<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">pmj</journal-id><journal-title-group><journal-title xml:lang="ru">Тихоокеанский медицинский журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Pacific Medical Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1609-1175</issn><publisher><publisher-name>TGMU</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.34215/1609-1175-2024-4-76-81</article-id><article-id custom-type="elpub" pub-id-type="custom">pmj-2833</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL RESEARCHES</subject></subj-group></article-categories><title-group><article-title>Клинико-эпидемиологические аспекты геморрагической лихорадки с почечным синдромом в Приморском крае</article-title><trans-title-group xml:lang="en"><trans-title>Clinical and epidemiological aspects of hemorrhagic fever with renal syndrome in the Primorsky Krai</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Иванис</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ivanis</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владивосток</p></bio><bio xml:lang="en"><p>Vladivostok</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Иунихина</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Iunikhina</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владивосток</p></bio><bio xml:lang="en"><p>Vladivostok</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5166-5569</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Попов</surname><given-names>А. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Popov</surname><given-names>A. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Александр Федорович Попов, профессор</p><p>кафедра эпидемиологии и военной эпидемиологии</p><p>690002; проспект Острякова, 2; Владивосток</p><p>тел.: 8 (914) 704-56-20</p></bio><bio xml:lang="en"><p>Alexander F. Popov, Professor</p><p>Department of Epidemiology and Military Epidemiology</p><p>690002; (2 Ostryakova Avenue; Vladivostok</p><p>phone: 8 (914) 704-56-20</p></bio><email xlink:type="simple">doctor.popov@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хомичук</surname><given-names>Т. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Khomichuk</surname><given-names>T. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владивосток</p></bio><bio xml:lang="en"><p>Vladivostok</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Захарова</surname><given-names>Г. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Zacharova</surname><given-names>G. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владивосток</p></bio><bio xml:lang="en"><p>Vladivostok</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Компанец</surname><given-names>Г. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Kompanets</surname><given-names>G. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владивосток</p></bio><bio xml:lang="en"><p>Vladivostok</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Верхотурова</surname><given-names>В. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Verkhoturova</surname><given-names>V. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владивосток</p></bio><bio xml:lang="en"><p>Vladivostok</p></bio><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Перевертень</surname><given-names>Л. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Pereverten</surname><given-names>L. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владивосток</p></bio><bio xml:lang="en"><p>Vladivostok</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кушнарева</surname><given-names>Т. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kushnareva</surname><given-names>T. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владивосток</p></bio><bio xml:lang="en"><p>Vladivostok</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Щелканов</surname><given-names>М. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Shchelkanov</surname><given-names>M. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владивосток</p></bio><bio xml:lang="en"><p>Vladivostok</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Тихоокеанский государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pacific State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Научно-исследовательский институт эпидемиологии и микробиологии имени Г.