Hantavirus Pulmonary Syndrome (HPS)

Pathogen
 Genus: Hantavirus
 Family: Bunyaviridae
- enveloped, segmented, -ssRNA

Virulence Factors
 A viral protein - inhibits cellular responses to interferon
 Intracellular replication - helps avoid immune surveillance

Signs and Symptoms

 fever, fatigue, muscle aches (particularly in large muscles of thighs, hips, back)
 headache, chills, gastrointestinal symptoms (nausea, vomiting, diarrhea, abdominal pain)
 Elevated leukocyte count, low/falling platelet count
 4-10 yrs after initial manifestation = coughing, shock, difficulty breathing
 50% of diagnosed patients die, drowning in their own fluids, despite intensive medical care
 Incubation period: 14-30 days

Pathogenesis
 Following inhalation, Hantavirus enters blood via unknown mechanism
 travel throughout body infecting cells of capillary walls (particularly in lungs)
 body responds with inflammation, which causes capillaries to leak fluid into surrounding tissue
 BP drops precipitously
 50% of patients die die from pneumonia & shock

TRANSMISSION:
 Two American strains of Hantavirus are transmitted via inhalation in dried mouse urine, feces, or saliva to infect the
lungs of humans

EPIDEMIOLOGY:
 mouse population ↑ = human more likely to contact mice & their excrement & saliva
 person-to-person spread does not occur
 Susceptibility: Those exposed to rodents in endemic areas

DIAGNOSIS:
 typical manifestations - low platelet count, sudden onset of fever, muscle aches of legs and trunk
 detection of anti-hantavirus IgM
 demonstration of hantaviral RNA - polymerase chain reaction

TREATMENT:
 NO pharmacological treatment
 Supportive care -- include pulmonary intubation, fever-reducing drugs, pain medication, supplementary oxygen

PREVENTION:
 NO vaccine
 rodent control