Fatal case of hemorrhagic fever with renal syndrome associated with hantavirus Seoul

Seoul orthohantavirus is one of the causative agents of hemorrhagic fever with renal syndrome (HFRS) in the Russian Far East. Foci of SEOV in Norway rats have been identified in the cities of Vladivostok and Khabarovsk.
The aim. Study of a clinical case of HFRS with a fatal outcome, from Komsomolsk-on-Amur in 2025.
Materials and methods. Samples of blood serum and autopsy material (blood, lung, spleen, liver, kidney tissues) from a resident of Komsomolsk-on-Amur with a clinical diagnosis of HFRS were examined using enzyme-linked immunosorbent assay (ELISA) and reverse transcription-polymerase chain reaction (RT-PCR) followed by sequencing.
Results. The laboratory studies confirmed the clinical diagnosis. Antibodies to hantaviruses in a titer of 1:3200 (IgM) and 1:1600 (IgG) were detected by the ELISA in the blood serum. SEOV RNA was detected in blood serum and autopsy material (blood, lung,
spleen, liver, kidney tissues) studying by the RT-PCR and using the OM-Screen-GLPSRV test system. Analysis of genome fragments showed high homology of SEOV from Komsomolsk-on-Amur with virus strains previously identified in Khabarovsk, as well as those widespread in China. Genetic evidence of human infection, associated with the Seoul virus circulating in the city of Komsomolsk-on-Amur has been obtained, and two hypotheses have been put forward for the formation of the focus: importation with infected rats from China or Khabarovsk, and the possible existence of a mainland variant of the virus in a vast territory, including the eastern regions of China and Khabarovsk Krai.
Conclusion. Third urban focus of Seoul hantavirus was detected in Russia. The fatal outcome of HFRS could be caused by a comorbidity: chronic alcohol intoxication with multiple organ manifestations.

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