П. Сомова; Дальневосточный федеральный университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute of Epidemiology and Microbiology named after G.P. Somov; Far Eastern Federal University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Тихоокеанский государственный медицинский университет; Дальневосточный федеральный университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pacific State Medical University; Far Eastern Federal University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Центр гигиены и эпидемиологии в Приморском крае</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Center for Hygiene and Epidemiology in Primorsky Territory</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>Дальневосточный федеральный университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Far Eastern Federal University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>Краевая клиническая инфекционная больница</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Regional Clinical Infectious Diseases Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>16</day><month>02</month><year>2025</year></pub-date><volume>0</volume><issue>4</issue><fpage>76</fpage><lpage>81</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Иванис В.А., Иунихина О.В., Попов А.Ф., Хомичук Т.Ф., Захарова Г.А., Компанец Г.Г., Верхотурова В.И., Перевертень Л.Ю., Кушнарева Т.В., Щелканов М.Ю., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Иванис В.А., Иунихина О.В., Попов А.Ф., Хомичук Т.Ф., Захарова Г.А., Компанец Г.Г., Верхотурова В.И., Перевертень Л.Ю., Кушнарева Т.В., Щелканов М.Ю.</copyright-holder><copyright-holder xml:lang="en">Ivanis V.A., Iunikhina O.V., Popov A.F., Khomichuk T.F., Zacharova G.A., Kompanets G.G., Verkhoturova V.I., Pereverten L.Y., Kushnareva T.V., Shchelkanov M.Y.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.tmj-vgmu.ru/jour/article/view/2833">https://www.tmj-vgmu.ru/jour/article/view/2833</self-uri><abstract><sec><title>   Цель</title><p>   Цель: оценка эпизоотической и клинико-эпидемиологической ситуации по заболеваемости геморрагической лихорадкой с почечным синдромом (ГЛПС) в Приморском крае в период 2019–2023 гг.</p></sec><sec><title>   Материалы и методы</title><p>   Материалы и методы. Ретроспективный клинико-эпидемиологический анализ заболеваемости ГЛПС проведен у 149 пациентов, эпизоотический процесс в популяциях мелких млекопитающих в природных и синантропных очагах изучен согласно общепринятым методикам.</p></sec><sec><title>   Результаты</title><p>   Результаты. Активность природных очагов ГЛПС, обусловленных циркуляцией 3 ортохантавирусов (Hantaan и его генотип Amur, Seoul) сохраняется, причем за счет доминирования носителя Amur в организме восточноазиатской мыши, несмотря на четкую тенденцию снижения заболеваемости (с 4,9 показателя среднего многолетнего уровня до 1,6 на 100 тысяч населения в 2019 г.). Отмечено преобладание тяжелых и осложненных форм инфекции (23,5 %), высокая летальность (до 11,5 % в 2023 г.). Выявлены некоторые клинико-патогенетические прогностические критерии тяжести ГЛПС в ранние сроки болезни.</p></sec><sec><title>   Заключение</title><p>   Заключение. Тяжесть течения, трудности первичной диагностики определяет ГЛПС как актуальную инфекцию здравоохранения региона.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>   Objective</title><p>   Objective. To assess the epizootic and clinical-epidemiological situation regarding the incidence of hemorrhagic fever with renal syndrome in the Primorsky Krai in the period 2019–2023.</p></sec><sec><title>   Materials and methods</title><p>   Materials and methods. A retrospective clinical and epidemiological study of the incidence of hemorrhagic fever with renal syndrome enrolled 149 patients. The epizootic process in populations of small mammals in natural and synanthropic foci was examined according to generally accepted methodologies.</p></sec><sec><title>   Results</title><p>   Results. The activity of natural foci of hemorrhagic fever with renal syndrome, caused by the circulation of three orthohantaviruses (Hantaan virus and its Amur and Seoul genotypes), remains significant, with a predominance of the Amur carrier in the body of the Korean field mouse. This occurs despite a clear downward trend in the incidence (from an average annual rate of 4.9 to 1.6 per 100,000 population in 2019). Severe and complicated forms of the infection notably prevailed (23.5 %), with high mortality rates (up to 11.5 % in 2023). Some clinical and pathogenetic prognostic criteria for the severity of hemorrhagic fever with renal syndrome were identified in the early stages of the disease.