![]() Therefore, the loss of the barrier function is not essential for virus replication but rather the result of the endothelial cells’ response to infection ( Figure 3). Virus replication is demonstrated in vitro and in vivo without cytopathic effect. ![]() Loss of endothelium barrier function: Orthohantaviruses endemic in Asia use beta integrin receptors to adhere to and penetrate endothelial cells. These results provide strong evidence that orthohantaviruses are endemic in India. In another study of 152 serum samples, 23 reacted with HTNV, PUUV, or SEOV. Analysis of serum samples revealed the cross-reactivity with SEOV in 12% and PUUV in 5% of individuals, respectively. In addition to Vellore, a high rate of orthohantavirus seropositivity was reported in healthy individuals from the Cochin and Chennai regions of India. Therefore, it was assigned a new name, a Thottapalayam thottimvirus, which is a proto-type shrew-borne orthohantavirus that belongs to the genus Thottimvirus. Although TPMV had morphological and genetic similarities with members of the genus Orthohantavirus of the family Hantaviridae, later, TPMV was shown to form a phylogenetically distinct genus. ![]() Initially, this virus was isolated from a non-rodent host, the house musk shrew ( Suncus murinus). Investigation of these outbreaks led to identifying a novel member of the genus Orthohantavirus named Thottapalayam virus (TPMV). The first cases of suspected orthohantavirus infection in India were reported in 1964 in Vellore. Additionally, conventional and novel approaches for preventing and treating orthohantavirus infection are discussed. We also described the clinical presentation and current understanding of the pathogenesis of orthohantavirus infection. We gave the synopsis of the history and diversity of orthohantaviruses in Asia. In this review, we summarized the current data on orthohantaviruses in Asia. Recently, orthohantavirus circulation was demonstrated in small mammals in Thailand and India, where orthohantavirus was not believed to be endemic. Along with those countries, HFRS tops the list of zoonotic infections in the Far Eastern Federal District of Russia. Orthohantaviruses are endemic to several Asian countries, such as China, South Korea, and Japan. Several species of orthohantaviruses were identified as causing infection, where Hantaan, Puumala, and Seoul viruses are most common. Orthohantavirus infection may cause Hemorrhagic Fever with Renal Syndrome (HRFS), a disease that is characterized by acute kidney injury and increased vascular permeability. This zoonotic infection is the result of exposure to the virus-contaminated aerosols. Hemorrhagic Fever with Renal Syndrome (HFRS) is the most frequently diagnosed zoonosis in Asia.
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