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7%) of 234 cases of hantavirus infection, mostly with PUUV, detected serologically or virologically during the same period in France.
Today, real-time PCR is considered the gold standard for rapid pathogen detection (18), and several assays were recently reported to detect individual hantavirus species such as PUUV (19) and DOBV (20).
Phylogenetic analysis of the L segment demonstrated this level of divergence was comparable to the divergence among many western European lineages of PUUV (Figure, panel B; online Technical Appendix Figure 3).
Molecular analyses of bank voles from endemic regions detected the presence of PUUV at 30 sites in Germany (Figure 1, panel A) and resulted in the definition of several PUUV sublineages of the Central European (CE) clade (3,8).
In contrast to the Fennoscandian Peninsula and parts of central Europe (4,5), little is known about the epidemiology of PUUV in Poland and the Baltic States.
Data on humoral immunity years after PUUV infection are not available for a representative cohort of German patients.
Antibodies to PUUV, Tula virus (TULV), and Seoul virus (SEOV) have been found in rodent populations in the Netherlands, and TULV has been isolated from common voles (Microtus arvalis) (5,6).
Serology results suggested that the causative agent was a hantavirus antigenically closer to PUUV (Table 1).
To explore patterns of death among persons who died during and after HFRS, we reviewed all causes of death of persons infected with PUUV in Sweden during 1997-2009.
We present the complete genome of PUUV directly recovered from a person with fatal infection.
Although 3 hantaviruses, Puumala virus (PUUV), Dobrava-Belgrade virus, and Tula virus circulate in rodent hosts in Germany and can infect humans (6-8), most hantavirus infections in humans are caused by PUUV.
Approximately 10,000-12,000 cases of infection with PUUV and DOBV occur in European Russia each year (3).