Nephropathia Epidemica in Metropolitan Area, Germany

To the Editor: Old World hantaviruses (family Bunyaviridae) are rodentborne pathogens that can cause hemorrhagic fever with renal syndrome (HFRS) (1). At least 3 different pathogenic hantavirus species have been detected in Europe: Dobrava-Belgrade virus (DOBV), Tula virus, and Puumala virus (PUUV) (1–3). Most human hantavirus infections in Europe are assigned to PUUV transmitted by bank voles (Myodes glareolus, formerly Clethrionomys glareolus). Although PUUV is thought to cause a mild form of HFRS, designated as nephropathia epidemica (NE), severe courses have been described with a case-fatality ratio of up to 0.6% (3).