Hantavirus pulmonary syndrome

Hantavirus
Transmission electron micrograph of the Sin Nombre Hantavirus
Virus classification
Group: Group V ((-)ssRNA)
Order: Unassigned
Family: Bunyaviridae
Genus: Hantavirus
Type species
Hantaan virus
Species

Bayou virus
Black Creek Canal virus
New York virus
Sin Nombre virus
Calabazo virus
Rockport virus
Oxbow virus
Maripa virus

Hantavirus pulmonary syndrome (HPS) is one of two potentially fatal syndromes of zoonotic origin caused by species of hantavirus.[1] These include Black Creek Canal virus (BCCV), New York virus (NYV), Sin Nombre virus (SNV), and certain other members of Hantavirus genera that are native to the United States and Canada.[2] Specific rodents are the principal hosts of the hantaviruses including the hispid cotton rat (Sigmodon hispidus) in southern Florida, which is the principal host of Black Creek Canal virus.,[3][4] the rice rat also in the south east, the deer mouse (Peromyscus maniculatus) in Canada and the Western United States is the principal host of Sin Nombre virus.[5][6] The white-footed mouse (Peromyscus leucopus) in the eastern United States is the principal host of New York virus.[7]

Epidemiology

Hantavirus pulmonary syndrome was first recognized during the 1993 outbreak in the Four Corners region of the southwestern United States. It was identified by Dr. Bruce Tempest. It was originally called Four Corners disease, but the name was changed to Sin Nombre virus after complaints by Native Americans that the name "Four Corners" stigmatized the region.[8] It has since been identified throughout the United States.

Transmission

The hispid cotton rat, indigenous to southern Florida, is the carrier of the Black Creek Canal virus

Transmission by aerosolized rodent excreta still remains the only known way the virus is transmitted to humans. In general, droplet and/or fomite transfer has not been shown in the hantaviruses in either the pulmonary or hemorrhagic forms.[9][10]

Signs and symptoms

Prodromal symptoms include flu-like symptoms such as fever, cough, myalgia, headache, lethargy and shortness-of-breath, which rapidly deteriorates into acute respiratory failure. It is characterized by the sudden onset of shortness-of-breath with rapidly evolving pulmonary edema; it is often fatal despite mechanical ventilation and intervention with potent diuretics. It has a fatality rate of 38%.

Treatment

There is no cure or vaccine for HPS. Treatment involves supportive therapy, including mechanical ventilation with supplemental oxygen during the critical respiratory-failure stage of the illness. Early recognition of HPS and admission to an intensive care setting offers the best prognosis.

Prevention

Rodent control in and around the home or dwellings remains the primary prevention strategy, as well as eliminating contact with rodents in the workplace and campsite. Closed storage sheds and cabins are often ideal sites for rodent infestations. Airing out of such spaces prior to use is recommended. People are advised to avoid direct contact with rodent droppings and wear a mask while cleaning such areas to avoid inhalation of aerosolized rodent secretions.[11]

See also

References

  1. Koster FT. Levy H. "Hantavirus cardiopulmonary syndrome: a new twist to an established pathogen", In: Fong IW, editor; Alibek K, editor. New and Evolving Infections of the 21st Century, New York: Springer-Verlag New York, Inc.; 2006. pp. 151–170.
  2. Nichol ST. Beaty BJ. Elliott RM. Goldbach R, et al. Family Bunyaviridae. In: Fauquet CM, editor; Mayo MA, editor; Maniloff J, editor; Desselberger U, et al., editors. Virus Taxonomy: 8th Report of the International Committee on Taxonomy of Viruses. San Diego, CA: Elsevier Academic Press;
  3. Rollin PE. Ksiazek TG. Elliott LH. Ravkov EV, et al. "Isolation of Black Creek Canal virus, a new hantavirus from Sigmodon hispidus in Florida", J Med Virol. 1995;46:35–39. [PubMed]
  4. Glass GE. Livingstone W. Mills JN. Hlady WG, et al. "Black Creek Canal virus infection in Sigmodon hispidus in southern Florida", Am J Trop Med Hyg. 1998;59:699–703. PubMed
  5. Childs JE. Ksiazek TG. Spiropoulou CF. Krebs JW, et al. "Serologic and genetic identification of Peromyscus maniculatus as the primary rodent reservoir for a new hantavirus in the southwestern United States", J Infect Dis. 1994;169:1271–1280. [PubMed]
  6. Drebot MA. Gavrilovskaya I. Mackow ER. Chen Z, et al. "Genetic and serotypic characterization of Sin Nombre-like viruses in Canadian Peromyscus maniculatus mice", Virus Res. 2001;75:75–86. [PubMed]
  7. Hjelle B. Lee SW. Song W. Torrez-Martinez N, et al. "Molecular linkage of hantavirus pulmonary syndrome to the white-footed mouse, Peromyscus leucopus: genetic characterization of the M genome of New York virus", J Virol. 1995;69:8137–8141. [PMC free article] [PubMed]
  8. "Death at the Corners". Discover Magazine. 1993-12-01. Retrieved 2013-03-25.
  9. Peters, C.J. (2006). "Emerging Infections: Lessons from the Viral Hemorrhagic Fevers". Transactions of the American Clinical and Climatological Association. Transactions of the American Clinical and Climatological Association. 117: 189–197.
  10. Crowley, J.; Crusberg, T. "Ebola and Marburg Virus Genomic Structure, Comparative and Molecular Biology". Dept. of Biology & Biotechnology, Worcester Polytechnic Institute.
  11. "CDC - Hantavirus Pulmonary Syndrome (HPS) - Hantavirus". Cdc.gov. 2013-02-06. Retrieved 2013-07-07.
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