{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T17:58:08Z","timestamp":1791655088334,"version":"4.3.4"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013169","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000}}],"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["19K10595"],"award-info":[{"award-number":["19K10595"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["23K05530"],"award-info":[{"award-number":["23K05530"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008968","name":"National Research Council Sri Lanka","doi-asserted-by":"publisher","award":["20-073"],"award-info":[{"award-number":["20-073"]}],"id":[{"id":"10.13039\/100008968","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009037","name":"Science and Technology Research Partnership for Sustainable Development","doi-asserted-by":"publisher","award":["JP23m0110019"],"award-info":[{"award-number":["JP23m0110019"]}],"id":[{"id":"10.13039\/501100009037","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020955","name":"Sakura Science Exchange Program","doi-asserted-by":"publisher","award":["S2022F0600232"],"award-info":[{"award-number":["S2022F0600232"]}],"id":[{"id":"10.13039\/501100020955","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003485","name":"Heiwa Nakajima Foundation","doi-asserted-by":"publisher","award":["Asian Region Priority Academic Research 2019"],"award-info":[{"award-number":["Asian Region Priority Academic Research 2019"]}],"id":[{"id":"10.13039\/501100003485","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003485","name":"Heiwa Nakajima Foundation","doi-asserted-by":"publisher","award":["2023"],"award-info":[{"award-number":["2023"]}],"id":[{"id":"10.13039\/501100003485","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In Sri Lanka, a high seroprevalence of antibodies against hantaviruses was reported in communities affected by chronic kidney disease of unknown etiology (CKDu). Recently, two rodent-borne hantaviruses, Lanka virus and Anjozorobe virus, were identified in these areas. However, it is unclear which virus is the source of infection in humans, and its pathogenicity is unknown.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology\/principal findings<\/jats:title>\n<jats:p>A total of 181 sera from febrile patients from two CKDu-endemic regions, Girandurukotte and Polonnaruwa, were examined and Lanka virus genome was detected in two IgM-positive febrile patients. Of 76 serum samples from patients with fever of unknown etiology collected during 2016 examined to identify hantavirus genomes, antibodies, and serotypes, 10 were IgG-positive with five of them having IgM also. They were all without clinical features of hemorrhagic fever with renal syndrome, but three patients required treatment in the intensive care unit. A serotyping strategy was established based on the antigenic difference of the glycoprotein Gn of Lanka and Anjozorobe viruses. Using this method, febrile patients were found to be infected with the Lanka virus and none of the patient sera showed Anjozorobe virus infection pattern. Additionally, a total of 373 previously diagnosed seropositive serum samples from CKDu patients and healthy residents were serotyped to categorize 87% of seropositives as Lanka virus infection.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions\/significance<\/jats:title>\n<jats:p>Lanka virus carried by little Indian field mouse <jats:italic>(Mus booduga)<\/jats:italic> is transmitted to humans, likely causing febrile illness occasionally while leading to severe disease in some of the febrile patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0013169","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T17:56:11Z","timestamp":1749664571000},"page":"e0013169","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Lanka virus, a Mus booduga-borne orthohantavirus infection-associated febrile illness in Sri Lanka"],"prefix":"10.1371","volume":"19","author":[{"given":"Devinda S.","family":"Muthusinghe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavani","family":"Senarathne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenta","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yomani D.","family":"Sarathkumara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanika","family":"Nanayakkara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sithumini M.W.","family":"Lokupathirage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhouoxing","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nipun