Summary
The number of known HPS cases in the United States is now >200, and the illness has occurred in all geographic areas of the country. Though the incidence of the disease is low, the mortality rate remains at 50%, owing to the difficulty in treating a simultaneous severe pulmonary capillary leak syndrome and cardiogenic shock. Adequate treatment of severe cases requires experienced critical care physicians and nurses, as well as advanced facilities. Although nosocomial transmission appears unlikely in North America, universal precautions must be used and some consideration may be given to the use of respiratory isolation.
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Keywords
- Adult Respiratory Distress Syndrome
- Hemorrhagic Fever With Renal Syndrome
- Serum Lactate Level
- Nosocomial Transmission
- Corner Area
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References
Armstrong, L. R., Zaki, S. R., Goldoft, M. J., Todd, R. L., Khan, A. S., Khabbaz, R. F., Ksiazek, T. G., & Peters, C. J. (1995). Hantavirus pulmonary syndrome associated with entering or cleaning rarely used, rodent-infested structures. J. Infect. Dis., 172, 1166.
Back, L. J., Yanagihara, R., Gibbs, C. J. Jr., Miyazaki, M., & Gajdusek, D. C. (1988). Leakey virus: a new hantavirus isolated from Mus musculus in the United States. J. Gen. Virol., 69, 3129–3132.
Bharadwaj, M., Botten, J., Torrez-Martinez, N., & Hjelle, B. (1997). Rio Mamore virus: genetic characterization of a newly recognized hantavirus of the pygmy rice rat, Oligo-ryzomys ryzomys microtis, from Bolivia. Am. J. Trop. Med. Hyg., 57, 368–374.
Bustamante, E. A., Levy, H., & Simpson, S. Q. (1997). Pleural fluid characteristics in hantavirus pulmonary syndrome. Chest, 112, 1133–1136.
Centers for Disease Control and Prevention. (1993). Update: hantavirus-associated illness-North Da kota. 1993. MMWR, 42, 707.
Centers for Disease Control and Prevention. (1994a). Hantavirus pulmonary syndrome—Northeastern United States, 1994. MMWR, 43, 548–549, 555–556.
Centers for Disease Control and Prevention. (1994b). Hantavirus pulmonary syndrome—Virginia, 1993. MMWR, 43. 876–877.
Centers for Disease Control and Prevention. (1994c). Newly identified hantavirus—Florida, 1994. MMWR, 43, 99, 105.
Crowley, M. R., Katz, R. W., Kessler, R., Simpson, S. Q., Levy, H., Hallin, G. W., Cappon, J., Krahling, J. B., & Wernly, J. (1998). Successful treatment of adults with severe Hantavirus pulmonary syndrome with extracorporeal membrane oxygenation. Crit. Cure Med., 26, 409–414.
Duchin, J. S., Koster, F. T., Peters, C. J., Simpson, G. L., Tempest, B., Zaki, S. R., Ksiazek, T. G., Rollin, P. E., Nichol, S.
Umland, E. T., Moolenar, R. L., Reef, S. E., Nolte, K. B., Gallaher, M. M., Butler, J. C., Breiman, R. F., and the Hantavirus Study Group. (1994). Hantavirus pulmonary syndrome: a clinical description of 17 patients with a newly recognized disease. The Hantavirus Study Group [see comments], N. Engl. J. Med., 330, 949–955.
Dull, S. M., Brillman, J. C., Simpson, S. Q., & Sklar, D. P. (1994). Hantavirus pulmonary syndrome: recognition and emergency department management. Ann. Emerg. Med., 24, 530–536.
Elliott, L. H., Ksiazek, T. G., Rollin, P. E., Spiropoulou, C. F., Morzunov, S., Monroe, M., Goldsmith, C. S., Humphrey, C. D., Zaki, S. R., Krebs, J. W., et al. (1994). Isolation of the causative agent of hantavirus pulmonary syndrome. Am. J. Trop. Med. Hyg., 51, 102–108.
Enria, D., Padula, P., Segura, E. L., Pini, N., Edelstein, A., Posse, C. R., & Weissenbacher, M. C. (1996). Hantavirus pulmonary syndrome in Argentina. Possibility of person to person transmission. Medicina, 56, 709–711.
Feldman, H., Sanchez, A., Morzunov, S., Spiropoulou, C. F., Rollin, P. E., Ksiazek, T. G., Peters, C. J., & Nichol, S. T. (1993). Utilization of autopsy RNA for the synthesis of the nucleocapsid antigen of a newly recognized virus associ-ated with hantavirus pulmonary syndrome. Virus Res., 30, 351–367.
