Prevention measures and communication strategies for hantavirus infection in Europe

Hantaviruses are a large group of RNA viruses that belong to the genus Hantavirus , family Bunyaviridae. Reservoirs for hantaviruses are mostly rodents. At least five hantaviruses – Puumala (PUUV), Dobrava-Belgrade (DOBV), Tula (TULV), Saarema (SAAV) and Seoul (SEOV) – circulate in Europe, but most reported human cases of infection are caused by PUUV and DOBV. 

Between 2000 and 2010 the annual number of reported hantavirus cases increased in Europe, although there were significant temporal and geographical fluctuations. In 2012, a sudden increase of hantavirus activity (e.g. in Germany and Slovenia) prompted the European Centre for Disease Prevention and Control (ECDC) to reassess the hantavirus situation in Europe and review the availability and scope of preventive and control measures. ECDC summarised all available information (as of 2012) on hantavirus for a total of 29 European countries; topics covered by the survey included the effectiveness of preventive measures, communication strategies, impact assessment studies and recommended preventive measures. 

This report presents the results of a literature review and a telephone survey among members of the European Network for Diagn ostics of ‘Imported’ Viral Diseases (ENIVD). ENIVD is a network of European laboratories working on diagnostics of imported, rare and emerging viral infections, including tick-borne encephalitis, hantavirus and dengue. The authors identified eight publications with a focus on hantavirus prevention measures in Europe, one of which presents specific strategies on what to communicate to the general public, how to disseminate information sheets and posters, and how to make medical doctors aware of recommended preventive measures. 

The situation in the 29 ENIVD member countries covered in this report was heterogeneous and varied widely (number of cases reported, presence of outbreaks in 2005–2012, distribution of the disease). The majority of the countries (26/29) had prepared institutional guidelines on preventive measures for hantavirus. Twenty-seven countries (90%) had a policy to communicate preventive measures through a variety of media in case of an outbreak; eight countries (28%) also provided information on a regular basis even before outbreaks. The most frequently used communication channels were mass media (TV, radio, newspapers), institutional websites (health and occupational health), presentations and workshops for health professionals, and articles in specialised journals. The majority of the countries have never performed impact assessment studies on the effectiveness of preventive measures, communication strategies, or awareness or knowledge studies. 

To prevent further human hantavirus infections in Europe, an integrated approach needs to be established, including predictive models which are adapted to the regional situation. There is also a need to evaluate the impact of preventive measures in the affected countries and increase the level of awareness in the population at risk. This often translates into increasing the availability of pertinent information through a variety of information channels.