S.","family":"Rathnayake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rydhnieya","family":"Vijeyakumaran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuo","family":"Koizumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomonori","family":"Kawakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Koizumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kouji H.","family":"Harada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilanthi","family":"Dissanayake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senanayake A. M.","family":"Kularathne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshimi","family":"Tsuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuzo","family":"Urata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiro","family":"Arikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandika D.","family":"Gamage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0062-2753","authenticated-orcid":true,"given":"Kumiko","family":"Yoshimatsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"key":"pntd.0013169.ref001","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1743-422X-7-15","article-title":"Molecular characterization of two hantavirus strains from different rattus species in Singapore","volume":"7","author":"P Johansson","year":"2010","journal-title":"Virol J"},{"key":"pntd.0013169.ref002","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.cimid.2007.05.011","article-title":"Hantavirus infection in East Asia","volume":"30","author":"H Kariwa","year":"2007","journal-title":"Comp Immunol Microbiol Infect Dis"},{"issue":"3","key":"pntd.0013169.ref003","first-page":"349","article-title":"Serologic evidence of Hantaan-like virus in rodents and man in Thailand","volume":"16","author":"MR Elwell","year":"1985","journal-title":"Southeast Asian J Trop Med Public Health"},{"issue":"3","key":"pntd.0013169.ref004","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1089\/vbz.2013.1359","article-title":"Anjozorobe hantavirus, a new genetic variant of Thailand virus detected in rodents from Madagascar","volume":"14","author":"J-M Reynes","year":"2014","journal-title":"Vector Borne Zoonotic Dis"},{"key":"pntd.0013169.ref005","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1099\/vir.0.006155-0","article-title":"A newly recognized hantavirus in the Asian house rat (Rattus tanezumi) in Indonesia","volume":"90","author":"A Plyusnina","year":"2009","journal-title":"J Gen Virol"},{"issue":"5","key":"pntd.0013169.ref006","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1099\/jgv.0.000440","article-title":"Discovery of hantavirus circulating among Rattus rattus in French Mayotte island, Indian Ocean","volume":"97","author":"C Filippone","year":"2016","journal-title":"J Gen Virol"},{"issue":"5","key":"pntd.0013169.ref007","doi-asserted-by":"crossref","first-page":"994","DOI":"10.4269\/ajtmh.2006.75.994","article-title":"Geographical distribution of hantaviruses in Thailand and potential human health significance of Thailand virus","volume":"75","author":"S Pattamadilok","year":"2006","journal-title":"Am J Trop Med Hyg"},{"issue":"4","key":"pntd.0013169.ref008","doi-asserted-by":"crossref","first-page":"348","DOI":"10.4103\/0255-0857.55456","article-title":"Hantavirus species in India: a retrospective study","volume":"27","author":"S Chandy","year":"2009","journal-title":"Indian J Med Microbiol"},{"issue":"1","key":"pntd.0013169.ref009","doi-asserted-by":"crossref","first-page":"72","DOI":"10.7883\/yoken.64.72","article-title":"Serological evidence of Thailand virus-related hantavirus infection among suspected leptospirosis patients in Kandy, Sri Lanka","volume":"64","author":"CD Gamage","year":"2011","journal-title":"Jpn J Infect Dis"},{"issue":"3","key":"pntd.0013169.ref010","doi-asserted-by":"crossref","first-page":"587","DOI":"10.3201\/eid2603.190320","article-title":"Human Exposure to Hantaviruses Associated with Rodents of the Murinae Subfamily, Madagascar","volume":"26","author":"HA Rabemananjara","year":"2020","journal-title":"Emerg Infect Dis"},{"issue":"8622","key":"pntd.0013169.ref011","first-page":"1263","article-title":"Hantavirus disease in Sri Lanka","volume":"2","author":"T Vitarana","year":"1988","journal-title":"Lancet"},{"issue":"5","key":"pntd.0013169.ref012","doi-asserted-by":"crossref","first-page":"533","DOI":"10.7883\/yoken.JJID.2021.837","article-title":"Hantavirus