The Distribution and Duration of Hantaan Virus in the Body Fluids of Patients with Hemorrhagic Fever with Renal Syndrome

The distribution and duration of Hantaan virus (HTNV) in the body fluids of patients were studied by immunofluorescence, reverse passive hemagglutination, and cell culture assays. Virus antigen of hemorrhagic fever with renal syndrome in peripheral blood mononuclear cells (PBMCs) was usually present before day 11 of the disease, especially from days 4-7. Virus isolates were more readily recovered from plasma early in the course of the illness and less frequently after day 7. The use of PBMCs rather than plasma enabled isolates to be recovered at a rate nearly twice that permitted by plasma and allowed the isolation peak of HTNV (days 4-7 after onset of disease) to extend an additional 2 or 3 d, thus prolonging the period of detectable viremia until days 8-11. PBMCs were especially useful in isolating viruses from patients with hemorrhagic fever with renal syndrome in whom antibody titers were generally high during the acute phase of the disease. HTNV was isolated from the cerebrospinal fluid of patients, but was difficult to recover from other body fluids.