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Singh S, Numan A, Sharma D, Shukla R, Alexander A, Jain GK, Ahmad FJ, Kesharwani P. Epidemiology, virology and clinical aspects of hantavirus infections: an overview. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:1815-1826. [PMID: 33886400 DOI: 10.1080/09603123.2021.1917527] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/08/2021] [Indexed: 06/12/2023]
Abstract
At the end of 2019 and 2020s, a wave of coronavirus disease 19 (COVID-19) epidemics worldwide has catalyzed a new era of 'communicable infectious diseases'. However, the world is not currently prepared to deal with the growing burden of COVID-19, with the unexpected arrival of Hantavirus infection heading to the next several healthcare emergencies in public. Hantavirus is a significant class of zoonotic pathogens of negative-sense single-stranded ribonucleic acid (RNA). Hemorrhagic renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS) are the two major clinical manifestations. Till date, there is no effective treatments or vaccines available, public awareness and precautionary measures can help to reduce the spread of hantavirus disease. In this study, we outline the epidemiology, virology, clinical aspects, and existing HFRS and HCPS management approaches. This review will give an understanding of virus-host interactions and will help for the early preparation and effective handling of further outbreaks in an ever-changing environment.
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Affiliation(s)
- Sima Singh
- Department of Pharmacy, University Institute of Pharma Sciences, Chandigarh University, Gharuan, Mohali, India
| | - Arshid Numan
- State Key Laboratory of ASIC and System, SIST, Fudan University, Shanghai, China
| | - Dinesh Sharma
- Pharmax Pharmaceuticals FZ LLC, Dubai Science Park - Al BarshaAl Barsha South, Dubai, United Arab Emirates
| | - Rahul Shukla
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research-Raebareli, Lucknow, India
| | - Amit Alexander
- Department of Pharmaceutical Technology (Formulations), National Institute of Pharmaceutical Education and Research, Guwahati, Sila Village, Nizsundarighopa, Changsari, Kamrup, Guwahati, Assam, India, 781101
| | - Gaurav Kumar Jain
- Department of Pharmaceutics, Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, New Delhi, India
| | - Farhan Jalees Ahmad
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
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Riquelme R. Hantavirus. Semin Respir Crit Care Med 2021; 42:822-827. [PMID: 34918323 DOI: 10.1055/s-0041-1733803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Hantaviruses are tri-segmented lipid-enveloped RNA viruses belonging to the Bunyaviridae family. Human infection corresponds to a zoonosis associated with two different clinical syndromes: hemorrhagic fever with renal syndrome that occurs in Asia and Europe and hantavirus cardiopulmonary syndrome (HCPS) that occurs in the North America, Central America and South America. The major pathogenic mechanisms in HCPS include (1) direct microvascular endothelial injury leading to increased capillary permeability and the development of noncardiogenic pulmonary edema and acute respiratory distress syndrome, and (2) exaggerated host immune response leading to secondary organ damage. The incubation period for this disease is quite long (6-39 days, median: 18 days); however, rapid progression to respiratory failure and shock can occur highlighting the importance of high index of clinical suspicion. Management revolves around high-quality supportive care. Various management and preventative strategies are currently being explored and warrant further examination to improve the overall outlook following infection with hantavirus.
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Affiliation(s)
- Raúl Riquelme
- Puerto Montt Hospital, San Sebastian University, Puerto Montt, Chile
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Mull N, Jackson R, Sironen T, Forbes KM. Ecology of Neglected Rodent-Borne American Orthohantaviruses. Pathogens 2020; 9:E325. [PMID: 32357540 PMCID: PMC7281597 DOI: 10.3390/pathogens9050325] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 12/31/2022] Open
Abstract
The number of documented American orthohantaviruses has increased significantly over recent decades, but most fundamental research has remained focused on just two of them: Andes virus (ANDV) and Sin Nombre virus (SNV). The majority of American orthohantaviruses are known to cause disease in humans, and most of these pathogenic strains were not described prior to human cases, indicating the importance of understanding all members of the virus clade. In this review, we summarize information on the ecology of under-studied rodent-borne American orthohantaviruses to form general conclusions and highlight important gaps in knowledge. Information regarding the presence and genetic diversity of many orthohantaviruses throughout the distributional range of their hosts is minimal and would significantly benefit from virus isolations to indicate a reservoir role. Additionally, few studies have investigated the mechanisms underlying transmission routes and factors affecting the environmental persistence of orthohantaviruses, limiting our understanding of factors driving prevalence fluctuations. As landscapes continue to change, host ranges and human exposure to orthohantaviruses likely will as well. Research on the ecology of neglected orthohantaviruses is necessary for understanding both current and future threats to human health.