Hemorrhagic Fever with Renal Syndrome - Suspected Cases in Sri Lanka: Clinical Picture and Epidemiology from 2013-2021","volume":"75","author":"R Muthugala","year":"2022","journal-title":"Jpn J Infect Dis"},{"key":"pntd.0013169.ref013","first-page":"4069862","article-title":"Two atypical cases of Hantavirus Infections from Sri Lanka","volume":"2018","author":"NDB Ehelepola","year":"2018","journal-title":"Case Rep Infect Dis"},{"key":"pntd.0013169.ref014","first-page":"5555613","article-title":"Two atypical cases of Hantavirus Infection: Experience from a Tertiary Care Unit in Sri Lanka","volume":"2021","author":"S Rupasinghe","year":"2021","journal-title":"Case Rep Infect Dis"},{"issue":"10","key":"pntd.0013169.ref015","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1017\/S0950268814003707","article-title":"Concomitant leptospirosis-hantavirus co-infection in acute patients hospitalized in Sri Lanka: implications for a potentially worldwide underestimated problem","volume":"143","author":"NP Sunil-Chandra","year":"2015","journal-title":"Epidemiol Infect"},{"key":"pntd.0013169.ref016","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.ijid.2017.02.004","article-title":"Serological evidence of hantavirus infection in Girandurukotte, an area endemic for chronic kidney disease of unknown aetiology (CKDu) in Sri Lanka","volume":"57","author":"CD Gamage","year":"2017","journal-title":"Int J Infect Dis"},{"issue":"1","key":"pntd.0013169.ref017","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s00705-018-4053-x","article-title":"Thailand orthohantavirus infection in patients with chronic kidney disease of unknown aetiology in Sri Lanka","volume":"164","author":"K Yoshimatsu","year":"2019","journal-title":"Arch Virol"},{"issue":"8","key":"pntd.0013169.ref018","doi-asserted-by":"crossref","first-page":"700","DOI":"10.3390\/v11080700","article-title":"Exposure to Hantavirus is a Risk Factor Associated with Kidney Diseases in Sri Lanka: A Cross Sectional Study","volume":"11","author":"YD Sarathkumara","year":"2019","journal-title":"Viruses"},{"issue":"12","key":"pntd.0013169.ref019","doi-asserted-by":"crossref","DOI":"10.1099\/jmm.0.001630","article-title":"Hantavirus infection as a risk factor for chronic kidney disease of unknown aetiology (CKDu) and its prevalence in endemic areas of Sri Lanka since 2010 according to a retrospective serological analysis","volume":"71","author":"CD Gamage","year":"2022","journal-title":"J Med Microbiol"},{"issue":"11","key":"pntd.0013169.ref020","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1089\/vbz.2018.2429","article-title":"Serological Evidence of Thailand Orthohantavirus or Antigenically Related Virus Infection Among Rodents in a Chronic Kidney Disease of Unknown Etiology Endemic Area, Girandurukotte, Sri Lanka","volume":"19","author":"SMW Lokupathirage","year":"2019","journal-title":"Vector Borne Zoonotic Dis"},{"key":"pntd.0013169.ref021","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.mehy.2016.04.009","article-title":"Chronic kidney disease of uncertain etiology in Sri Lanka: Are leptospirosis and Hantaviral infection likely causes?","volume":"91","author":"CD Gamage","year":"2016","journal-title":"Med Hypotheses"},{"issue":"3","key":"pntd.0013169.ref022","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0193056","article-title":"Morphological and clinical findings in Sri Lankan patients with chronic kidney disease of unknown cause (CKDu): similarities and differences with Mesoamerican Nephropathy","volume":"13","author":"J Wijkstr\u00f6m","year":"2018","journal-title":"PLoS One"},{"issue":"3","key":"pntd.0013169.ref023","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s10653-010-9339-1","article-title":"Chronic kidney diseases of uncertain etiology (CKDue) in Sri Lanka: geographic distribution and environmental implications","volume":"33","author":"R Chandrajith","year":"2011","journal-title":"Environ Geochem Health"},{"issue":"11","key":"pntd.0013169.ref024","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1038\/ki.2011.258","article-title":"Uncertain etiologies of proteinuric-chronic kidney disease in rural Sri Lanka","volume":"80","author":"NTC Athuraliya","year":"2011","journal-title":"Kidney Int"},{"issue":"4","key":"pntd.0013169.ref025","doi-asserted-by":"crossref","first-page":"275","DOI":"10.2188\/jea.JE20140074","article-title":"Epidemiology of chronic kidney disease, with special emphasis on