We acknowledge Clement and colleagues for their comments [1] on our paper [2]. We agree that many controversies are being discussed by the hantavirus community, particularly surrounding the interpretation of serological results and the designation of new species and strains. Within this setting, we are grateful for the opportunity to respond to the key factual and methodological points raised by Clements et al. [...

Beeching, Nick J

Carroll, Miles W

Christley, Robert M

Coole, Louise

Hewson, Roger

Jameson, Lisa J

Newman, Edmund NC

Newton, Autilia

Viruses

PubMed

Jameson, Lisa J.

Newman, Edmund N.C.

Carroll, Miles W.

Beeching, Nicholas

Christley, Robert M.

LSTM Research Portal

Viruses 2014, 6, 3425-3427; doi:10.3390/v6093425  viruses ISSN 1999-4915 www.mdpi.com/journal/viruses Reply Reply to Comment Clement et al.: (Prevalence of Antibodies against Hantaviruses in Serum and Saliva of Adults Living or Working on Farms in Yorkshire, United Kingdom) Lisa J. Jameson 1,2,*, Autilia Newton 3, Louise Coole 4, Edmund N. C. Newman 1,  Miles W. Carroll 1, Nick J. Beeching 5, Roger Hewson 1 and Robert M. Christley 2 1 Microbiology Services, Public Health England, Porton Down, Wiltshire SP4 0JG, UK;  E-Mails: edmund.newman@phe.gov.uk (E.N.C.N.); miles.carroll@phe.gov.uk (M.W.C.);  roger.hewson@phe.gov.uk (R.H.) 2 Institute of Infection and Global Health, University of Liverpool, Liverpool L69 7BE, UK;  E-Mail: robc@liverpool.ac.uk 3 Public Health England, Yorkshire and the Humber, York YO41 1LZ, UK;  E-Mail: autilia.newton@phe.gov.uk 4 Field Epidemiology Services, Public Health England, Leeds LS2 7UE, UK;  E-Mail: louise.coole@phe.gov.uk 5 Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK;  E-Mail: beeching@liverpool.ac.uk * Author to whom correspondence should be addressed; E-Mail: lisa.jameson@phe.gov.uk;  Tel.: +44-0-1980-612100. Received: 29 August 2014; in revised form: 3 September 2014 / Accepted: 3 September 2014 /  Published: 12 September 2014  We acknowledge Clement and colleagues for their comments [1] on our paper [2]. We agree that many controversies are being discussed by the hantavirus community, particularly surrounding the interpretation of serological results and the designation of new species and strains. Within this setting, we are grateful for the opportunity to respond to the key factual and methodological points raised by Clements et al. The decision of whether Saaremaa virus (SAAV) is a separate species of hantavirus is not within the scope of our study: we followed the guidelines of the International Committee on Taxonomy of Viruses (ICTV) which lists SAAV separately from Dobrava virus. Serological cross-reactions between certain hantavirus species are widely acknowledged and referred to in our discussion of results. Given the published molecular evidence of a Seoul hantavirus in the region [3,4] and unpublished confirmation OPEN ACCESS Viruses 2014, 6 3426   of virus amplified from a human sample with 100% homology to Cherwell [5], we are confident in assuming that the samples reactive for both Seoul and Hantaan represent Seoul infection. We did not intend to suggest that insectivore-related hantaviruses are pathogenic to humans and  our text does not state this. It does assume that transmission occurs (even if only between reservoir animals) through excreted virus, which is the known route for all studied hantaviruses. Transovarial transmission is not an effective route for maintenance of hantaviruses, so excretion seems the most likely manner for insectivore-borne hantaviruses to be sustained in nature. We acknowledge that it might have been useful for readers less familiar with the history of hantavirus research in the UK if we had cited the work of McKenna et al. [6]. However, that study focused  on symptomatic patients and ours used a subset of healthy volunteers, limiting the validity of direct comparison. We believe that the PHLS farmers cohort study [7] provides a more appropriate comparator group. Regarding the inclusion of IgM titres, it is unreasonable to compare high titre acute samples, as reported by McKenna et al. [6], Jameson et al. [3] and Taori et al. [8], to samples from persons who may have been exposed decades prior to sampling. Given that our volunteers were not sick, we are