% CI, 60%-94%). No serious adverse events were attributed to vaccination. Candid 1, the first vaccine for the prevention of illness caused by an arenavirus, is safe and highly efficacious.

Tolerance and antiviral effect of ribavirin in patients with Argentine hemorrhagic fever.

Tolerance and antiviral effect of ribavirin was studied in 6 patients with Argentine hemorrhagic fever (AHF) of more than 8 days of evolution. Administration of ribavirin resulted in a neutralization of viremia and a drop of endogenous interferon titers. The average time of death was delayed. A reversible anemia was the only adverse effect observed. From these results, we conclude that ribavirin has an antiviral effect in advanced cases of AHF, and that anemia, the only secondary reaction observed, can be easily managed. The possible beneficial effect of ribavirin during the initial days of AHF is discussed.

Correlation between endogenous interferon and the clinical evolution of patients with Argentine hemorrhagic fever.

To explore the endogenous interferon levels in patients of Argentine hemorrhagic fever (AHF) with different clinical evolution of the disease, 29 fatal and 33 surviving cases of AHF were analyzed. As previously reported, the titers of endogenous alpha-IFN in patients with AHF are very high, generally between 2,000 and 64,000 IU/ml. Thus far, these are the highest levels of circulating interferon detected in any human viral disease. In this study it was found that during the second week of evolution the titers of interferon were significantly higher in fatal cases than in survivors. Therefore, very high levels of interferon have a prognostic value in AHF.

Importance of dose of neutralising antibodies in treatment of Argentine haemorrhagic fever with immune plasma.

P6 a retrospective study outcome in patients with Argentine haemorrhagic fever was associated with the amount of neutralising antibodies against Junin virus present in the transfused units of immune plasma. Low doses of neutralising antibodies were associated with higher mortality. A prospective study gave comparable results. A dose of no less than 3000 therapeutic units of neutralising antibodies per kg body weight is recommended. It is also suggested that the lack of effectiveness of immune plasma in the treatment of other viral haemorrhagic fevers, such as Lassa fever and Crimean-Congo haemorrhagic fever, may be due to a low dose of the specific neutralising antibodies.

Endogenous interferon in Argentine hemorrhagic fever.

The induction of endogenous interferon (IFN) was studied in 28 cases of Argentine hemorrhagic fever (AHF), a severe systemic disease caused by Junin virus. Serum samples were taken daily during the acute period, both before and after administration of immune plasma. This form of treatment has been found to reduce mortality when given early in the course of AHF. High titers of circulating IFN were present in the serum samples taken before treatment. IFN titers drastically dropped after transfusion of immune plasma. The antiviral activity was stable at pH 2 and was completely neutralized only by antibodies against IFN-alpha. Thus, we concluded that circulating endogenous IFN in patients with AHF can be considered as typical IFN-alpha. Fever, chills, and backache were associated with the higher levels of IFN. An inverse correlation between days of evolution of the disease and IFN activity was also observed.

Junin virus activity in two rural populations of the Argentine hemorrhagic fever (AHF) endemic area.

To determine the prevalence of inapparent infection with Junin virus among the rural population and its relation to the clinical disease, a serological study was carried out in two zones of the endemic area of Argentine hemorrhagic fever (AHF). From the first appearance of AHF in the zones (1963) and the moment of the survey (1977), 14 years had passed. A total of 695 serum samples were obtained, 540 from Córdoba and 155 from Buenos Aires. Of the 695 serum samples, 83 were positive for neutralizing antibodies against Junin virus. Total infection (clinical and inapparent cases) reached 11.6% and 12.03% in the Buenos Aires and Córdoba zones, respectively, showing that the total prevalence of infection in two zones separated by 320 miles, are very much alike. In Córdoba province, the prevalence of clinical infection was 7.59%, while that for inapparent infection was 4.44%. Values for the Province of Buenos Aires were 9.67% and 1.93%, respectively. In addition to a low prevalence of inapparent infections, the results of this survey show that roughly 90% of the population is susceptible to contract the disease; this stresses the need to immunize susceptible individuals in the endemic area.