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Affiliation(s)
- Nathaniel Mull
- Department of Biological Sciences, University of Arkansas, Fayetteville, AR 72701, USA; (R.J.); (K.M.F.)
| | - Reilly Jackson
- Department of Biological Sciences, University of Arkansas, Fayetteville, AR 72701, USA; (R.J.); (K.M.F.)
| | - Tarja Sironen
- Department of Virology, University of Helsinki, 00290 Helsinki, Finland;
- Department of Veterinary Biosciences, University of Helsinki, 00790 Helsinki, Finland
| | - Kristian M. Forbes
- Department of Biological Sciences, University of Arkansas, Fayetteville, AR 72701, USA; (R.J.); (K.M.F.)
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Adams DA, Thomas KR, Jajosky RA, Foster L, Baroi G, Sharp P, Onweh DH, Schley AW, Anderson WJ. Summary of Notifiable Infectious Diseases and Conditions - United States, 2015. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2017; 64:1-143. [PMID: 28796757 DOI: 10.15585/mmwr.mm6453a1] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The Summary of Notifiable Infectious Diseases and Conditions - United States, 2015 (hereafter referred to as the summary) contains the official statistics, in tabular and graphical form, for the reported occurrence of nationally notifiable infectious diseases and conditions in the United States for 2015. Unless otherwise noted, data are final totals for 2015 reported as of June 30, 2016. These statistics are collected and compiled from reports sent by U.S. state and territories, New York City, and District of Columbia health departments to the National Notifiable Diseases Surveillance System (NNDSS), which is operated by CDC in collaboration with the Council of State and Territorial Epidemiologists (CSTE). This summary is available at https://www.cdc.gov/MMWR/MMWR_nd/index.html. This site also includes summary publications from previous years.
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Affiliation(s)
- Deborah A Adams
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Kimberly R Thomas
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Ruth Ann Jajosky
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Loretta Foster
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Gitangali Baroi
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Pearl Sharp
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Diana H Onweh
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Alan W Schley
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
| | - Willie J Anderson
- Division of Health Informatics and Surveillance, Office of Public Health Scientific Services, CDC
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Hantavirus infection among children hospitalized for febrile illness suspected to be dengue in Barbados. J Infect Public Health 2015; 9:81-7. [PMID: 26153080 DOI: 10.1016/j.jiph.2015.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 05/27/2015] [Accepted: 06/12/2015] [Indexed: 01/29/2023] Open
Abstract
Emerging picture of hantavirus infection in the South America is characterized by greater proportion of childhood infection and wider spectrum of disease from mild asymptomatic to lethal cardiopulmonary disease. Barbados is endemic for dengue and leptospirosis, both of which share clinical features with hantavirus infection and in many cases neither of these diagnosis could be confirmed. We investigate whether some of the children hospitalized with suspected dengue could indeed have been hantavirus infections. In this prospective study children hospitalized with suspected dengue were tested for hantavirus infection using ELISA for the IgM antibodies. Thirty-eight children tested positive for hantavirus infection. They presented with fever, headache and mild respiratory and gastrointestinal symptoms and signs. None of them had features suggestive of hantavirus cardiopulmonary syndrome. Blood count values ranged from low to normal to high for their age. There were no deaths. Hantavirus infection is prevalent in this Caribbean country. It predominantly presents with milder disease and is responsible for some of the nonspecific febrile illnesses in children.