Fulhorst, C. F., Monroe, M. C., Salas, R. A., Duno, G., Utrera, A., Ksiazek, T. G., Nichol, S. T., de Manzione, N. M., Tovar, D., & Tesh, R. B. (1997). Isolation, characterization and geographic distribution of Cano Delgadito virus, a newly discovered South American hantavirus (family Bunyaviridae). Virus Res., 51, 159–171.
Green, W., Feddersen, R., Yousef, O., Behr, M., Smith, K., Nestler, J., Jenison, S., Yamada, T., & Hjelle, B. (1998). Tissue distribution of hantavirus antigen in naturally infected humans and deer mice. J. Infect. Dis., 177, 1696–1700.
Hallin, G. W., Simpson, S. Q., Crowell, R. E., James, D. S., Koster, F. T., Mertz, G. J., & Levy, H. (1996). Cardio-pulmonary manifestations of hantavirus pulmonary syndrome. Crit. Care Med., 24, 252–258.
Hjelle, B., Chavez-Giles, F., Torrez-Martinez, N., Yates, T., Sarisky, J., Webb, J., & Ascher, M. (1994a). Genetic identification of a novel hantavirus of the harvest mouse Reithro-dontomys megalotis. J. Virol., 68, 6751–6754.
Hjelle, B., Jenison, S., Mertz, G., Koster, F., & Foucar, K. (1994b). Emergence of hantaviral disease in the south-western United States. West. J. Med., 161, 467–473.
Hjelle, B., Jenison, S., Torrez-Martinez, N., Yamada, T., Nolte, K., Zumwalt, R., MacInnes, K., & Myers, G. (1994c). A novel hantavirus associated with an outbreak of fatal respi-ratory disease in the southwestern United States: evolution-ary relationships to known hantaviruses. J. Virol., 68 592–596.
Hjelle, B., Spiropoulou, C. E., Torrez-Martinez, N., Morzunov, S., Peters, C. J., & Nichol, S. T. (1994d). Detection of Muerto Canyon virus RNA in peripheral blood mono-nuclear cells from patients with hantavirus pulmonary syn-drome. J. Infect. Dis., 170, 1013–1017.
Hjelle, B., Krolikowski, J., Torrez-Martinez, N., Chavez-Giles, F., Vanner, C., & Laposata, E. (1995a). Phylogenetically distinct hantavirus implicated in a case of hantavirus pulmonary syndrome in the northeastern United States. J. Med. Virol., 46, 21–27.
Hjelle, B., Lee, S. W., Song, W., Torrez-Martinez, N., Song, J. W., Yanagihara, R., Gavrilovskaya, I., & Mackow, E. R. (1995b). Molecular linkage of hantavirus pulmonary syndrome to the white-footed mouse, Peromyscus leucopus: genetic characterization of the M genome of New York virus 1. J. Virol., 69, 8137–8141.
Hjelle, B., Torrez-Martinez, N., & Koster, F. T. (1996a). Hantavirus pulmonary syndrome-related virus from Bolivia. Lancet, 347, 57. Letter.
Hjelle, B., Torrez-Martinez, N., Koster, F. T, Jay, M., Ascher, M. S., Brown, T., Reynolds, P., Ettestad, P., Voorhees, R. E., Sarisky, J., Enscore, R. E., Sands, L., Mosley, D. G., Kioski, C., Bryan, R. T., & Sewell, C. M. (1996b). Epidemiologic linkage of rodent and human hantavirus genomic sequences in case investigations of hantavirus pulmonary syndrome. J. Infect. Dis., 173, 781–786.
Hjelle, B., Jenison, S., Torrez-Martinez, N., Herring, B., Quan, S., Polito, A., Pichuantes, S., Yamada, T., Morris, C., Elgh, F., Lee, H. W., Artsob, H., & Dinello, R. (1997). Rapid and specific detection of Sin nombre virus antibodies in patients with hantavirus pulmonary syndrome by a strip immunoblot assay suitable for field diagnosis. J. Clin. Microbiol., 35, 600–608.
Hopkins, R. O., Larson-Lohr, V., Weaver, L. K., & Bigler, E. D. (1998). Neuropsychological impairments following hanta-virus pulmonary syndrome. J. Int. Neuropsychol. Soc., 4, 190–196.
Hutchinson, K. L., Rollin, P. E., & Peters, C. J. (1998). Pathogenesis of a North American hantavirus, Black Creek Canal virus, in experimentally infected Sigmodon hispidus. Am. J. Trop. Med. Hyg., 59, 58–65.
Javer, A. R., Elliott, H. F., & Longridge, N. S. (1998). Hantavirus infection: a possible cause of delayed sensorineural hearing loss. Otolaryngol. Head Neck Surg., 118, 697–701.
