Hantavirus pulmonary syndrome

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Hantavirus pulmonary syndrome
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Fever, muscle aches, fatigue, cough, shortness of breath
Complications	Respiratory failure, shock
Onset	1 to 8 weeks after exposure
Duration
Types
Causes	Hantavirus
Risks	Exposure to rodents or their droppings
Diagnosis	Serology, PCR
Differential diagnosis	Influenza, pneumonia, sepsis
Prevention	Avoiding contact with rodents
Treatment	Supportive care, mechanical ventilation
Medication
Prognosis
Frequency	Rare
Deaths

• It manifests with flu-like symptoms but it rapidly progresses to life-threatening respiratory problems.

Hantaviruses

• Hantaviruses are a family of viruses spread mainly by rodents and can cause varied disease syndromes in people worldwide.
• Infection with any hantavirus can produce hantavirus disease in people.
• Hantaviruses in the Americas are known as ‚ÄúNew World‚Äù hantaviruses and may cause hantavirus pulmonary syndrome (HPS). Other hantaviruses, known as ‚ÄúOld World‚Äù hantaviruses, are found mostly in Europe and Asia and may cause hemorrhagic fever with renal syndrome (HFRS).
• Each hantavirus serotype has a specific rodent host species and is spread to people via aerosolized virus that is shed in urine, feces, and saliva, and less frequently by a bite from an infected host.

The most important hantavirus in the United States that can cause HPS is the Sin Nombre virus, spread by the deer mouse.

Radiographic progression of hantavirus pulmonary syndrome in patient

Hantavirus Pulmonary Syndrome (HPS)

Hantavirus Pulmonary Syndrome (HPS) is a severe, sometimes fatal, respiratory disease in humans caused by infection with hantaviruses.

• Anyone who comes into contact with rodents that carry hantaviruses is at risk of HPS.
• Rodent infestation in and around the home remains the primary risk for hantavirus exposure.
• Even healthy individuals are at risk for HPS infection if exposed to the virus.
• To date, no cases of HPS have been reported in the United States in which the virus was transmitted from one person to another.
• In fact, in a study of health care workers who were exposed to either patients or specimens infected with related types of hantaviruses (which cause a different disease in humans), none of the workers showed evidence of infection or illness.

Cases of Hantavirus Pulmonary Syndrome (HPS)

Early symptoms include fatigue, fever and muscle aches, especially in the large muscle groups—thighs, hips, back, and sometimes shoulders. About half of all HPS patients also experience headaches, dizziness, chills, and abdominal problems, such as nausea, vomiting, diarrhea, and abdominal pain. Late Symptoms:

• Lungs Fill with Fluid
• Shortness of Breath

Four to 10 days after the initial phase of illness, the late symptoms of HPS appear. These include coughing and shortness of breath, with the sensation of, as one survivor put it, "a tight band around my chest and a pillow over my face" as the lungs fill with fluid.

Deer mouse, Peromyscus maniculatus

Transmission

People can get HPS when they are exposed to infected rodents. Exposures may include:

• Breathing in the virus. This may happen when rodent urine and droppings containing hantavirus are stirred up into the air.
• Touching eyes, nose or mouth after touching rodent droppings, urine, or nesting materials that contain the virus.
• A bite from an infected rodent.

HPS is not spread from person to person.

Diagnosis

Diagnosing HPS in an individual who has only been infected for a few days is difficult, because early

Transmission electron micrograph of the Sin Nombre Hantavirus

symptoms such as fever, muscle aches, and fatigue are easily confused with influenza. Experiencing all of the following would strongly suggest HPS infection:

• A history of potential rodent exposure
• Fever and fatigue
• Shortness of breath

Anyone experiencing these symptoms and having a history of recent rodent exposure should see their physician immediately and mention their potential rodent exposure.

Treatment

• There is no specific treatment, cure, or vaccine for HPS.
• If infected individuals are recognized early and receive medical care in an intensive care unit, they may do better.
• In intensive care, patients are intubated and given oxygen therapy to help them through the period of severe respiratory distress.
• The earlier the patient is brought in to intensive care, the better.

Prevention

• When people get HPS, it‚Äôs usually because they‚Äôve been exposed to infected rodents or their droppings.
• So, the best way to help prevent HPS is to eliminate or minimize contact with rodents in your home, workplace, or campsite.

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