unable to see the benefit of testing for IgM in our anonymised study. The principal aim of our study was to provide a preliminary investigation of the seroprevalence to hantaviruses among farm workers and dwellers in a region of Great Britain in which a recent case of HFRS had occurred. As part of this investigation, a limited questionnaire was answered by participants to explore some possible risk factors. In order to limit the burden to participants, the questionnaire was deliberately kept short and only a limited set of questions was included. The results only pertain to the study sample (i.e., farmers and farm dwellers) and the potential impact of using a convenience sample, rather than a random sample, is noted in our discussion. Further studies to evaluate the role of a wider range of potential risk factors are now warranted. Within Table 2, “NA” is used to denote “not available” (rather than not assessed). Several odds ratios were not available, as the calculations involved category values of zero; for example, all 9 seropositive participants reported seeing rats and none reported not seeing rats. The commercially available Euroimmun IFA (Luebeck, Germany) is a useful and convenient diagnostic assay for acute samples and serosurveys as it covers a panel of hantavirus species. It is not designed to confirm the causative species. We agree with Clement et al. that only molecular methods are able to do this. Thus we were cautious in interpreting the results of the samples reacting to the other hantavirus species and at no point suggested they were likely to be result of a Sin Nombre (SNV) infection, instead we described them as SNV/Puumala-like hantaviruses. We and peer reviewers at the time understood that this subtle statement alluded to the inexactness of the IFA technique at this level. We focused attention on the results of SEOV, since this is where we had provided molecular evidence of its existence, as indicated above. While acknowledging the concerns of Clements et al., we stand by the key findings and design of our study, which has provided new data on the seroprevalence of hantavirus infection in a farming community in which the first molecularly confirmed case in the UK had recently been detected [2]. More detailed studies logically follow on from these preliminary findings and are now in progress.  Viruses 2014, 6 3427   References and Notes 1. Clement, J.; McKenna, P.; Vergote, V.; van Ranst, M. Comment on Jameson et al.: Prevalence  of antibodies against hantaviruses in serum and saliva of adults living or working on farms in Yorkshire, United Kingdom. Viruses 2014, 6, 3415–3424. 2. Jameson, L.J.; Newton, A.; Coole, L.; Newman, E.N.; Carroll, M.W.; Beeching, N.J.; Hewson, R.; Christley, R.M. Prevalence of antibodies against hantaviruses in serum and saliva of adults living or working on farms in Yorkshire, United Kingdom. Viruses 2014, 6, 524–534. 3. Jameson, L.J.; Logue, C.H.; Atkinson, B.; Baker, N.; Galbraith, S.E.; Carroll, M.W.; Brooks, T.; Hewson, R. The continued emergence of hantaviruses: Isolation of a Seoul virus implicated in human disease, United Kingdom, October 2012. Euro Surveill. 2013, 18, pii=20344. 4. Jameson, L.J.; Taori, S.K.; Atkinson, B.; Levick, P.; Featherstone, C.A.; van der Burgt, G.; McCarthy, N.; Hart, J.; Osborne, J.C.; Walsh, A.L.; et al. Pet rats as a source of hantavirus in England and Wales, 2013. Euro Surveill. 2013, 18, pii=20415. 5. Brooks, T.J.G. Rare and Imported Pathogens Laboratory, Public Health England, Porton Down, UK. Unpublished work, 2013. 6. McKenna, P.; Clement, J.; Matthys, P.; Coyle, P.; McCaughey C. Serological evidence of Hantavirus disease in Northern Ireland. J. Med. Virol. 1994, 43, 33–38. 7. Thomas, D.R.; Salmon, R.L.; Coleman, T.J.; Morgan-Capner, P.; Sillis, M.; Caul, E.O.; Morgan, K.; Paiba, G.A.; Bennett, M.; Ribeiro, D.; et al. Occupational exposure to animals and risk of zoonotic illness in a cohort of farmers, farmworkers and their families in England. J. Agric. Saf. Health 1999, 5, 373–382. 8. Taori, S.K.; Jameson, L.J.; Campbell, A.; Drew, P.J.; McCarthy, N.D.; Hart, J.; Osborne, J.C.; Sudhanva, M.; Brooks, T.J.G. UK hantavirus, renal failure, and pet rats. Lancet 2013, 381, 1070. © 2014 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/). 

