What is hantavirus?

Causes and Symptoms

Hantavirus, which is distantly related to Ebola virus, is transmitted through contact with the urine and droppings of wild rodents, such as the deer mouse and cotton rat. Contact usually involves the inhalation of contaminated particles in dust. Hantavirus is not transmissible between humans.

Infection takes two major forms. In South America, one strain causes hemorrhagic fever with renal
syndrome, involving kidney failure, hemorrhaging, and shock. In the United States, another strain results in hantavirus pulmonary syndrome. Early symptoms mimic influenza; they include fever, chills, muscle aches, nausea and vomiting, malaise, and a dry cough. After initial improvement, increasing shortness of breath follows and may progress to pulmonary

edema, internal bleeding, respiratory failure, and death.

Treatment and Therapy

Diagnosis of hantavirus pulmonary syndrome involves physical examination for hypoxia, hypotension, and acute
respiratory distress syndrome. Laboratory tests show an elevated white blood cell count and a decreasing platelet count, and chest X-rays may reveal edema. The presence of hantavirus is confirmed through serological testing.

There is no cure for hantavirus pulmonary syndrome; treatment is focused on alleviating the symptoms. This condition must be treated in the intensive care unit (ICU) of a hospital, as careful monitoring of respiratory function and blood gases is essential. In severe cases, the use of an endotracheal tube and a ventilator becomes necessary. Experiments have been performed with intravenous ribavirin therapy; the efficacy of this treatment is being evaluated. Unfortunately, even with aggressive measures, the death rate ranges from 50 to 80 percent.

Perspective and Prospects

The incidence of hantavirus pulmonary syndrome seemed to rise sharply in the 1990s. Epidemiologists were uncertain whether the number of cases increased or more cases were reported following identification of the virus in the United States in 1993.

Because much remains to be learned about the transmission, development, and treatment of hantavirus infection, public health efforts have been in education and prevention. Hikers and campers are thought to be at a greater risk; they are urged to avoid exposure to rodent droppings and questionable water sources. People entering cabins, sheds, or other buildings that have not been used recently should air out the building first and disinfect all surfaces.

Bibliography

Cockrum, E. Lendell. Rabies, Lyme Disease, Hanta Virus, and Other Animal-Borne Human Diseases in the United States and Canada. Tucson, Ariz.: Fisher Books, 1997.

Dugdale, David C., Jatin M. Vyas, and David Zieve. "Hantavirus." Medline Plus, March 11, 2011.

"Hantavirus." Centers for Disease Control and Prevention, November 1, 2012.

Kumar, Vinay, et al., eds. Robbins Basic Pathology. 9th ed. Philadelphia: Saunders/Elsevier, 2012.

McCoy, Krisha. "Hantavirus Infection." Health Library, January 4, 2013.

Meyer, Andrea S., and David R. Harper. Of Mice, Men, and Microbes: Hantavirus. San Diego, Calif.: Academic Press, 1999.

Murray, Patrick R., Ken S. Rosenthal, and Michael A. Pfaller. Medical Microbiology. 6th ed. Philadelphia: Mosby/Elsevier, 2009.

Pan American Health Organization. Hantavirus in the Americas: Guidelines for Diagnosis, Treatment, Prevention, and Control. Washington, D.C.: Author, 1999.

Sompayrac, Lauren. How Pathogenic Viruses Work. Boston: Jones and Bartlett, 2002.

Strauss, James, and Ellen Strauss. Viruses and Human Disease. 2d ed. Boston: Academic Press/Elsevier, 2008.