Archives of Virology

, Volume 164, Issue 1, pp 267–271 | Cite as

Thailand orthohantavirus infection in patients with chronic kidney disease of unknown aetiology in Sri Lanka

  • K. YoshimatsuEmail author
  • C. D. Gamage
  • Y. D. Sarathkumara
  • T. Kulendiran
  • D. S. Muthusinghe
  • N. Nanayakkara
  • L. Gunarathne
  • K. Shimizu
  • Y. Tsuda
  • J. Arikawa
Brief Report


Chronic kidney disease of unknown aetiology (CKDu) reported in Sri Lanka and other countries is a mysterious and serious disease. Recently, we reported a high seroprevalence of antibodies to a hantavirus antigen among CKDu patients in Girandurukotte, Badulla district, Sri Lanka. However, the type of hantavirus with which the residents were infected was not determined. In this study, a total of 89 seropositive sera were examined to identify their serotypes using an indirect immunofluorescent antibody assay, a truncated-N-protein-based enzyme-linked immunosorbent assay, and a cross-neutralization test. These results indicated that the residents in this area were frequently infected with Thailand orthohantavirus or an antigenically related virus.



We express sincere thanks to Dr. Akio Koizumi of Kyoto University Graduate School of Medicine for helpful discussions.

Compliance with ethical standards

Ethical approval

The study was approved by the Institutional Ethical Review Committee, Faculty of Medicine, University of Peradeniya, Sri Lanka (2016/EC/64), and was also approved by the Ethical Review Committee of the Faculty of Medicine, Hokkaido University, Japan (M17-023). Patient/participant consent was obtained prior to recruitment into the study.

Conflict of interest

We declare that we have no conflict of interest.


