An Immune Adherence Assay for Discrimination Between Etiologic Agents of Hemorrhagic Fever with Renal Syndrome

Antigens of the viruses that cause hemorrhagic fever with renal syndrome (HFRS) and antibodies to these antigens were titrated in an immune adherence hemagglutination (IAHA) test and a CF test. Vero-E6 cells infected with the SR-11 strain of HFRS virus, an isolate from rats associated with a laboratory outbreak in Japan, and the 76-118 strain of Hantaan virus, the etiologic agent of Korean hemorrhagic fever, were used as antigens in the IAHA, CF, and indirect immunofluorescent antibody (IFA) tests. Sera from patients with different types of HFRS were tested against both strains of virus. Titers of antibody detected by the IFA test were similar for the two strains, but the IAHA test discriminated between antibodies to the two types of HFRS virus. Antigenic differences between HFRS viruses were suggested by the results of the IAHA test. Various forms of hemorrhagic fever with renal syndrome (HFRS) have been reported from many parts of the world. These diseases are all characterized by fever, hemorrhage, and renal involvement, but the severity of illness and the epidemio