Two Cases of Hemorrhagic Fever with Renal Syndrome in Northern Greece

Two cases of hemorrhagic fever with renal syndrome were diagnosed in woodcutters presumably exposed to wild rodents and their urine in a forest in northern Greece. The disease was characterized by acute renal insufficiency without hemorrhagic manifesta-tions. One patient required hemodialysis, but both recovered without sequelae and developed a fourfold increase in titer of antibody to Hantaan virus, as determined by an immunofluorescence test. These are the first reported cases of hemorrhagic fever with renal syndrome in Greece. Hemorrhagic fever with renal syndrome (HFRS) is an acute febrile nephropathy caused by closely related zoonotic viruses in the family Bunyaviridae [1, 2]. Hantaan virus, isolated in 1978 from lung tissue of field mice (Apodemus agrarius) is asso-ciated with Korean hemorrhagic fever, a highly malignant form of HFRS [3]. A related virus re-covered from voles (Clethrionomys glariolus) in Scandinavia is apparently the cause of the milder form of HFRS, nephropathia epidemica [4]. HFRS has also been recognized in the Sovie