The Specificity of Epizootic and Epidemiological Processes in Natural Foci of Hemorrhagic Fever with Renal Syndrome and Tick-Borne Encephalitis in Russia, as the Basis for the Prospects of Creating a Combined Vaccine for the Prevention of These Infections
Abstract
:1. Introduction
2. Etiology of HFRS and TBE
- Aerogenic (airborne dust) transmission—hantaviruses, along with aerosols containing waste products from mammals, enter the human lungs through the upper respiratory tract, where conditions for their reproduction are most favorable. From there, they can spread through the bloodstream to other organs [33,37,38,39].
- By contact—with hantavirus-infected waste products of mammals that come into direct contact with damaged skin, mucous membranes of the eyes, nose, or mouth [40].
- Intrauterine transmission—information on monitoring pregnant women with HFRS; 10 out of 84 had stillborn children. At the same time, hantaviruses were isolated from four dead children, and antibodies to the virus were found in two surviving children, which lasted up to 3 years [49].
- Tick bites—current evidence suggests that hantaviruses infect ticks naturally and that infected ticks can transmit hantavirus through the bite of small susceptible mammals (possibly with saliva), as well as transovarially (vertically) to their offsprings [50,51,52,53,54]. In addition, there are data on the incidence of HFRS in humans after the administration of suspensions of Gamasoidea and Trombiculidae mites [55,56,57,58,59].
3. Ecology of Hantaviruses
- A two-membered parasitic system “virus–warm-blooded host”, where the virus can circulate without the involvement of arthropods as vectors—these are non-transmissible zoonotic diseases.
- The presence of each hantavirus or its gene variant in only one reservoir host (species or subspecies), which is evolutionarily related and able to maintain the foci, and its inability to be replaced in this capacity by other warm-blooded animals, is the species specificity of the pathogen [82]. As a result, there are no foci of this virus outside the range of the main host, which serves as the source of infection in natural foci and is responsible for infecting people throughout the epizootic process and all phases of this virus’s range. This is why hantavirus infections differ fundamentally from other natural zoonotic diseases, which can have two or more warm-blooded animal species as their main or additional hosts and can be interchangeable in terms of carrying the pathogen both in time and space.
- The asymptomatic course of infection in the infected virus carriers which does not affect their vital activities, such as growth, reproduction, and mobility, and therefore does not impact the size or age-functional structure of populations and is known as a latent or inapparent form of infection in natural hosts.
- Lifelong persistence of the virus in the body of the reservoir host, with its reproduction being activated and released into the external environment through excreta, such as saliva, urine, and feces. This is most often seen in the first month after infection, during which time the infection is considered to be persistent with short periods of active virus carriage.
4. Ecology of the TBE Virus
5. Epidemiological Analysis of the Incidence of HFRS and TBE
6. Conclusions
- number of small mammal species that feed ticks are infected with hantaviruses, although only reservoir hosts of viruses participate in their transmission;
- transovarial transmission of hantaviruses in ticks is possible only hypothetically and further field and experimental studies are needed for definitive proof;
- small mammals from the orders Rodentia and Insectivora retain hantaviruses and can transmit them to uninfected animals and ticks;
- ticks store hantaviruses and can transmit them to mammals and other ticks;
- transmission of TBEV from ticks to humans is generally recognized, but for hantaviruses, the causative HFRS agents, it is possible only hypothetically on the basis of indirect data;
- the true role of ticks of various taxonomic affiliations in hantaviruses natural foci and the possibility to transmit the HFRS pathogen by ticks to humans requires further field and experimental studies;
- identification of mild and erased forms of the clinical course of HFRS and TBE, as well as errors in clinical diagnosis, determine the presence of natural immunity in the population, the value of which reflects the level of clinical and serological diagnosis and the number of unaccounted patients with these infections;
- among patients with HFRS and TBE, the mortality rate is 0.4% and 1.6%, respectively; children under the age of 14 get sick in 2.5% and 13% of cases, respectively;
- HFRS and TBE incidence per 105. people is higher among rural residents;
- most cases of HFRS were registered in the autumn-winter period, and TBE—at the end of June—the first half of July;
- HFRS and TBE cases are registered in 42 out of 85 administrative regions of Russia; in 18 regions—only HFRS; in 13—only TBE; in 12 regions—no clinically diagnosed HFRS or TBE cases have been identified;
- comparative epidemiological analysis of data on HFRS and TBE incidence in Russia indicates the promise of using a combined vaccine to prevent these infections.
