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Hantavirus: Could it occur in the United States?. Danny L. Self (Ph.D.) Walden University PUBH 8165-3 Dr. Lezah Brown-Ellington Winter 2012-2013. Hantavirus. Old World Hantavirus New World Hantavirus. (Centers for Disease Control and Prevention, 2012 ). Host of the Hantavirus. Rodents

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hantavirus could it occur in the united states

Hantavirus: Could it occur in the United States?

Danny L. Self (Ph.D.)

Walden University

PUBH 8165-3

Dr. Lezah Brown-Ellington

Winter 2012-2013

hantavirus
Hantavirus
  • Old World Hantavirus
  • New World Hantavirus
host of the hantavirus
Host of the Hantavirus
  • Rodents
    • Deer mouse
    • Cotton rat
    • Rice rat
    • White-footed mouse
deer mouse peromyscus maniculatus
Deer mouse (Peromyscus maniculatus)

(Centers for Disease Control and Prevention, 2012)

hemorrhagic fever with renal syndrome hfrs
Hemorrhagic Fever with Renal Syndrome (HFRS)
  • Korean hemorrhagic fever
  • Epidemic hemorrhagic fever
  • Nephropathis epidemica
  • Hantaan virus
  • Dobrava virus
  • Saaremaa virus
  • Seoul virus
  • Puumala virus
hantavirus pulmonary syndrome hps
Hantavirus Pulmonary Syndrome (HPS)
  • Infectious disease caused by the Hantavirus
    • Flu-like symptoms
  • Occur irregularly in rural areas
  • Numerous types
    • Sin Nombre hantavirus
    • Carried by rodents
  • Treatment limited
characteristics of some known hantaviruses
Characteristics of some known Hantaviruses

(Centers for Disease Control and Prevention, 2012)

comparison of hfrs hps
Comparison of HFRS & HPS

(Centers for Disease Control and Prevention, 2012)

clinical case definition
Clinical Case Definition
  • A febrile illness (body temperature of 101° F or greater) characterized by bilateral diffuse interstitial edema that may radiographically resemble ARDS, with respiratory compromise which requires supplemental oxygen, which develops within 72 hours of hospitalization, and occurring in a previously healthy person
  • Unexplained respiratory illness resulting in death, with an autopsy examination demonstrating noncardiogenic pulmonary edema without an identifiable cause
laboratory criteria for diagnosis
Laboratory Criteria for Diagnosis
  • Detection of hantavirus-specific immunoglobulin M or rising titers of hantavirus-specific immunoglobulin G
  • Detection of hantavirus-specific ribonucleic acid sequence by polymerase chain reaction in clinical specimens
  • Detection of hantavirus antigen by immunohistochemistry
incidence
Incidence
  • Human to human transmission does not exist
  • U.S. national parks
  • One’s own home
potential risk activities for hps
Potential risk activities for HPS
  • Opening and cleaning previously unused buildings
  • Housecleaning activities
  • Work-related exposure
  • Campers
  • Hikers
ecology
Ecology

Enzootic Cycle

Epizootic Cycle

(Centers for Disease Control and Prevention, 2012)

transmission of the hantavirus
Transmission of the Hantavirus

(Arizona Geographic Alliance, 2001)

symptoms
Symptoms

Early Symptoms

Late Symptoms

Lungs fill with fluid

Shortness of breath

  • Fatigue
  • Fever
  • Muscle aches
  • Headaches
  • Dizziness
  • Chills
  • Abdominal problems
signs tests
Signs & Tests

Results from physical exam

Tests

Blood tests to check for Hantavirus

Complete blood count (CBC)

Complete metabolic panel

Kidney and liver function tests

Chest x-ray

  • Acute respiratory distress syndrome (ARDS)
  • Kidney failure
  • Low blood pressure (hypotension)
  • Low blood oxygen levels
treatment
Treatment
  • Oxygen
  • Breath tube or machine
  • Ribavirin
complications
Complications
  • Kidney failure
  • Heart failure
  • Lung failure
expectations prognosis
Expectations(Prognosis)
  • Advances rapidly
  • If lungs are infected death will follow
prevention
Prevention
  • Avoid exposure to rodent urine or droppings
incidences in the united states
Incidences in the United States
  • 1993
    • Four Corners
    • Appalachian Trail
  • 2012
    • Yosemite National Park
annual u s hps cases case fatality 1993 2011
Annual U.S. HPS Cases & Case-fatality (1993-2011)