  1. 1.
    Chandy S, Okumura M, Yoshimatsu K, Ulrich RG, John GT, Abraham P, Arikawa J, Sridharan G (2009) Hantavirus species in India: a retrospective study. Indian J Med Microbiol 27:348–350CrossRefGoogle Scholar
  2. 2.
    de Oliveira RC, Guterres A, Fernandes J, D’Andrea PS, Bonvicino CR, de Lemos ER (2014) Hantavirus reservoirs: current status with an emphasis on data from Brazil. Viruses 6:1929–1973CrossRefGoogle Scholar
  3. 3.
    Elwell MR, Ward GS, Tingpalapong M, LeDuc JW (1985) Serologic evidence of Hantaan-like virus in rodents and man in Thailand. Southeast Asian J Trop Med Public Health 16:349–354Google Scholar
  4. 4.
    Fulhorst CF, Monroe MC, Salas RA, Duno G, Utrera A, Ksiazek TG, Nichol ST, de Manzione NM, Tovar D, Tesh RB (1997) Isolation, characterization and geographic distribution of Cano Delgadito virus, a newly discovered South American hantavirus (family Bunyaviridae). Virus Res 51:159–171CrossRefGoogle Scholar
  5. 5.
    Gamage CD, Yasuda SP, Nishio S, Kularatne SA, Weerakoon K, Rajapakse J, Nwafor-Okoli C, Lee RB, Obayashi Y, Yoshimatsu K, Arikawa J, Tamashiro H (2011) Serological evidence of Thailand virus-related hantavirus infection among suspected leptospirosis patients in Kandy, Sri Lanka. Jpn J Infect Dis 64:72–75Google Scholar
  6. 6.
    Gamage CD, Yoshimatsu K, Sarathkumara YD, Thiviyaaluxmi K, Nanayakkara N, Arikawa J (2017) Serological evidence of hantavirus infection in Girandurukotte, an area endemic for chronic kidney disease of unknown aetiology (CKDu) in Sri Lanka. Int J Infect Dis 57:77–78CrossRefGoogle Scholar
  7. 7.
    Jameson LJ, Taori SK, Atkinson B, Levick P, Featherstone CA, van der Burgt G, McCarthy N, Hart J, Osborne JC, Walsh AL, Brooks TJ, Hewson R (2013) Pet rats as a source of hantavirus in England and Wales, 2013. Eurosurveillance 18:e57538Google Scholar
  8. 8.
    Johansson P, Yap G, Low HT, Siew CC, Kek R, Ng LC, Bucht G (2010) Molecular characterization of two hantavirus strains from different rattus species in Singapore. Virol J 7:15CrossRefGoogle Scholar
  9. 9.
    Kitamura T, Morita C, Komatsu T, Sugiyama K, Arikawa J, Shiga S, Takeda H, Akao Y, Imaizumi K, Oya A, Hashimoto N, Urasawa S (1983) Isolation of virus causing hemorrhagic fever with renal syndrome (HFRS) through a cell culture system. Jpn J Med Sci Biol 36:17–25CrossRefGoogle Scholar
  10. 10.
    Koma T, Yoshimatsu K, Pini N, Safronetz D, Taruishi M, Levis S, Endo R, Shimizu K, Yasuda SP, Ebihara H, Feldmann H, Enria D, Arikawa J (2010) Truncated hantavirus nucleocapsid proteins for serotyping Sin Nombre, Andes, and Laguna Negra hantavirus infections in humans and rodents. J Clin Microbiol 48:1635–1642CrossRefGoogle Scholar
  11. 11.
    Kruger DH, Schonrich G, Klempa B (2011) Human pathogenic hantaviruses and prevention of infection. Hum Vaccines 7:685–693CrossRefGoogle Scholar
  12. 12.
    Miettinen MH, Makela SM, Ala-Houhala IO, Huhtala HS, Koobi T, Vaheri AI, Pasternack AI, Porsti IH, Mustonen JT (2009) Tubular proteinuria and glomerular filtration 6 years after puumala hantavirus-induced acute interstitial nephritis. Nephron Clin Pract 112:c115–c120CrossRefGoogle Scholar
  13. 13.
    Miettinen MH, Makela SM, Ala-Houhala IO, Huhtala HS, Hurme MA, Koobi T, Partanen JA, Pasternack AI, Vaheri A, Porsti IH, Mustonen JT (2010) The severity of acute Puumala hantavirus infection does not predict the long-term outcome of patients. Nephron Clin Pract 116:c89–c94CrossRefGoogle Scholar
  14. 14.
    Milazzo ML, Cajimat MN, Romo HE, Estrada-Franco JG, Iniguez-Davalos LI, Bradley RD, Fulhorst CF (2012) Geographic distribution of hantaviruses associated with neotomine and sigmodontine rodents, Mexico. Emerg Infect Dis 18:571–576CrossRefGoogle Scholar
  15. 15.
    Palihawadana P (2009) Research programme for chronic kidney disease of unknown aetiology in Sri Lanka. WER Sri Lanka 36(49):1–4Google Scholar
  16. 16.
    Pattamadilok S, Lee BH, Kumperasart S, Yoshimatsu K, Okumura M, Nakamura I, Araki K, Khoprasert Y, Dangsupa P, Panlar P, Jandrig B, Kruger DH, Klempa B, Jakel T, Schmidt J, Ulrich R, Kariwa H, Arikawa J (2006) Geographical distribution of hantaviruses in Thailand and potential human health significance of Thailand virus. Am J Trop Med Hyg 75:994–1002CrossRefGoogle Scholar
  17. 17.
    Plyusnin A, Vapalahti O, Lundkvist A (1996) Hantaviruses: genome structure, expression and evolution. J Gen Virol 77:2677–2687CrossRefGoogle Scholar
  18. 18.
    Plyusnina A, Ibrahim IN, Plyusnin A (2009) A newly recognized hantavirus in the Asian house rat (Rattus tanezumi) in Indonesia. J Gen Virol 90:205–209CrossRefGoogle Scholar
  19. 19.
    Reynes JM, Soares JL, Hue T, Bouloy M, Sun S, Kruy SL, Flye Sainte Marie F, Zeller H (2003) Evidence of the presence of Seoul virus in Cambodia. Microbes Infect 5:769–773CrossRefGoogle Scholar
  20. 20.
    Reynes JM, Razafindralambo NK, Lacoste V, Olive MM, Barivelo TA, Soarimalala V, Heraud JM, Lavergne A (2014) Anjozorobe hantavirus, a new genetic variant of Thailand virus detected in rodents from Madagascar. Vector Borne Zoonotic Dis 14:212–219CrossRefGoogle Scholar
  21. 21.
    Rippe B (2006) Is there an increased long-term risk of hypertension and renal impairment after Puumala virus-induced nephropathy? Kidney Int 69:1930–1931CrossRefGoogle Scholar
  22. 22.
    Stohwasser R, Raab K, Darai G, Bautz EK (1991) Primary structure of the large (L) RNA segment of nephropathia epidemica virus strain Hallnas B1 coding for the viral RNA polymerase. Virology 183:386–391CrossRefGoogle Scholar
  23. 23.
    Sunil-Chandra NP, Clement J, Maes P, de Silva HJ, van Esbroeck M, van Ranst M (2015) Concomitant leptospirosis-hantavirus co-infection in acute patients hospitalized in Sri Lanka: implications for a potentially worldwide underestimated problem. Epidemiol Infect 143:2081–2093CrossRefGoogle Scholar
  24. 24.
    Vitarana T, Colombage G, Bandaranayake V, Lee HW (1988) Hantavirus disease in Sri Lanka [letter]. Lancet 2:1263Google Scholar
  25. 25.
    Weaver VM, Fadrowski JJ, Jaar BG (2015) Global dimensions of chronic kidney disease of unknown etiology (CKDu): a modern era environmental and/or occupational nephropathy? BMC Nephrol 16:145CrossRefGoogle Scholar
  26. 26.
    Yoshimatsu K, Arikawa J, Kariwa H (1993) Application of a recombinant baculovirus expressing hantavirus nucleocapsid protein as a diagnostic antigen in IFA test: cross reactivities among 3 serotypes of hantavirus which causes hemorrhagic fever with renal syndrome (HFRS). J Vet Med Sci 55:1047–1050CrossRefGoogle Scholar
  27. 27.
    Yoshimatsu K, Arikawa J (2014) Serological diagnosis with recombinant N antigen for hantavirus infection. Virus Res 187:77–83CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Microbiology and Immunology, Faculty of MedicineHokkaido UniversitySapporoJapan
  2. 2.Graduate School of Infectious DiseaseHokkaido UniversitySapporoJapan
  3. 3.Department of Microbiology, Faculty of MedicineUniversity of PeradeniyaPeradeniyaSri Lanka
  4. 4.Postgraduate Institute of ScienceUniversity of PeradeniyaPeradeniyaSri Lanka
  5. 5.Nephrology and Transplantation UnitTeaching Hospital KandyKandySri Lanka
  6. 6.Renal Clinic, District HospitalGirandurukotteSri Lanka
  7. 7.Graduate School of MedicineHokkaido UniversitySapporoJapan

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