A novel genotype of Hantaan orthohantavirus harbored by Apodemus agrarius chejuensis as a potential etiologic agent of hemorrhagic fever with renal syndrome in Republic of Korea

Abstract

Background Orthohantaviruses, causing hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome, pose a significant public health threat worldwide. Despite the significant mortality and morbidity, effective antiviral therapeutics or vaccines for orthohantavirus infections are currently unavailable. This study aimed to investigate the prevalence of HFRS-associated orthohantaviruses and identify the etiological agent of orthohantavirus outbreaks in southern Republic of Korea (ROK). Methodology/Principal findings We collected small mammals on Jeju Island during 2018-2020. We detected the Hantaan virus (HTNV)-specific antibodies and RNA using an indirect immunofluorescence assay test and reverse transcription-polymerase chain reaction on Apodemus agrarius chejuensis (A. chejuensis). The prevalence of anti-HTNV antibodies among rodents was 14.1%. A total of six seropositive mice harbored HTNV RNA. The amplicon-based next-generation sequencing provided nearly full-length tripartite genomic sequences of six HTNV harbored by A. chejuensis. Phylogenetic and tanglegram analyses were conducted for inferring evolutionary relationships between orthohantaviruses with their reservoir hosts. Phylogenetic analyses identified a novel distinct HTNV genotype. The detected HTNV genomic sequences were phylogenetically related to a viral sequence derived from HFRS patient in southern ROK. Tanglegram analysis demonstrated the segregation of HTNV genotypes corresponding to Apodemus spp. divergence. Conclusions/Significance Our results suggest that A. chejuensis-borne HTNV may be a potential etiological agent of HFRS in southern ROK. Ancestral HTNV may infect A. chejuensis prior to geological isolation between the Korean peninsula and Jeju Island, supporting the co-evolution of orthohantaviruses and rodents. This study arises awareness among physicians for HFRS outbreaks in southern ROK. Author summary According to the Korea Disease Control and Prevention Agency, about 18 HFRS cases have been reported over the past decade on Jeju Island, Republic of Korea (ROK). Currently, no report for the etiological agent associated with hemorrhagic fever with renal syndrome (HFRS) on Jeju Island is available. We report the nearly whole-genome sequences and have characterized a novel HTNV genotype carried by the Jeju striped field mice (Apodemus chejuensis) collected from Jeju Island. The phylogenetic analysis of HTNV revealed well-supported phylogeographic clusters, showing a high genetic divergence by the distribution of rodent reservoir hosts. To our knowledge, this study is the first provisional report that suggests molecular evidence of orthohantavirus outbreaks associated with hantaviral disease on Jeju Island. Although our observations are provisional, the novel genotype of HTNV harbored by A. chejuensis may be a potential etiological agent of HFRS in southern ROK. This study provides important insights into the male-predominance prevalence, genetic diversity, and molecular evolutionary dynamics of orthohantaviruses circulating in the ROK.