Jenison, S., Yamada, T., Morris, C., Anderson, B., Torrez-Martinez, N., Keller, N., & Hjelle, B. (1994). Characteriza-tion of human antibody responses to four corners hantavirus infections among patients with hantavirus pulmonary syndrome. J. Virol., 68, 3000–3006.
Jenison, S., Hjelle, B., Simpson, S., Hallin, G., Feddersen, R., & Koster, F. (1995). Hantavirus pulmonary syndrome: clinical, diagnostic, and virologic aspects. Semin. Respir. Infect., 10, 259–269.
Ketai, L. H., Williamson, M. R., Telepak, R. J., Levy, H., Koster, F. T., Nolte, K. B., & Allen, S. E. (1994). Hantavirus pulmonary syndrome: radiographic findings in 16 patients. Radiology, 191, 665–668.
Ketai, L. H., Kelsey, C. A., Jordan, K., Levin, D. L., Sullivan, L. M., Williamson, M. R., Wiest, P. W., & Sell, J. J. (1998). Distinguishing hantavirus pulmonary syndrome from acute respiratory distress syndrome by chest radiography: are there different radiographic manifestations of increased alveolar permeability? J. Thorac. Imaging, 13, 172–177.
Khan, A. S., Spiropoulou, C. F., Morzunov, S., Zaki, S. R., Kohn, M. A., Nawas, S. R., McFarland, L., & Nichol, S. T. (1995). Fatal illness associated with a new hantavirus in Louisiana. J. Med. Virol., 46, 281–286.
Khan, A. S., Gaviria, M., Rollin, P. E., Hlady, W. G., Ksiazek, T. G., Armstrong, L. R., Greenman, R., Ravkov, E., Kolber, M., Anapol, H., Sfakianaki, E. D., Nichol, S. T., Peters, C. J., & Khabbaz, R. F. (1996). Hantavirus pulmonary syndrome in Florida: association with the newly identified Black Creek Canal virus. Am. J. Med., 100, 46–48.
Lee, P. W., Amyx, H. L., Yanagihara, R., Gajdusek, D. C., Goldgaber, D., & Gibbs, C. J., Jr. (1985). Partial characterization of Prospect Hill virus isolated from meadow voles in the United States. J. Infect. Dis., 152, 826–829.
Li, D., Schmaljohn, A. L., Anderson, K., & Schmaljohn, C. S. (1995). Complete nucleotide sequences of the M and S segments of two hantavirus isolates from California: evi-dence for reassortment in nature among viruses related to hantavirus pulmonary syndrome. Virology, 206, 973–983.
Lopez, N., Padula, P., Rossi, C., Lazaro, M. E., & Franze-Fernandez, M. T. (1996). Genetic identification of a new hantavirus causing severe pulmonary syndrome in Argentina. Virology, 220, 223–226.
McCormick, J. (1991). Crimean-Congo hemorrhagic fever (CCHF), in: Hunter’s Tropical Medicine (G. T. Slrickland, ed.), Philadelphia: WB Saunders Company, pp. 248–254.
McKee KT Jr, L. J., & Peters CJ, J. K. (1991). Hantaviruses, in: Textbook of Human Virology (R. B. Belshe, ed.). St. Louis: Mosby, Yearbook, Inc., pp. 615–632.
Moolenaar, R. L., Dalton, C., Lipman, H. B., Umland, E. T., Gallaher, M., Duchin, J. S., Chapman, L., Zaki, S. R., Ksiazek, T. G., Rollin, P. E., Nichol, S., Cheek, J. E., Butler, J. C., Peters, C. J., & Breiman, R. F. (1995). Clinical features that differentiate hantavirus pulmonary syndrome from three other acute respiratory illnesses. Clin. Infect. Dis., 21, 643–649.
Morzunov, S. P., Feldman, H., Spiropoulou, C. F., Semenova, V. A., Rollin, P. E., Ksiazek, T. G., Peters, C. J., & Nichol, S. T. (1995). A newly recognized virus associated with a fatal case of hantavirus pulmonary syndrome in Louisiana. J. Virol., 69, 1980–1983.
Nolle, K. B., Feddersen, R. M., Foucar, K., Zaki, S. R., Koster, F. T., Madar, D., Merlin, T. L., McFeeley, P. J., Umland, E. T., & Zumwalt, R. E. (1995). Hantavirus pulmonary syndrome in the United Slates: a pathological description of a disease caused by a new agent. Hum. Pathol, 26, 110–120.
Padula, P. J., Edelstein, A., Miguel, S. D., Lopez, N. M., Rossi, C. M., & Rabinovich, R. D. (1998). Hantavirus pulmonary syndrome outbreak in Argentina: molecular evidence for person-to-person transmission of Andes virus. Virology, 241, 323–330.
