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Case Reports
. 2018 Nov 16;18(1):578.
doi: 10.1186/s12879-018-3482-1.

Case report: two confirmed cases of human Seoul virus infections in Indonesia

Khie Chen Lie  1 , Mochamad Helmi Aziz  2 , Herman Kosasih  3 , Aaron Neal  4 , Caleb Leonardo Halim  2 , Wahyu Nawang Wulan  2 , Muhammad Karyana  5 , Usman Hadi  6
Affiliations
Case Reports

Case report: two confirmed cases of human Seoul virus infections in Indonesia

Khie Chen Lie et al. BMC Infect Dis. .

Abstract

Background: Seoul virus (SEOV) is a member of hantavirus family, which is transmitted to humans by Rattus rattus and Rattus norvegicus. Diagnosing SEOV infection is difficult because the clinical presentations are often undifferentiated with other viral or bacterial infections and assays to test antibodies seroconversion and RNA detection are not available in resource-limited setting like Indonesia.

Case presentation: We report two confirmed cases of SEOV infection from Indonesia. Here, we illustrate the clinical presentations, hematology and biochemistry profiles, and outcomes of the two cases. Phylogenetic analysis revealed that SEOV sequences have highest homology to isolates obtained from rodents in Indonesia.

Conclusions: This report highlights the importance of considering SEOV infection in febrile patients with lymphopenia, thrombocytopenia, and elevation of liver enzyme despite the absence of hemorrhagic manifestations and renal syndromes. The public health importance of rodent-borne diseases such as SEOV infection urges an integrated epidemiological surveillance both in humans and rodents in Indonesia.

Keywords: Detection; Indonesia; Seoul virus.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the IRBs of Dr. Soetomo General Hospital (192/Panke.KKE/VIII/2012) and the National Institute of Health and Research and Development (NIHRD), Ministry of Health, Indonesia (KE.01.05/EC/407/2012) and registered in clinicaltrials.gov (NCT02763462). All participants provided written, informed consent to participate in the study.

Consent for publication

Written informed consent was obtained from the patients for publication of this Case Report and any accompanying data (tables).

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Phylogenetic analysis of the partial N gene of Seoul virus (SEOV) detected in the AFIRE study. A neighbor-joining tree was constructed based on nucleotides 338 through 587 of the SEOV N gene ORF and its homologues in other hantaviruses. The SEOV strains identified in the AFIRE study are shown in bold. The scale bar indicates nucleotide substitutions per site. The sequences of the N gene segments of SEOV obtained in this study were submitted to GenBank under accession no. MG561966 and MG561967
See this image and copyright information in PMC

References

    1. Lee HW, Baek LJ, Johnson KM. Isolation of Hantaan virus, the etiologic agent of Korean hemorrhagic fever, from wild urban rats. J infec dis. 1982;146(5):638–644. doi: 10.1093/infdis/146.5.638. - DOI - PubMed
    1. Zhang Y-Z, Dong X, Li X, Ma C, Xiong H-P, Yan G-J, et al. Seoul virus and hantavirus disease, Shenyang, People’s republic of China. Emerg Infect Dis. 2009;15(2):200–206. doi: 10.3201/eid1502.080291. - DOI - PMC - PubMed
    1. Lam SK, Chua KB, Myshrall T, Devi S, Zainal D, Afifi SA, et al. Serological evidence of hantavirus infections in Malaysia. Southeast Asian J Trop Med Public Health. 2001;32(4):809–813. - PubMed
    1. Wong TW, Chan YC, Joo YG, Lee HW, Lee PW, Yanagihara R. Hantavirus infections in humans and commensal rodents in Singapore. Trans R Soc Trop Med Hyg. 1989;83(2):248–251. doi: 10.1016/0035-9203(89)90666-4. - DOI - PubMed
    1. Kim YS, Ahn C, Han JS, Kim S, Lee JS, Lee PW. Hemorrhagic fever with renal syndrome caused by the Seoul virus. Nephron. 1995;71(4):419–427. doi: 10.1159/000188762. - DOI - PubMed

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