What is hantavirus ? What is hantavirus pulmonary syndrome (HPS)?

The term hantavirus represents several groups of RNA-containing viruses (that are members of the virus family of Bunyaviridae) that are carried by rodents and can cause severe respiratory infections termed hantavirus pulmonary syndrome (HPS) and hemorrhagic fever with renal syndrome (HFRS).

HPS is found mainly in the Americas (Canada, U.S., Argentina, Brazil, Chile, Panama, and others) while HFRS is found mainly in Russia, China, and Korea but may be found in Scandinavia and Western Europe and occasionally in other areas. Like HPS, HFRS results from hantaviruses that are transmitted by rodent urine, rodent droppings, or saliva (rodent bite), by direct contact with the animals, or by aerosolized dust contaminated with rodent urine or feces to human skin breaks or to mucous membranes of the mouth, nose, or eyes. The vast majority of HPS and HFRS infections do not transfer from person to person.

• Hantavirus pulmonary syndrome (HPS) facts

1. Hantaviruses are RNA viruses transmitted to humans by rodents (rodent-borne).
2. Hantavirus pulmonary syndrome (HPS) is a disease in which, in the late stage of infection with a hantavirus subtype, patients experience lung congestion, fluid accumulation in the lungs, and shortness of breath. Early symptoms (fatigue, fever, muscle aches) are nonspecific. In addition, some hantaviruses can cause hemorrhagic fever with renal syndrome (HFRS) as the disease progresses.
3. Hantavirus is not contagious (in North America).
4. The incubation period for hantavirus is about one to five weeks.
5. About 38% of hantavirus infections are lethal (mortality rate); specialists usually care for infected patients.
6. HPS is caused by hantaviruses that cause lung capillaries to leak fluid into the lung tissue.
7. Physicians usually diagnose HPS presumptively by the patient’s lung symptoms or the patient’s association with rodents or the patient’s probable contact with rodent-contaminated airborne dust; chest X-rays provide additional evidence, but definitive diagnosis is usually done at a specialized lab or the U.S. Centers for Disease Control and Prevention (CDC).
8. There is no specific treatment of HPS; doctors usually treat patients in an intensive care facility and often require respiratory support (intubation and mechanical ventilation).
9. Risk factors are any association with rodents and their airborne body excretions.
10. If the HPS patient survives, there are usually no long-term complications.
11. Prevention of HPS centers on avoidance of rodent contamination; there is no vaccine available to prevent hantavirus infection or HPS.

• What is Hantavirus |Hantavirus Symptoms 

The flu (influenza) is a viral disease of the respiratory tract. Characteristic symptoms are

1. fever
2. chills
3. cough
4. malaise headache

Other symptoms can occur, like

1. nausea and vomiting
2. muscle or body aches
3. tiredness and fatigue
4. appetite loss
5. sore throat
6. diarrhea

• What is the history of hantavirus pulmonary syndrome?

In 1993, health officials noted the first recognized outbreak of HPS in the “Four Corners” area of the U.S., where the states of Arizona, New Mexico, Colorado, and Utah meet. Two otherwise healthy young people, a Navajo Indian and his fiancée, suddenly became short of breath and died. This unusual situation triggered a review of deaths in the four states that resulted in identification of five other young people who recently died with similar breathing problems.

During the next few weeks, health care providers treated additional people in the same geographic area with similar pulmonary syndromes. Tissues from affected patients were sent to the CDC, where researchers searched for causes and found a link among the patients: infection with a previously unknown type of hantavirus.

Since other known hantaviruses (in Asia and Europe) were known to be transmitted to people by rodents, the researchers started trapping rodents from June to August 1993 to determine if the virus was associated with the animals.

In November 1993, a rodent (a deer mouse) trapped by CDC researchers in a house where a person who developed the pulmonary syndrome lived yielded the previously unknown virus. In addition, army researchers soon isolated the same virus from an infected patient who also had exposures to mice. This new hantavirus was first termed Muerto Canyon virus, then Sin Nombre virus (SNV), and eventually simply hantavirus.

The disease caused by this virus was termed hantavirus pulmonary syndrome (HPS). Further investigations suggested that other people had died from this infection in the past, as autopsy tissue contained the virus. When health researchers studied Navajo Indian medical traditions, the Navajo medical culture apparently recognized the disease and had associated it with mice.

The outbreak in 1993 probably occurred because environmental factors led to favorable survival and proliferation of mice. The mouse population was about tenfold greater in 1993 than in 1992 in the Four Corners area.

• What are risk factors for hantavirus pulmonary syndrome?

The major risk factor for HPS is association with a rodent infestation, their saliva, urine, or feces or with dust, dirt, or surfaces contaminated with such items, either by direct contact or by aerosol. Barns, sheds, homes, or buildings easily entered by rodents (for example, deer mouse or Peromyscus maniculatus) are potential places for hantaviruses to come in contact with humans.

Rural areas that have forests and fields that can support a large rodent population are areas that increase the risk of exposure to HPS. Camping and hiking in areas known to have a high rodent population and occupying areas where rodents may seek shelter increase one’s risk.

Those who work in areas that may be shelter for rodents (for example, crawl spaces, vacated buildings, construction sites) may also have increased risk of HPS. The risk is higher in people who work in areas known to have produced HPS infections.

• How long is hantavirus contagious?

In North America, there is no evidence that hantavirus is contagious. In South America, an estimated 16-35 days was the contagious period for a rare few patients who investigators considered to have exhibited person-to-person transfer with a type of hanta virus termed Andes virus.

• What is the incubation period for hantavirus?

According to the CDC, in North America, the incubation period (time from initial exposure to the virus and development of the first symptoms) is between one to five weeks after initial exposure to infected rodent urine, droppings, or saliva. In South American outbreaks, researchers estimate that the incubation period varies from about 12-27 days.

• What is the treatment for hantavirus pulmonary syndrome? |

  What is Hantavirus |Hantavirus Symptoms

At this time, there is no definitive treatment for HPS other than early recognition of HPS and subsequent medical support (usually consisting of symptomatic medical treatment and respiratory support or mechanical ventilation).

The CDC suggests that early treatment in an intensive care unit may allow the patient to survive severe HPS. Experimentally, physicians have administered the antiviral medication ribavirin (Rebetol, Copegus), but there are no clear data currently that establish that the drug is effective against HPS; however, its use against HFRS early in the disease suggests ribavirin can decrease illness and deaths. There is no vaccine available to protect against any hantaviruses to date.

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