hantavirus deaths per year

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  • Feb 11, 2020

Hantavirus Disease, by State of Reporting | Hantavirus | DHCPP | CDC
Hantavirus Disease, by State of Reporting | Hantavirus | DHCPP | CDC

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In the last 20 years of surveillance for hantavirus in humans in the United States, 624 cases of hantavirus pulmonary syndrome (HPS) have been reported, 96% of them occur in states west of the Mississippi. Most infections Hantavirus is caused by a virus Sin Nombre, but cases of HPS is caused by Bayou, Black Creek Canal, Monongahela, and viral New York have been reported, and cases of dengue fever in the country is obtained and renal syndrome caused by viruses Seoul also has occur. Rarely, hantavirus infections result in mild illness that does not develop into HPS. advanced testing and monitoring of clinical cases in humans will improve our understanding of the etiologic agent involved and the spectrum of disease.

In 1993, an outbreak of severe respiratory disease in the Four Corners region of the United States (as defined by the boundary is divided between the state of New Mexico, Arizona, Colorado, and Utah) became national headlines. The invention of a new disease, hantavirus syndrome, pulmonary (HPS) (), agents etiology, virus Sin Nombre (SNV) (), and the reservoir rodent, deer (Peromyscus maniculatus) (), are among the most prominent findings in flood new revelations about hantaviruses in America. Reliable and fast diagnostic tests coupled with national surveillance create a condition where the patient is tested, the relevant information collected regarding the exposure of rodents and rodent viruses potential host caught and tested. Within a few years, four additional hantaviruses related diseases indigenous to the United States described: Bayou, Black Creek Canal, New York, and Monongahela virus. We now understand that several hantaviruses are endemic to North America, and human infection continue to occur where humans come into contact with infected rodents. Through a review of the literature and data from the registry hantavirus supervision of the Center for Disease Control and Prevention (CDC) in Atlanta, Georgia, United States of America, we have summarized the spectrum and distribution of human hantavirus infections in the United States through July 9th, 2013.

Hantaviruses (Bunyaviridae family, genus Hantavirus) are rodent and insectivore virus-borne distributed on all continents except Antarctica (). It is not known whether all hantaviruses cause disease in humans. Humans become infected through direct contact with infected rodents or inhaling the virus that has been shed in rodent feces, blood, and saliva and then becomes an aerosol. Old World hantaviruses known human pathogens (eg, viruses Hantaan, Dobrava, Seoul, and Puumala) causes hemorrhagic fever and renal syndrome (HFRS), where the main organ affected is the kidney. Symptoms include fever; myalgia; and gastrointestinal, bladder, brain, and bleeding of the conjunctiva. Acute renal failure with oliguria HFRS caused by the often lasts for several days before spontaneously resolve (). All New World hantaviruses known pathogens for humans, including SNV and Andes virus, the cause of HPS, where the main organs affected are the lungs. Prodrome symptoms include fever, myalgia, and gastrointestinal symptoms followed by rapid onset of pulmonary edema (,,). Due to insufficiency of the heart, causing heart failure and death, can stand in severe cases, many researchers and doctors refer to diseases such as hantavirus cardiopulmonary syndrome (,). Thrombocytopenia, a left shift, and hemokonsentrasi abnormal laboratory findings were typical (). The only species of hantavirus with evidence of transmission from human to human is the Andes virus, which is endemic to South America (). In the United States, ≈90% of hantavirus infection acquired through household or occupational exposures (), although outbreaks in 2012 between Yosemite National Park visitors are an important example of hantavirus exposure recreation ().

National surveillance for hantavirus infection in the United States began in 1993, and became a national HPS should be reported in 1995 (). Clinical case definition, which was approved by the Council of State and Territorial Epidemiology, including fever and pulmonary symptoms (bilateral diffuse interstitial edema, the clinical diagnosis of acute respiratory distress syndrome, or radiographic evidence of pulmonary edema noncardiogenic) or respiratory illness resulting in death and examination described demonst autopsynoncardiogenic rating pulmonary edema without an identifiable cause (). HPS clinically compatible cases are confirmed by laboratory testing (serological analysis, PCR, or immunohistochemical analysis) with a positive result for hantavirus infection. laboratory confirmation is required for cases reported through the National Notifiable Diseases Surveillance System.