</p></sec><sec><title>   Conclusion</title><p>   Conclusion. The severity of the disease course and difficulties in primary diagnosis define the hemorrhagic fever with renal syndrome to be a significant public health concern in the region.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>геморрагическая лихорадка с почечным синдромом</kwd><kwd>ортохантавирусы</kwd><kwd>эпидемиология</kwd><kwd>клиника</kwd><kwd>диагностика</kwd></kwd-group><kwd-group xml:lang="en"><kwd>hemorrhagic fever with renal syndrome</kwd><kwd>orthohantaviruses</kwd><kwd>epidemiology</kwd><kwd>clinic</kwd><kwd>diagnosis</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Авторы заявляют о финансировании проведенного исследования из собственных средств</funding-statement><funding-statement xml:lang="en">The authors declare funding for the study from their own funds.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Савицкая Т.А., Иванова А.В., Зубова А.А. Хантавирусные болезни : обзор эпидемиологической ситуации в мире. Анализ эпидемиологической ситуации по геморрагической лихорадке с почечным синдромом в Российской Федерации в 2023 г. и прогноз на 2024 г. Проблемы особо опасных инфекций. 2024;(1):113–24. doi: 10.21055/0370-1069-2024-1-113-124</mixed-citation><mixed-citation xml:lang="en">Savitskaya TA, Ivanova AV, Zubova AA. Hantavirus diseases : review of the epidemiological situation in the world. Analysis of the epidemiological situation of hemorrhagic fever with renal syndrome in the Russian Federation in 2023 and forecast for 2024. Problems of Particularly Dangerous Infections. 2024; (1):113–24 (In Russ.) doi: 10.21055/0370-1069-2024-1-113-124</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Tariq M, Kim DM. Hemorrhagic fever with renal syndrome : literature review, epidemiology, clinical picture and pathogenesis. Infection &amp; Chemotherapy. 2022;54(1):1–19. doi: 10.3947/ic2021.0148</mixed-citation><mixed-citation xml:lang="en">Tariq M, Kim DM. Hemorrhagic fever with renal syndrome : literature review, epidemiology, clinical picture and pathogenesis. Infection &amp; Chemotherapy. 2022;54(1):1–19. doi: 10.3947/ic2021.0148</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Avšič-Županc T, Saksida A, Korva M. Hantavirus infections. Clin. Microbiol. Infect. 2019; 21S: e6-e16. doi: 10.1111/1469-0691-12291</mixed-citation><mixed-citation xml:lang="en">Avšič-Županc T, Saksida A, Korva M. Hantavirus infections. Clin. Microbiol. Infect. 2019; 21S: e6-e16. doi: 10.1111/1469-0691-12291</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Ишмухаметов А.А., Дзагурова Т.К., Морозов В.Г. Характеристика хантавирусов – возбудителей зоонозных геморрагических лихорадок. Эпидемиология и вакцинопрофилактика. 2017;16, 3(94): 26–32. doi: 10.31631/2073-3046-2017-16-3-26-32</mixed-citation><mixed-citation xml:lang="en">Ishmukhametov AA, Dzagurova TK, Morozov VG. Characteristics of Hantaviruses as Causative Agents of the Zoonotic Hemorrhagic Fevers. Epidemiology and Vaccinal Prevention. 2017;16(3):26–32 (In Russ.) doi: 10.31631/2073-3046-2017-16-3-26-32</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Kabwe E, Davidyuk Y, Shamsutdinov A. Prevalence of the Puumala orthohantavirus strains in the Pre-Kama Area of the Republic of Tatarstan, Russia. Pathogens. 2020;9(9):775 doi: 10.3390/9090775</mixed-citation><mixed-citation xml:lang="en">Kabwe E, Davidyuk Y, Shamsutdinov A. Prevalence of the Puumala orthohantavirus strains in the Pre-Kama Area of the Republic of Tatarstan, Russia. Pathogens. 2020;9(9):775 doi: 10.3390/9090775</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Zhonoxing Wei, Kenta Shimizu, Rakiiy S. Sarii pathological studies on Hantaan vires-infected mice simulating severe. Hemorrhagic fever with renal syndrome. Viruses.2022;14:2247. doi: 10.3392/v14102247</mixed-citation><mixed-citation xml:lang="en">Zhonoxing Wei, Kenta Shimizu, Rakiiy S. Sarii pathological studies on Hantaan vires-infected mice simulating severe. Hemorrhagic fever with renal syndrome. Viruses.2022;14:2247. doi: 10.3392/v14102247</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Яшина Л.Н., Сметанникова Н.А., Компанец Г.Г. Молекулярная эпидемиология патогенных хантавирусов на Дальнем Востоке России, 2015–2018г.г. Проблемы особо опасных инфекций. 