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Núñez JJ, Fritz CL, Knust B, Buttke D, Enge B, Novak MG, Kramer V, Osadebe L, Messenger S, Albariño CG, Ströher U, Niemela M, Amman BR, Wong D, Manning CR, Nichol ST, Rollin PE, Xia D, Watt JP, Vugia DJ. Hantavirus infections among overnight visitors to Yosemite National Park, California, USA, 2012. Emerg Infect Dis 2015; 20:386-93. [PMID: 24565589 PMCID: PMC3944872 DOI: 10.3201/eid2003.131581] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
TOC summary: A rare hantavirus outbreak reaffirms the need for control of deer mice and public awareness of the risks posed by contact with them. In summer 2012, an outbreak of hantavirus infections occurred among overnight visitors to Yosemite National Park in California, USA. An investigation encompassing clinical, epidemiologic, laboratory, and environmental factors identified 10 cases among residents of 3 states. Eight case-patients experienced hantavirus pulmonary syndrome, of whom 5 required intensive care with ventilatory support and 3 died. Staying overnight in a signature tent cabin (9 case-patients) was significantly associated with becoming infected with hantavirus (p<0.001). Rodent nests and tunnels were observed in the foam insulation of the cabin walls. Rodent trapping in the implicated area resulted in high trap success rate (51%), and antibodies reactive to Sin Nombre virus were detected in 10 (14%) of 73 captured deer mice. All signature tent cabins were closed and subsequently dismantled. Continuous public awareness and rodent control and exclusion are key measures in minimizing the risk for hantavirus infection in areas inhabited by deer mice.
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Abstract
In the past 20 years of surveillance for hantavirus in humans in the United States, 624 cases of hantavirus pulmonary syndrome (HPS) have been reported, 96% of which occurred in states west of the Mississippi River. Most hantavirus infections are caused by Sin Nombre virus, but cases of HPS caused by Bayou, Black Creek Canal, Monongahela, and New York viruses have been reported, and cases of domestically acquired hemorrhagic fever and renal syndrome caused by Seoul virus have also occurred. Rarely, hantavirus infections result in mild illness that does not progress to HPS. Continued testing and surveillance of clinical cases in humans will improve our understanding of the etiologic agents involved and the spectrum of diseases.
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Armien B, Pascale JM, Muñoz C, Mariñas J, Núñez H, Herrera M, Trujillo J, Sánchez D, Mendoza Y, Hjelle B, Koster F. Hantavirus fever without pulmonary syndrome in Panama. Am J Trop Med Hyg 2013; 89:489-94. [PMID: 23836565 DOI: 10.4269/ajtmh.12-0334] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
In Panama, hantavirus pulmonary syndrome (HPS) is caused by Choclo virus, a species phylogenetically related to Andes and Maporal viruses. Up to 60% of the population has been positive for specific serum antibody in community-based surveys, but mortality is very uncommon. In four western Panama clinics, we tested individuals presenting with a severe febrile prodrome for acute hantavirus (HV) infection by immunoglobulin M enzyme-linked immunosorbent assay and reverse transcription polymerase chain reaction as well as clinically similar infections, such as dengue and leptospirosis. From 2006 to 2009, at least 21% of 117 patients diagnosed with HV infection had HV Fever (HF) with no evidence of pulmonary edema (no respiratory distress or radiographic lung infiltrates), and 44% of patients had very mild HPS (radiographic pulmonary edema but no respiratory insufficiency). HV infection caused by Choclo virus in Panama presents often as HF, which contrasts with HV in the Americas but is consistent with the high seroprevalence in endemic regions.
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Affiliation(s)
- Blas Armien
- Epidemiology and Microbiology, Gorgas Memorial Institute for Health Research, Panama City, Panama.