English

Reply to Comment Clement et al.: (Prevalence of Antibodies against Hantaviruses in Serum and Saliva of Adults Living or Working on Farms in Yorkshire, United Kingdom)

Jameson, Lisa

Newman, Edmund

Carroll, Miles

Christley, Robert

LSTM Online Archive

Hantaviruses are an established cause of haemorrhagic fever with renal syndrome (HFRS) in Europe. Following a confirmed case of HFRS in the UK, in an individual residing on a farm in North Yorkshire and the Humber, a tidal estuary on the east coast of Northern England, and the subsequent isolation of a Seoul hantavirus from rats trapped on the patient's farm, it was considered appropriate to further investigate the public health risk of this virus in the region. Of a total 119 individuals tested, nine (7.6%) were seropositive for hantavirus antibodies. Seven of the seropositive samples showed a stronger reaction to Seoul and Hantaan compared to other clinically relevant hantaviruses. Observation of rodents during the day, in particular mice, was associated with a reduced risk of seropositivity. In addition to one region known to be at risk following an acute case, five further potential risk areas have been identified. This study supports recently published evidence that hantaviruses are likely to be of public health interest in the region

University of Liverpool Repository

Prevalence of Antibodies against Hantaviruses in Serum and Saliva of Adults Living or Working on Farms in Yorkshire, United Kingdom

Lisa Jameson

Autilia Newton

Louise Coole

Edmund Newman

Miles Carroll

Nick Beeching

Roger Hewson

Robert Christley

Crossref

Hantaviruses are an established cause of haemorrhagic fever with renal syndrome (HFRS) in Europe. Following a confirmed case of HFRS in the UK, in an individual residing on a farm in North Yorkshire and the Humber, a tidal estuary on the east coast of Northern England, and the subsequent isolation of a Seoul hantavirus from rats trapped on the patient’s farm, it was considered appropriate to further investigate the public health risk of this virus in the region. Of a total 119 individuals tested, nine (7.6%) were seropositive for hantavirus antibodies. Seven of the seropositive samples showed a stronger reaction to Seoul and Hantaan compared to other clinically relevant hantaviruses. Observation of rodents during the day, in particular mice, was associated with a reduced risk of seropositivity. In addition to one region known to be at risk following an acute case, five further potential risk areas have been identified. This study supports recently published evidence that hantaviruses are likely to be of public health interest in the region

Lisa J. Jameson

Edmund N. C. Newman

Miles W. Carroll

Nick J. Beeching

Robert M. Christley

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Article Prevalence of Antibodies against Hantaviruses in Serum and Saliva of Adults Living or Working on Farms in Yorkshire, United Kingdom

Hantaviruses are an established cause of haemorrhagic fever with renal syndrome (HFRS) in Europe. Following a confirmed case of HFRS in the UK, in an individual residing on a farm in North Yorkshire and the Humber, a tidal estuary on the east coast of Northern England, and the subsequent isolation of a Seoul hantavirus from rats trapped on the patient’s farm, it was considered appropriate to further investigate the public health risk of this virus in the region. Of a total 119 individuals tested, nine (7.6%) were seropositive for hantavirus antibodies. Seven of the seropositive samples showed a stronger reaction to Seoul and Hantaan compared to other clinically relevant hantaviruses. Observation of rodents during the day, in particular mice, was associated with a reduced risk of seropositivity. In addition to one region known to be at risk following an acute case, five further potential risk areas have been identified. This study supports recently published evidence that hantaviruses are likely to be of public health interest in the region.</p

Hantaviruses are an established cause of haemorrhagic fever with renal syndrome (HFRS) in Europe. Following a confirmed case of HFRS in the UK, in an individual residing on a farm in North Yorkshire and the Humber, a tidal estuary on the east coast of Northern England, and the subsequent isolation of a Seoul hantavirus from rats trapped on the patient’s farm, it was considered appropriate to further investigate the public health risk of this virus in the region. Of a total 119 individuals tested, nine (7.6%) were seropositive for hantavirus antibodies. Seven of the seropositive samples showed a stronger reaction to Seoul and Hantaan compared to other clinically relevant hantaviruses. Observation of rodents during the day, in particular mice, was associated with a reduced risk of seropositivity. In addition to one region known to be at risk following an acute case, five further potential risk areas have been identified. This study supports recently published evidence that hantaviruses are likely to be of public health interest in the region

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Prevalence of Antibodies against Hantaviruses in Serum and Saliva of Adults Living or Working on Farms in Yorkshire, United Kingdom

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