2019;4:102–8. doi: 10.21055/0370-1069-2019-4-102-108</mixed-citation><mixed-citation xml:lang="en">Yashina LN, Smetannikova NA., Kompanets GG. Molecular epidemiology of pathogenic hantaviruses in the Russian Far East, 2015–2018. Problems of Particularly Dangerous Infections. 2019; 4;102–8 (In Russ.) doi: 10.21055/0370-1069-2019-4-102-108</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Kushnareva TV, Slonova RA. The Natural host range of Hantaviruses and their reservoir potential in the dynamic of the epizootic process within the ecosystems of Primorsky Krai. Contemporary Problems of Ecology. 2014;7(1);19–25.</mixed-citation><mixed-citation xml:lang="en">Kushnareva TV, Slonova RA. The Natural host range of Hantaviruses and their reservoir potential in the dynamic of the epizootic process within the ecosystems of Primorsky Krai. Contemporary Problems of Ecology. 2014;7(1);19–25.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Компанец Г.Г., Иунихина О.В. Современные эпидемиологические аспекты геморрагической лихорадки с почечным синдромом : к 85-летию изучения на Дальнем Востоке России. Тихоокеанский медицинский журнал.2018;3;9–13.</mixed-citation><mixed-citation xml:lang="en">Kompanets GG, Iunikhina OV. Modern epidemiological aspects of hemorrhagic fever with renal syndrome : to the 85&lt;sup&gt;th&lt;/sup&gt; anniversary of study in the Russian Far East. Pacific Medical Journal. 2018;3;9–13 (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Иванис В.А., Кушнарева Т.В., Компанец Г.Г., Верхотурова В.И., Иунихина О.В., Перевертень Л.Ю., Максема И.П. Геморрагическая лихорадка с почечным синдромом на юге Дальнего Востока России: актуальные проблемы диагностики и терапии. Журнал Инфектологии. 2015;7(3);51–8. doi: 10.226251/2027-6732-2015-7-3-51-58</mixed-citation><mixed-citation xml:lang="en">Ivanis VA, Kushnareva TV, Kompanets GG, Verhoturova VI, Iunikhina OV, Pereverten LJ, Maksema IP. Hemorrhagic fever with renal syndrome in the south of the Russian Far East: current problems of diagnosis and therapy. Journal Infectology. 2015;7(3);51–8 (In Russ.) doi: 10.226251/2027-6732-2015-7-3-51-58</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Слонова Р.А., Кушнарева Т.В., Иунихина О.В. Динамика выявления хантавируса в органах выделения мышей рода Apodemus и ее связь с эпидемическим проявлением хантавирусной инфекции. Вопросы вирусологии. 2010;2:38–42.</mixed-citation><mixed-citation xml:lang="en">Slonova RA, Kushnareva TV, Iunikhina OV. Dynamics of detection of hantavirus in the excretory organs of mice of the genus Apodemus and its connection with the epidemic manifestation of hantavirus infection. Problems of Virology. 2010:2:38–42 (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Albornoz A, Hoffmann AB, Lozach PY. Early Bunyavirus-Host Cell. Interaction. Viruses. 2016;8(5): pii E143. doi: 10.3390/v8050143</mixed-citation><mixed-citation xml:lang="en">Albornoz A, Hoffmann AB, Lozach PY. Early Bunyavirus-Host Cell. Interaction. Viruses. 2016;8(5): pii E143. doi: 10.3390/v8050143</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Risteska-Nejashmikj V, Ristikj-Stomnaroska D, Borevska G. Facing of family doctor with Hantavirus infection. J. Med. Sci. 2019;7 (10):1660–4. doi: 10.3889/oamjms.2019.468</mixed-citation><mixed-citation xml:lang="en">Risteska-Nejashmikj V, Ristikj-Stomnaroska D, Borevska G. Facing of family doctor with Hantavirus infection. J. Med. Sci. 2019;7 (10):1660–4. doi: 10.3889/oamjms.2019.468</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Moore RА., Griffen D. Hantavirus Syndrome. Stat Pearls Publishing LLC [Internet]. Author Information. Last Update: May 10, 2019. https: www.nlm.gov/books/NBK.513243/ PMID: 30020615. (available date/25/05/2024)</mixed-citation><mixed-citation xml:lang="en">Moore RА., Griffen D. Hantavirus Syndrome. Stat Pearls Publishing LLC [Internet]. Author Information. Last Update: May 10, 2019. https: www.nlm.gov/books/NBK.513243/ PMID: 30020615. (available date/25/05/2024)</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Dreshaj Sh, Ajazaj L, Hasani NA. Nonfatal case of Dobrava Hantavirus hemorrhagic fever with renal syndrome combined with Hantavirus cardiopulmonary syndrome. J. Glob. Infect. 2018;10(1):22–5. doi: 10.4103/jgid.jgid1217</mixed-citation><mixed-citation xml:lang="en">Dreshaj Sh, Ajazaj L, Hasani NA. Nonfatal case of Dobrava Hantavirus hemorrhagic fever with renal syndrome combined with Hantavirus cardiopulmonary syndrome. J. Glob. Infect. 2018;10(1):22–5. doi: 10.4103/jgid.jgid1217</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