(Centers for Disease Control and Prevention, 2012)

yosemite national park
Yosemite National Park
  • September 2012
    • 10 confirmed cases
    • 3 deaths
september 6 2012 case count state of residence map
September 6, 2012: Case Count (State of Residence) Map

(Centers for Disease Control and Prevention, 2012)

september 13 2012 case count state of residence map
September 13, 2012: Case Count (State of Residence) Map

(Centers for Disease Control and Prevention, 2012)

current case count state of residence map
Current Case Count (State of Residence) Map

(Centers for Disease Control and Prevention, 2012)

incidences outside the united states
Incidences Outside the United States
  • HFRS
    • 150,000 – 200,000 cases
  • HPS
    • 200 cases
slide34
Geographical representation of approximate Hantaviral disease incidence by country per year.

Jonsson C B et al. Clin. Microbiol. Rev. 2010;23:412-441

references
References
  • Arizona Geographic Alliance. (2001). Hantavirus Student Guide: Arizona Geographic Alliance. Retrieved from Arizona Geographic Alliance: http://alliance.la.asu.edu/model/geoliteracyCD/LessonFiles/DornVaagen/DornHantaS.pdf
  • Bi, Z., Formenty, P. B., & Roth, C. E. (2007). Hantavirus Infection: A Review and Global Update. J Infect Developing Countries 2008, 3-23.
  • Ceneters for Disease Control and Prevention. (1994, December 4). MMWR - Emerging Infectious Diseases Hantavirus Puolmonary Syndrome --Virginia, 1993: Ceneters for Disease Control and Prevention . Retrieved from Ceneters for Disease Control and Prevention: http://www.cdc.gov/mmwr/preview/mmwrhtml/00033796.htm
  • Centers for Disease Control and Prevention. (2011, May 17). Hantavirus: Hemorrhagic Fever with Renal Syndrome (HFRS): Centers for Disease Control and Prevention. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/hantavirus/hfrs/index.html
  • Centers for Disease Control and Prevention. (2012 , August 29). Rodents in the United States that caryy Hantavirus: Centers for Disease Control and Prevention. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/hantavirus/rodents/index.html
  • Centers for Disease Control and Prevention. (2012, August 29). Deer mouse habitat in North America: Centers for Disease Control and Prevention. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/hantavirus/rodents/deer-mouse.html
references1
References
  • Centers for Disease Control and Prevention. (2012, August 29). Ecology - Hantavirus: Centers for Disease Control and Prevention. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/hantavirus/technical/hanta/ecology.html
  • Centers for Disease Control and Prevention. (2012, December 26). Hantavirus - Surveillance: Centers for Disease Control and Prevention. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/hantavirus/surveillance/state-of-exposure.html
  • Centers for Disease Control and Prevention. (2012, August 29). Hantavirus Pulmonary Syndrome (HPS) Case Definition: Centers for Disease Control and Prevention. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/hantavirus/health-care-workers/hps-case-definition.html
  • Centers for Disease Control and Prevention. (2012, August 29). Hantavirus: Virology: Centers for Disease Control and Prevention. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/hantavirus/technical/hanta/virology.html
  • Centers for Disease Control and Prevention. (2012, August 29). How people get Hantavirus Pulmonary Syndrome: Centers for Disease Control and Prevention. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/hantavirus/hps/transmission.html
references2
References
  • Centers for Disease Control and Prevention. (2012, September 17). Outbreak of Hantavirus Infection in Yosemite National Park: Centers for DiseaseControl and Prevention. Retrieved from Centers for DiseaseControl and Prevention: http://www.cdc.gov/hantavirus/outbreaks/yosemite-national-park-2012.html
  • Centers for Disease Control and Prevention. (2012, August 29). Signs & Symptoms for Hantavirus Pulmonary Syndrome: Centers for Disease Control and Prevention. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/hantavirus/hps/symptoms.html
  • Jonsson, C. B., Figueiredo, L. T., & Vapalahti, O. (2010). A Global Perspective on Hantavirus Ecology, Epidemiology, and Disease. American Society of Microbiology, 415-441.
  • Mayo Clinic Staff. (2011, February 11). Hantavirus Pulmonary Syndrom: Mayo Clinic. Retrieved from Mayo Clinic: http://www.mayoclinic.com/health/hantavirus-pulmonary-syndrome/DS00900
  • PubMed Health. (2011, March 11). Hantavirus: PubMed Health. Retrieved from PubMed Health: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002358/
  • The Free Dictionary. (2013). Medical-dictionary: The Free Dictionary. Retrieved from The Free Dictionary: http://medical-dictionary.thefreedictionary.com
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