TEMPORAL DYNAMICS OF PUUMALA VIRUS-ANTIBODY PREVALENCE IN VOLES AND OF NEPHROPATHIA-EPIDEMICA INCIDENCE IN HUMANS

Puumala (PUU) virus is the etiologic agent of nephropathia epidemica (NE) in humans. This disease is highly endemic in Vasterbotten county, Sweden, with an annual incidence of 19.2 (range 3.7-37.4) per 100,000 inhabitants. Voles are considered to be both the main reservoir and the vector of PUU virus. A total of 3,591 rodents (mainly Clethrionomys glareolus, C. rufocanus, and Microtus agrestis) trapped in Vasterbotten between 1979 and 1987 were tested for the presence of PUU virus antibodies by enzyme-linked immunosorbent assay. The predominant species, C. glareolus (71% [2,544 of 3,591]), also had the highest antibody prevalence (19% [483 of 2,544]). In C. glareolus, the antibody prevalence rate increased with weight (age), reaching more than 50% in the heaviest weight group, and suggesting that horizontal infection may be important. The highest frequency (25%) of antibody-positive C. rufocanus was also found in the highest weight groups. Microtus agrestis showed low absolute numbers and a low antibody prevalence rate (5%). In C. glareolus, both antibody prevalence and weight were recurrently higher in the spring than in the previous fall. The antibody prevalence rate in spring was positively correlated with the vole density in the previous fall and spring. The fall antibody prevalence rate was directly dependent on C. glareolus density. The incidence of human NE in the fall was dependent on the concurrent density of C. glareolus, whereas the incidence of NE in the spring was dependent on vole density the previous fall.