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McLean N, Kelly A, Molinar E, Ghachu J, Hart L, O'Brien C, Wright K, Schountz T, Hartney C, Lehmer EM. How can hantaviruses kill humans but leave deer mice unaffected? ACTA ACUST UNITED AC 2012. [DOI: 10.1893/0005-3155-83.3.81] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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10
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Clement J, Maes P, Lagrou K, Van Ranst M, Lameire N. A unifying hypothesis and a single name for a complex globally emerging infection: hantavirus disease. Eur J Clin Microbiol Infect Dis 2012; 31:1-5. [PMID: 22068273 PMCID: PMC7101631 DOI: 10.1007/s10096-011-1456-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 10/11/2011] [Indexed: 12/11/2022]
Affiliation(s)
- J. Clement
- National Reference Laboratory for Hantavirus Infections, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - P. Maes
- National Reference Laboratory for Hantavirus Infections, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - K. Lagrou
- National Reference Laboratory for Hantavirus Infections, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - M. Van Ranst
- National Reference Laboratory for Hantavirus Infections, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - N. Lameire
- Nephrology, University Hospital Gent, De Pintelaan 85, 9000 Gent, Belgium
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Rusnak JM. Experience with Ribavirin for Treatment and Postexposure Prophylaxis of Hemorrhagic Fever Viruses: Crimean Congo Hemorrhagic Fever, Lassa Fever, and Hantaviruses. APPLIED BIOSAFETY 2011. [DOI: 10.1177/153567601101600203] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Abstract
Hantaviruses are enzootic viruses that maintain persistent infections in their rodent hosts without apparent disease symptoms. The spillover of these viruses to humans can lead to one of two serious illnesses, hantavirus pulmonary syndrome and hemorrhagic fever with renal syndrome. In recent years, there has been an improved understanding of the epidemiology, pathogenesis, and natural history of these viruses following an increase in the number of outbreaks in the Americas. In this review, current concepts regarding the ecology of and disease associated with these serious human pathogens are presented. Priorities for future research suggest an integration of the ecology and evolution of these and other host-virus ecosystems through modeling and hypothesis-driven research with the risk of emergence, host switching/spillover, and disease transmission to humans.
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Prince HE, Su X, Hogrefe WR. Utilization of hantavirus antibody results generated over a five-year period to develop an improved serologic algorithm for detecting acute Sin Nombre hantavirus infection. J Clin Lab Anal 2007; 21:7-13. [PMID: 17245757 PMCID: PMC6648957 DOI: 10.1002/jcla.20145] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
In the United States most cases of hantavirus pulmonary syndrome (HPS) are caused by the Sin Nombre virus (SNV) and are typically identified by serology. The goal of this study was to assess the performance of our hantavirus serologic testing algorithm by reviewing results generated over five years. Sera were screened for pan-hantavirus immunoglobulin (Ig)G and IgM by enzyme-linked immunosorbent assay (ELISA). Screen IgG+ sera were then tested by immunoblot for SNV glycoprotein-specific IgG, and screen IgM+ sera were tested for SNV-specific IgM using an ELISA that measured differential reactivity to SNV and Seoul nucleocapsid proteins. Although only 13% of sera were positive in one or both screening assays, 85% of screen+sera lacked SNV antibodies. Nearly all (97%) screen IgM-IgG+ samples lacked SNV IgG, and 90% of screen IgM+IgG- samples lacked SNV IgM. However, SNV IgM testing of screen IgM+IgG- samples appears to be necessary, since this test identified nine of 37 patients with acute HPS (based on clinical feedback). A screen IgM+IgG+ result was a good predictor of SNV antibody detection and acute HPS. These findings were used to design a modified algorithm that identified all 37 patients with acute HPS, but reduced the number of specimens that required SNV antibody testing by 42%.
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Affiliation(s)
- Gary D Overturf
- University of New Mexico-School of Medicine, Albuquerque, NM, USA
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Bayard V, Kitsutani PT, Barria EO, Ruedas LA, Tinnin DS, Muñoz C, de Mosca IB, Guerrero G, Kant R, Garcia A, Caceres L, Gracia FG, Quiroz E, de Castillo Z, Armien B, Libel M, Mills JN, Khan AS, Nichol ST, Rollin PE, Ksiazek TG, Peters CJ. Outbreak of hantavirus pulmonary syndrome, Los Santos, Panama, 1999-2000. Emerg Infect Dis 2004; 10:1635-42. [PMID: 15498167 PMCID: PMC3320309 DOI: 10.3201/eid1009.040143] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
An outbreak of hantavirus pulmonary syndrome occurred in the province of Los Santos, Panama, in late 1999 and early 2000. Eleven cases were identified; 9 were confirmed by serology. Three cases were fatal; however, no confirmed case-patient died. Case-neighborhood serologic surveys resulted in an overall hantavirus antibody prevalence of 13% among household and neighborhood members from the outbreak foci. Epidemiologic investigations did not suggest person-to-person transmission of hantavirus infection. By use of Sin Nombre virus antigen, hantavirus antibodies were detected in Oligoryzomys fulvescens and Zygodontomys brevicauda cherriei. This outbreak resulted in the first documented cases of human hantavirus infections in Central America.
