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American Journal of Epidemiology Vol. 127, No. 4: 801-807
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health

research-article

INCIDENCE AND GEOGRAPHIC DISTRIBUTION OF SEROLOGICALLY VERIFIED CASES OF NEPHROPATHIA EPIDEMICA IN SWEDEN

BO SETTERGREN1,, PER JUTO2, GÖRAN WADELL2, BIRGER TROLLFORS1 and S. RAGNAR NORRBY1

1Department of Infectious Diseases, University of Umeå Umeå, Sweden
2Department of Virology, University of Umeå Umeå Sweden

Reprint requests to Dr. Bo Settergren, Department of Infectious Diseases, University of Umaå, Umeå University Hospital, S-90185 Umeå, Sweden

A nationwide survey of hospitalized, seroiogically verified adult nephropathia epidemics cases in Sweden from 1978 to 1981 was performed. Serum was collected from 1,063 patients with a diagnosis of nephropathia epidemica or one of 10 other renal diseases with related symptoms. Sera were analyzed by indirect immunofluorescence technique for the presence of immunoglobulln G antibodies to Hantaan virus, causative agent of Korean hemorrhagic fever that cross-reacts with the nephropathia epidemics agent Antibodies were present in 388 patients, 355 of whom also fulfilled four or more of six criteria for clinical diagnosis of nephropathia epidemica. The male:female ratio was 2.7:1. The total number of cases In Sweden varied between 26 and 144 per year, which coincided with the fluctuations in small rodent populations. The highest incidence was found in Västerbotten County, with a maximum crude incidence rate of 23.5 cases per 100,000 Inhabitants per year. Mean crude incidence in Sweden during the study period was 1.3 cases per 100,000 inhabitants per year. The southernmost cases lived in proximity to the 59th parallel. Thus, nephropathia epidemics was found to be prevalent south of the 60th parallel, which was previously assumed to be its southern boundary.

hemorrhagic fever; epidemic; rodent diseases; virus diseases


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