Dobrava-Belgrade Virus | Ask Microbiology

Dobrava‑Belgrade virus (DOBV) is a member of the genus Orthohantavirus (family Hantaviridae) and one of the Old World hantaviruses that cause haemorrhagic fever with renal syndrome (HFRS). It has a tri‑segmented negative‑sense RNA genome (S, M and L) encoding the nucleocapsid protein, glycoproteins Gn and Gc and RNA‑dependent RNA polymerase. The virus was first identified in Slovenia and the former Yugoslavia, and its name reflects both Dobrava (a locality in Slovenia) and Belgrade (Serbia).

Classification, Genotypes and Transmission

Dobrava‑Belgrade virus belongs to the Dobrava orthohantavirus species, which comprises several genetic lineages associated with different Apodemus mice. The Dobrava genotype is carried by the yellow‑necked field mouse (Apodemus flavicollis) and is linked to severe HFRS with case fatality rates approaching 10–12 %. The Kurkino genotype is hosted by the striped field mouse (A. agrarius) and causes a milder disease with mortality below 1 %. The Saaremaa genotype, also found in A. agrarius, and the Sochi genotype, carried by the Black Sea field mouse (A. ponticus), contribute to variable clinical outcomes. Like other hantaviruses, DOBV persists in its rodent hosts and is shed in urine, faeces and saliva. Humans become infected by inhaling aerosols of contaminated excreta, typically during agricultural work or cleaning rodent‑infested structures. Person‑to‑person transmission has not been documented. Virions are enveloped, and their replication in vascular endothelium leads to increased permeability, haemorrhage and acute kidney injury.

Geographic Distribution and Disease Burden

DOBV occurs across southeastern and central Europe, including Slovenia, Croatia, Bosnia and Herzegovina, Greece, Serbia, North Macedonia, Bulgaria, Austria, Germany and Turkey. Outbreaks are often associated with fluctuations in rodent populations. Severe epidemics with high mortality were recorded in the mid‑1990s in Slovenia and Greece. Subsequent investigations revealed that Dobrava genotype infections predominated in mountainous forest regions, whereas Kurkino genotype infections were more common in lowland agricultural areas. Cases have also been reported from Estonia, Slovakia and European Russia, though often with milder disease. Clinical manifestations include fever, thrombocytopenia, abdominal pain and renal failure; hypotension and haemorrhagic complications may occur with Dobrava genotype infection. Supportive therapy remains the cornerstone of management, focusing on fluid balance and renal replacement when needed. There is no licensed vaccine; control measures emphasize reducing contact with wild rodents through hygiene and proper storage of food and animal feed.

Dobrava‑Belgrade virus is notable for its genetic diversity and the variable severity of disease associated with different rodent hosts. Understanding regional genotypes and their reservoirs aids in surveillance and prevention. Public health education and rodent control continue to be vital tools for reducing human infection.