As the July 9, 2013, there were 624 reported cases of HPS in 34 countries (), including 31 cases that occurred prior to 1993 and retrospectively diagnosed on autopsy tissue archives or convalescent serum samples (-). The location is determined exposure to 593 cases, and 570 (96%) of these exposures occur in states west of the Mississippi. Infection twelve were confirmed by PCR analysis is caused by species of hantavirus other than SNV (): 5 infections caused by viruses Bayou, one by the Black Creek Canal virus, New York 2 by a virus, and 4 by the Monongahela virus. Because the test is widely available serologic cross-reactive to all New World hantaviruses (,), identification of the virus should be done by PCR sequencing; This method requires acute specimen is collected and transported to the laboratory frozen to preserve RNA for analysis. It is not always possible, but efforts to collect specimens suitable for molecular analysis can contribute to further our understanding of hantaviruses cause disease in the United States.

Hantavirus pulmonary syndrome (HPS) cases by exposure countries, the United States, 1993-2013. A total of 624 cases occurred in 34 countries; country exposure is not known for 28 cases. The cumulative number of cases for each country is current as of 9 July 2013.

The CDC has recorded a total of 10 laboratory confirmed cases of acute infection hantavirus that do not fit the definition of clinical cases of HPS, 6 of the description of clinical cases have been reported previous (,,). Because this patient has no pulmonary symptoms, they are not included in the number of cases nationwide HPS. It is believed that infection with hantavirus humans rarely resulted in mild disease without pulmonary symptoms, a statement that is reinforced in the wake of the 2012 Yosemite outbreak, where infection hantavirus laboratory confirmed only two acute without pulmonary symptoms are identified, although serology extensive test-more than 3,000 samples tested at 1 commercial laboratories only (). However, during pulmonary symptoms are the necessary elements for hantavirus cases reported to the CDC (and possibly also for the state public health authorities), milder cases of hantavirus infection will continue to be counted. This presents a missed opportunity to understand the full spectrum of hantavirus disease and diminished awareness of where and how people are affected by hantaviruses. In light of this, we propose that the clinical case definition should be adjusted so that all laboratory-confirmed hantavirus infection were reported to the health authorities.

Old World hantaviruses have also been found in this country. For example, Seoul virus has been found in the Norway rat (Rattus norvegicus) and the black rat (Rattus rattus) in urban areas throughout the United States (,). Serosurvei series in Baltimore, Maryland, residents show that humans have serologic evidence of viral exposure Seoul and identified three cases according to clinical criteria for acute HFRS (). In 2008, the first Seoul virus infection in the country obtained was confirmed by PCR was found in the population Baltimore (). HPS cases have not been confirmed associated with viral infection Seoul acquiring land in Texas in 2010 have also been described (). HFRS should be considered in cases of fever and acute renal failure in people who live or work in an environment that may have mice

hantavirus infection imported cases also occur in the United States .; First described in the 1950s when HFRS was detected at 2 military personnel returning from the Korean War (,). More recently, in 2009, HFRS is generated from imported cases of viral infection Seoul resident of Wisconsin developed shortly after he returned from a visit to China (); in 2010, serologically confirmed HPS resulting from infections acquired in Brazil developed the Brazilian visitors to Florida (); and in 2012, HFRS due to Puumala virus infection acquired in Germany developed German visitors to Florida.

HPS caused by the SNV continues became the dominant form of hantavirus infection in the United States. However, we must continue to consider hantaviruses as a cause of disease in patients with an exposure of mice that are outside the western United States, which is different from the usual clinical presentation of pulmonary disease, or who are not associated with exposure deer mice.

Dr KNUST is a veterinarian and epidemiologist at the Viral Special Pathogens Branch, CDC. His primary research interest is a zoonotic disease.

Dr Rollin is a medical doctor and team lead in Viral Special Pathogens Branch, CDC. His research interests are zoonotic and high containment virus

Suggested citation for this article :. KNUST B, Rollin PE. Summary twenty years of surveillance for human hantavirus infections, USA. Emerg Infect Dis [Internet]. 2013 December [date cited].

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