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Affiliation(s)
- Vicente Bayard
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
- University of Panama, Panama City, Panama
| | | | | | | | | | | | | | | | - Rudick Kant
- Pan American Health Organization, Washington DC, USA
| | - Arsenio Garcia
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Lorenzo Caceres
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | | | - Evelia Quiroz
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | | | - Blas Armien
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Marlo Libel
- Pan American Health Organization, Washington DC, USA
| | - James N. Mills
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ali S. Khan
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Stuart T. Nichol
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Pierre E. Rollin
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Täger Frey M, Vial PC, Castillo CH, Godoy PM, Hjelle B, Ferrés MG. Hantavirus prevalence in the IX Region of Chile. Emerg Infect Dis 2003; 9:827-32. [PMID: 12890323 PMCID: PMC3023426 DOI: 10.3201/eid0907.020587] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
An epidemiologic and seroprevalence survey was conducted (n=830) to assess the proportion of persons exposed to hantavirus in IX Region Chile, which accounts for 25% of reported cases of hantavirus cardiopulmonary syndrome. This region has three geographic areas with different disease incidences and a high proportion of aboriginals. Serum samples were tested for immunoglobulin (Ig) G antibodies by enzyme-linked immunosorbent assay against Sin Nombre virus N antigen by strip immunoblot assay against Sin Nombre, Puumala, Río Mamoré, and Seoul N antigens. Samples from six patients were positive for IgG antibodies reactive with Andes virus; all patients lived in the Andes Mountains. Foresting was also associated with seropositivity; but not sex, age, race, rodent exposure, or farming activities. Exposure to hantavirus varies in different communities of IX Region. Absence of history of pneumonia or hospital admission in persons with specific IgG antibodies suggests that infection is clinically inapparent.
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Caramello P, Canta F, Bonino L, Moiraghi C, Navone F, Lipani F, Balbiano R, Caputo AM, Gai V. Puumala virus pulmonary syndrome in a Romanian immigrant. J Travel Med 2002; 9:326-9. [PMID: 12962589 DOI: 10.2310/7060.2002.30014] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Hantaviruses belong to the Bunyaviridae family, which is comprised of Bunyavirus, Phlebovirus, Nairovirus, and Hantavirus. Euroasiatic Hantaviruses belong to two distinct subfamilies: Murinae (comprising Hantaan, Dobrava, and Seoul viruses), which are responsible for hemorrhagic fever with renal syndrome (HFRS), and Arvicolinae (comprising Puumala virus), responsible for nephropathia epidemica (NE) and HFRS. On the contrary, the New World Hantavirus belongs to the Sigmodontinae subfamily and includes the North American viruses: Sin Nombre, Monongahela; New York, Bayou, Black Creek Canal, and the South American, which comprise the Andes, Oran, Lechiguanas, Laguna Negra, Juquitiba; both groups are responsible for the hantavirus pulmonary syndrome (HPS).
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Fritz CL, Fulhorst CF, Enge B, Winthrop KL, Glaser CA, Vugia DJ. Exposure to rodents and rodent-borne viruses among persons with elevated occupational risk. J Occup Environ Med 2002; 44:962-7. [PMID: 12391776 DOI: 10.1097/00043764-200210000-00016] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Persons who have frequent contact with rodents as part of their occupation may be at increased risk of exposure to rodent-borne viruses such as Sin Nombre virus (SNV), the agent of hantavirus pulmonary syndrome, and Whitewater Arroyo virus (WWA), a New World arenavirus. Eighty-one persons with possible occupational exposure to rodents completed questionnaires and provided specimens for serologic testing. Seventy-two participants reported handling rodents as part of their job. The mean total number of rodents handled during participants' careers was approximately 2200. IgG antibody to lymphocytic choriomeningitis virus was detected in serum from one (1.2%) participant. IgG antibody to SNV, WWA, and Amapari viruses was not detected in any of the serum specimens. Despite considerable exposure to rodents, participants did not have significant serological evidence of exposure to rodent-borne viruses.
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Affiliation(s)
- Curtis L Fritz
- California Department of Health Services, Division of Communicable Disease Control, P.O. Box 942732, MS 486, Sacramento, CA 94234-7320, USA.