chronic kidney disease of uncertain etiology, in the north central region of Sri Lanka","volume":"25","author":"KB Jayasekara","year":"2015","journal-title":"J Epidemiol"},{"issue":"2","key":"pntd.0013169.ref026","doi-asserted-by":"crossref","first-page":"83","DOI":"10.4038\/sljss.v42i2.7966","article-title":"A review of the national response to CKDu in Sri Lanka","volume":"42","author":"AAP De Alwis","year":"2019","journal-title":"Sri Lanka J Soc Sci"},{"issue":"7","key":"pntd.0013169.ref027","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1016\/j.ekir.2023.04.010","article-title":"Describing natural history and exploring risk factors for kidney function decline in persons with CKD of uncertain etiology in Sri Lanka","volume":"8","author":"P Hewavitharana","year":"2023","journal-title":"Kidney Int Rep"},{"issue":"10","key":"pntd.0013169.ref028","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.3390\/v13101984","article-title":"Identification of Novel Rodent-Borne Orthohantaviruses in an Endemic Area of Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka","volume":"13","author":"DS Muthusinghe","year":"2021","journal-title":"Viruses"},{"key":"pntd.0013169.ref029","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1099\/0022-1317-70-3-615","article-title":"Characterization of Hantaan virus envelope glycoprotein antigenic determinants defined by monoclonal antibodies","author":"J Arikawa","year":"1989","journal-title":"J Gen Virol"},{"issue":"2","key":"pntd.0013169.ref030","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s12199-011-0224-z","article-title":"Evidence of tubular damage in the very early stage of chronic kidney disease of uncertain etiology in the North Central Province of Sri Lanka: a cross-sectional study","volume":"17","author":"S Nanayakkara","year":"2012","journal-title":"Environ Health Prev Med"},{"issue":"8","key":"pntd.0013169.ref031","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1007\/s00705-003-0113-x","article-title":"Serological analysis of hemorrhagic fever with renal syndrome (HFRS) patients in Far Eastern Russia and identification of the causative hantavirus genotype","volume":"148","author":"H Miyamoto","year":"2003","journal-title":"Arch Virol"},{"issue":"5","key":"pntd.0013169.ref032","doi-asserted-by":"crossref","first-page":"838","DOI":"10.3201\/eid1205.051487","article-title":"Hantavirus in African wood mouse, Guinea","volume":"12","author":"B Klempa","year":"2006","journal-title":"Emerg Infect Dis"},{"issue":"4","key":"pntd.0013169.ref033","first-page":"406","article-title":"The neighbor-joining method: a new method for reconstructing phylogenetic trees","volume":"4","author":"N Saitou","year":"1987","journal-title":"Mol Biol Evol"},{"issue":"3","key":"pntd.0013169.ref034","first-page":"512","article-title":"Estimation of the number of nucleotide substitutions in the control region of mitochondrial DNA in humans and chimpanzees","volume":"10","author":"K Tamura","year":"1993","journal-title":"Mol Biol Evol"},{"key":"pntd.0013169.ref035","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1186\/1743-422X-11-87","article-title":"Development of an immunochromatography strip test based on truncated nucleocapsid antigens of three representative hantaviruses","volume":"11","author":"T Amada","year":"2014","journal-title":"Virol J"},{"key":"pntd.0013169.ref036","doi-asserted-by":"crossref","first-page":"556737","DOI":"10.3389\/fcimb.2020.556737","article-title":"Association of Hantavirus Infections and Leptospirosis With the Occurrence of Chronic Kidney Disease of Uncertain Etiology in the North Central Province of Sri Lanka: A Prospective Study With Patients and Healthy Persons","volume":"10","author":"NP Sunil-Chandra","year":"2020","journal-title":"Front Cell Infect Microbiol"},{"key":"pntd.0013169.ref037","author":"K Aplin","year":"2017"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0013169","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013169","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T18:33:21Z","timestamp":1750876401000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0013169"}},"subtitle":[],"editor":[{"given":"David","family":"Safronetz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,6,11]]},"references-count":37,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6,11]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0013169","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,11]]}}}