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1. Introduction
In the United Kingdom (UK) in 2012, public health authorities became aware of several cases of acute kidney injury associated with infection from a zoonotic, rodent-borne virus; hantavirus. In the UK, the most common hantavirus is Seoul virus, the predominant hosts of which are brown rats (Rattus norvegicus). Rats rarely show signs of disease, but are thought to shed the virus through their urine, feces, and saliva. Humans can become infected through the inhalation of aerosolised rodent excreta [1]. Hantaviruses in the UK were not thought to be of concern until Seoul virus was detected in a patient with acute kidney injury in 2012 [2]. The patient had regular exposure to wild rats (R. norvegicus) at their home. Later the same year, Seoul virus was detected in another patient with acute kidney injury [3,4]. This patient had two pet rats (R. norvegicus), which were identified as the source of the infection. Subsequently, a national serosurveillance study determined an overall hantavirus seroprevalence of 34% in a sample of 79 pet rat owners, of which the majority (26/27) were seropositive for Seoul virus, and one had a weak positive reaction to Hantaan virus [5], a more severe hantavirus. Since 2011, there have been eight clinical cases of Seoul virus associated with pet rats in the UK [6]. A high Seoul virus prevalence (81%) has also been detected in a sample of 21 pet rats from one breeding colony in the UK [6]; therefore, it is likely that there are more cases of Seoul virus that are currently unreported or undetected.
The public health response to the emergence of Seoul virus was to try and educate rat owners about the potential risks posed by their pet. However, one common misconception about communicating health messages is that knowledge and information drive behaviour [7]. This approach to behaviour change has been widely critiqued, and wider determinants of health behaviour have highlighted the importance of social and structural influences [8]. For example, following the emergence of hantavirus, pet rat owners were advised not to ‘kiss pet rodents or hold them close to (their) face’ [9]; yet messages such as this fail to take into account the way in which pet rat owners live and interact with their rats.
The...