Author Contributions
Funding
Conflicts of Interest
References
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Area of Russia | No. of Regions Examined | No. of People Examined by IFA | No. of Positive People | % Positive People |
---|---|---|---|---|
Total for Russia | 52 out of 76 | 65,492 | 2781 | 4.2 |
European Russia | 38 out of 49 | 52,788 | 2504 | 4.7 |
Asian Russia | 14 out of 27 | 12,704 | 277 | 2.2 |
Area of Russia | No. of HFRS and TBE Cases | Annual Average Morbidity Rate Per 105 People | Children under 14 Years Old | Case Fatality | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
HFRS | TBE | HFRS | TBE | HFRS | % | TBE | % | HFRS | % | TBE | % | |
Total for Russia | 164,582 | 71,579 | 4.9 | 2.5 | 4030 | 2.5 | 9414 | 13.0 | 668 | 0.4 | 1136 | 1.6 |
European part | 162,044 | 28,355 | 9.7 | 1.2 | 3957 | 2.4 | 3949 | 14.0 | 572 | 0.4 | 442 | 1.6 |
Asian part | 2538 | 43,224 | 0.6 | 5.6 | 73 | 2.9 | 5465 | 12.6 | 96 | 3.8 | 694 | 1.6 |
Western Siberia | 300 | 22,206 | 0.4 | 8.0 | 6 | 2.0 | 2848 | 13.0 | 5 | 1.7 | 295 | 1.3 |
Eastern Siberia | 9 | 17,765 | 0.1 | 8.6 | 0 | - | 2190 | 12.3 | 2 | 2.9 | 224 | 1.3 |
Far East | 2228 | 3251 | 1.4 | 1.3 | 67 | 3.0 | 427 | 13.0 | 89 | 4.0 | 175 | 5.4 |
HFRS Cases | TBE Cases | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Area of Russia | Total | Rural Residents | Per 105 People | Urban Residents | Per 105 People | Ratio: Rural/Urban | Total | Rural Residents | Per 105 People | Urban Residents | Per 105 People | Ratio: Rural/Urban |
Total for Russia | 164,582 | 58,384 | 6.6 | 106,198 | 4.3 | 1.5 | 71,579 | 24,709 | 2.8 | 46,870 | 1.9 | 1.5 |
European part | 162,044 | 5758 | 8.7 | 104,537 | 6.4 | 1.4 | 28,355 | 8827 | 2.1 | 19,528 | 1.2 | 1.8 |
Asian part | 2538 | 876 | 0.4 | 1661 | 0.2 | 2 | 43,224 | 15,882 | 7.1 | 27,342 | 3.4 | 2.1 |
Western Siberia | 300 | 37 | 0.06 | 263 | 0.05 | 1.2 | 22,206 | 8156 | 9.1 | 14,050 | 3.0 | 3.0 |
Eastern Siberia | 9 | 2 | 0.04 | 5 | 0.03 | 1.3 | 17,765 | 6251 | 12.2 | 11,516 | 6.1 | 2.0 |
Far East | 2229 | 837 | 1.0 | 1393 | 0.8 | 1.3 | 3251 | 1475 | 1.8 | 1776 | 1.1 | 1.6 |
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Tkachenko, E.; Balkina, A.; Trankvilevsky, D.; Kolyasnikova, N.; Teodorovich, R.; Vorovich, M.; Popova, Y.; Kurashova, S.; Egorova, M.; Belyakova, A.; et al. The Specificity of Epizootic and Epidemiological Processes in Natural Foci of Hemorrhagic Fever with Renal Syndrome and Tick-Borne Encephalitis in Russia, as the Basis for the Prospects of Creating a Combined Vaccine for the Prevention of These Infections. Viruses 2024, 16, 1292. https://doi.org/10.3390/v16081292
Tkachenko E, Balkina A, Trankvilevsky D, Kolyasnikova N, Teodorovich R, Vorovich M, Popova Y, Kurashova S, Egorova M, Belyakova A, et al. The Specificity of Epizootic and Epidemiological Processes in Natural Foci of Hemorrhagic Fever with Renal Syndrome and Tick-Borne Encephalitis in Russia, as the Basis for the Prospects of Creating a Combined Vaccine for the Prevention of These Infections. Viruses. 2024; 16(8):1292. https://doi.org/10.3390/v16081292
Chicago/Turabian StyleTkachenko, Evgeniy, Alexandra Balkina, Dmitriy Trankvilevsky, Nadezda Kolyasnikova, Rostislav Teodorovich, Mikhail Vorovich, Yulia Popova, Svetlana Kurashova, Maria Egorova, Alla Belyakova, and et al. 2024. "The Specificity of Epizootic and Epidemiological Processes in Natural Foci of Hemorrhagic Fever with Renal Syndrome and Tick-Borne Encephalitis in Russia, as the Basis for the Prospects of Creating a Combined Vaccine for the Prevention of These Infections" Viruses 16, no. 8: 1292. https://doi.org/10.3390/v16081292