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American Journal of Epidemiology Vol. 149, No. 12: 1142-1151
Copyright © 1999 by The Johns Hopkins University School of Hygiene and Public Health

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Puumala Virus Infections in Finland: Increased Occupational Risk for Farmers

Katariina Vapalahti1, Mikko Paunio2, Markus Brummer-Korvenkontio1, Antti Vaheri1 and Olli Vapalahti1

1Department of Virology, Haartman Institute, University of Helsinki Helsinki, Finland
2Department of Public Health, University of Helsinki Helsinki, Finland

Puumala hantavirus, transmitted by bank voles (Clethrionomys glareolus), causes a mild-type hemorrhagic fever with renal syndrome. The disease is common in Finland and is considered an occupational hazard for farmers, but the actual risk has not been assessed by analytical studies. Data on 5, 132 serologically confirmed Puumala virus infections during 1989–1994 were analyzed, and cases among farmers and the population living in similar conditions were compared. The farmers contracted the disease earlier and more often than did the comparison group. In the province of Mikkeli with the highest incidence (70/100, 000), the risk ratio was 5.1 (95% confidence interval (Cl) 3.0–8.4) for 20- to 29-year-old farmers; in the older age groups, the risk was still increased but the risk ratios were lower. The peak incidence in the comparison group was 10 years later (age group 30–39 years). For the whole country, the result was similar although less marked. The average risk ratio adjusted by age, sex, and geographic variation was 1.7 (95% Cl 1.5–1.8) for the whole country and 1.9 (95% Cl 1.5–2.3) for the Mikkeli province, where 80% of Puumala virus infections among young farmers could be estimated to be attributable to occupation. Am J Epidemiol 1999; 149:1142–51.

hantavirus; hantavirus infections; hemorrhagic fever with renal syndrome; occupational exposure; risk


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