Peters, J. K. (1994). Viral hemorrhagic fevers, in: Infectious Diseases (J. M. Hoeprich & A. R. Ronald, eds.). Philadelphia: J.B. Lippincott Company, pp. 924–929.
Peters, J. K. (1995). California encephalitis viruses, hantaviruses, and other bunyaviridae, in: Principles and Practice of Infectious Disease (B. J. Mandell & R. Dolin, eds.). New York: Churchill Livingstone, pp. 1567–1572.
Rawlings, J. A., Torrez-Martinez, N., Neill, S. U., Moore, G. M., Hicks, B. N., Pichuantes, S., Nguyen, A., Bharadwaj, M., & Hjelle, B. (1996). Cocirculation of multiple hantaviruses in Texas, with characterization of the small (S) genome of a previously undescribed virus of cotton rats (Sigmodon hispidus). Am. J. Trop. Med. Hyg., 55, 6722–679.
Rosenberg, R. B., Waagner, D. C., Romano, M. J., Kanase, H. N., & Young, R. B. (1998). Hantavirus pulmonary syndrome treated with inhaled nitric oxide. Pediatr. Infect. Dis. J., 17, 749–752
Schwarz, T. F., Zaki, S. R., Morzunov, S., Peters, C. J., & Nichol, S. T. (1995). Detection and sequence confirmation of Sin Nombre virus RNA in paraffin-embedded human tissues using one-step RT-PCR. J. Virol. Methods, 51, 349–356.
Simpson, S. Q., Jones, P. W., Davies, P. D., & Cushing, A. (1995). Social impact of respiratory infections. Chest, 108(Suppl. 2), 63S–69S.
Song, J. W., Baek, L. J., Gajdusek, D. C., Yanagihara, R., Gavrilovskaya, I., Luft, B. J., Mackow, E. R., & Hjelle, B. (1994). Isolation of pathogenic hantavirus from white-fooled mouse (Peromyscus leucopus). Lancet, 344, 1637. Letter.
Spiropoulou, C. F., Morzunov, S., Feldmann, H., Sanchez, A., Peters, C. J., & Nichol, S. T. (1994). Genome structure and variability of a virus causing hantavirus pulmonary syndrome. Virology, 200, 715–723.
Torrez-Martinez, N., Song, W., & Hjelle, B. (1995). Nucleotide sequence analysis of the M genomic segment of El Moro Canyon hantavirus: antigenic distinction from four corners hantavirus. Virology, 211, 336–338.
Vitek, C. R., Breiman, R. F., Ksiazek, T. G., Rollin, P. E., McLaughlin, J. C., Umland, E. T., Nolte, K. B., Loera, A., Sewell, C. M., & Peters, C. J. (1996). Evidence against person-to-person transmission of hantavirus to health care workers. Clin. Infect. Dis., 22, 824–826.
Wells, R. M., Sosa Estani, S., Yadon, Z. E., Enria, D., Padula, P., Pini, N., Mills, J. N., Peters, C. J., & Segura, E. L. (1997a). An unusual hantavirus outbreak in southern Argentina: person-to-person transmission? Hantavirus Pulmonary Syndrome Study Group for Patagonia. Emerg. Infect. Dis., 3, 171–174.
Wells, R. M., Young, J., Williams, R. J., Armstrong, L. R., Busico, K., Khan, A. S., Ksiazek, T. G., Rollin, P. E., Zaki, S. R., Nichol, S. T., & Peters, C. J. (1997b). Hantavirus transmission in the United States. Emerg. Infect. Dis., 3, 361–365.
Whitten, P., Crowell, R. E., & Levy, H. (1997). Shock in a patient exposed to rodents. Chest, 112, 1674–1676.
Yamada, T., Hjelle, B., Lanzi, R., Morris, C., Anderson, B., & Jenison, S. (1995). Antibody responses to Four Corners hantavirus infections in the deer mouse (Peromyscus maniculatus): identification of an immunodominant region of the viral nucleocapsid protein. J. Virol., 69, 1939–1943.
Zaki, S. R., Greer, P. W., Coffield, L. M., Goldsmith, C. S., Nolte, K. B., Foucar, K., Feddersen, R. M., Zumwalt, R. E., Miller, G. L., Khan, A. S. (1995). Hantavirus pulmonary syndrome. Pathogenesis of an emerging infectious disease. Am. J. Pathol., 146, 552–579.
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Iimpson, S.Q. (2002). Hantavirus Pulmonary Syndrome. In: Marrie, T.J. (eds) Community-Acquired Pneumonia. Springer, Boston, MA. https://doi.org/10.1007/0-306-46834-4_40
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