Journal of Preventive Medicine & Infectious Diseases

Abstract

This study evaluated serological evidence of hantavirus infections in patients with acute febrile illnesses (AFI) at the Medical Research Institute (MRI) in Sri Lanka, with a concurrent assessment of dengue virus infections. By analyzing both pathogens within the same population, the study aimed to enhance diagnostic accuracy and elucidate the clinical relevance of hantavirus infections.

A retrospective analysis was performed on 58 patients aged 0.5 to 71 years (mean age ± SD: 29.8 ± 26.27), including 37 males, 18 females, and 3 individuals with unreported gender. Data extracted from samples collected between January and May 2024 from diverse regions of Sri Lanka were analysed. Hantavirus infection was identified through IgM antibody detection via ELISA, while dengue virus diagnosis relied on NS1 antigen testing, IgM assays, and PCR. Serological evidence confirmed hantavirus infection in 12% of cases, with no co-infections observed. Dengue virus was detected in 13.7% of cases. Hantavirus infections were associated with severe systemic complications, including cardiac issues (e.g., pericarditis), renal failure, and pulmonary conditions such as acute respiratory distress syndrome (ARDS) and pulmonary hemorrhage. In contrast, dengue infections presented distinct clinical features, including dengue hemorrhagic fever (DHF) with hepatomegaly, neurological involvement (e.g., viral encephalitis), and typical dengue fever without severe systemic impact.

The findings highlight the utility of serological testing, particularly IgM ELISA, for diagnosing hantavirus infections in AFI. The study underscores the need for routine inclusion of hantavirus diagnostics in endemic regions and calls for further research to refine diagnostic strategies for co-circulating febrile illnesses.