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Peters CJ, Khan AS. Hantavirus pulmonary syndrome: the new American hemorrhagic fever. Clin Infect Dis 2002; 34:1224-31. [PMID: 11941549 DOI: 10.1086/339864] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2001] [Revised: 12/20/2001] [Indexed: 11/03/2022] Open
Abstract
The recognition of hantavirus pulmonary syndrome (HPS) after the investigation of a cluster of unexplained respiratory deaths in the southwestern United States during the spring of 1993 showcased our ability to recognize new and emerging diseases, given the correct juxtaposition of a new clinical entity with circumscribed epidemiologic features that are analyzed with novel diagnostic methods. In less than a decade, HPS has become established as a pan-American zoonosis due to numerous viruses maintained by sigmodontine rodents with rodent- and virus-specific epidemiologic profiles. The classical features of the syndrome-acute febrile illness associated with prominent cardiorespiratory compromise after direct contact or inhalation of aerosolized rodent excreta-has been extended to include clinical variants, including disease with frank hemorrhage, that have confirmed that this syndrome is a viral hemorrhagic fever. Efforts are under way to refine prevention strategies, to understand the pathogenesis of the shock, and to identify therapeutic modalities.
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Affiliation(s)
- C J Peters
- University of Texas Medical Branch, Galveston, TX, USA
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Affiliation(s)
- A Plyusnin
- Haartman Institute, University of Helsinki, FIN-00014 Helsinki, Finland
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Enria DA, Briggiler AM, Pini N, Levis S. Clinical manifestations of New World hantaviruses. Curr Top Microbiol Immunol 2001; 256:117-34. [PMID: 11217400 DOI: 10.1007/978-3-642-56753-7_7] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- D A Enria
- Instituto Nacional de Enfermedades Virales Humanas Dr. Julio I. Maiztegui (INEVH), ANLIS, Monteagudo 2510, 2700 Pergamino, Argentina
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Linderholm M, Elgh F. Clinical characteristics of hantavirus infections on the Eurasian continent. Curr Top Microbiol Immunol 2001; 256:135-51. [PMID: 11217401 DOI: 10.1007/978-3-642-56753-7_8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- M Linderholm
- Department of Infectious Diseases, Umeå University, 901 85 Umeå, Sweden.
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Abstract
The initial identification in 1993 of hantavirus pulmonary syndrome as a novel, highly fatal respiratory illness among American Indians in the southwestern USA in 1993 opened the window to the recognition of a well-established pan-American zoonosis with a myriad of causative viruses and rodent vectors, although all are New World hantaviruses among New World sigmodontine rodents. The clinical spectrum of symptoms has also been expanded to include asymptomatic infection through to fulminant hemorrhagic fever. Although the use of ribavirin, an antiviral drug, was disappointing in an early, open-labeled trial, early detection and supportive care is much better refined. However, much work remains in probing the pathogenesis of this syndrome to help define and explore therapeutic options and the mechanism of person-to-person transmission with Andes virus, one of the viruses that cause hantavirus pulmonary syndrome. Current remote sensing efforts and longitudinal ecologic investigations need to be expanded in order to focus prevention efforts better.
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Affiliation(s)
- A S Khan
- Special Pathogens Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
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24
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Abstract
Since the first outbreak of hantavirus pulmonary syndrome (HPS) in 1993, understanding of the vast distribution and potential impact of hantaviruses has grown. At least 277 cases of HPS have been documented in the United States. The full clinical spectrum has yet to be elucidated, and one outbreak suggested the possibility of person-to-person transmission. New research has identified the b-3 integrins as cellular receptors for hantaviruses and has determined the pivotal role of the immune system in pathogenesis. Rapid diagnosis has been facilitated by a new immunoblot assay to detect Sin Nombre virus infection. Treatment remains primarily supportive; however, a placebo- controlled trial of ribavirin is ongoing. Extracorporeal membrane oxygenation may be a potential therapy in severe cases; inhaled nitric oxide needs further study. Vaccines developed against hantaviruses associated with hemorrhagic fever and renal syndrome might be effective against HPS-associated strains.
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Affiliation(s)
- Marilyn Fabbri
- Infectious Diseases Section (111), Veterans Affairs New York Harbor Health Care System, 423 East 23rd Street, New York, NY 10010, USA.
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