is hantavirus the plague

  • 7 min read
  • Feb 09, 2020

What is hantavirus? | MNN - Mother Nature Network
What is hantavirus? | MNN – Mother Nature Network

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Karras, David J. MD

Dr. Karras is a professor of emergency medicine, associate chairman for academic affairs and director of research in the department of emergency medicine at Temple University School of Medicine in Philadelphia, PA.

Two cases of bubonic plague appeared recently in New York City, but the hantavirus has appeared throughout the United States led to the term outbreak images of vast, death horrifyingly painful to the victim succumbing to high fever, respiratory problems, and skin ulcers necrotic. These images are accurate.

Plague, also known as the Black Death, is one of the defining events of the European Middle Ages and Renaissance. During the two-year period in the 14th century, nearly half of the population of Western Europe were killed by the plague, and death rates exceed 65 per cent reported in many major cities. Some 20 million deaths associated with this first wave of the Black Death in Europe. Epidemics and pandemics continue to attack and destroy the cities of Europe for the next 200 years. plague finally appeared in the United States, the latest urban, rat-borne plague occurred in Los Angeles in the 1920s. A last major epidemic outbreak swept Europe after World War II.

This may come as a surprise that outbreaks continued to be reported throughout the world, up to 3,000 cases are reported each year, mostly in small villages in Africa, Asia, and South America. In the US, there continues to be a sporadic case of an outbreak to 40 cases are reported each year. Most cases of plague in the US are found in the desert Southwest. As we have seen with other recent outbreaks of infectious diseases, however, raises the possibility of quick trips different human plague outbreak far from their site of origin.

As a case in point, two cases of plague were reported in New York City in 2002 (MMWR 2003; 52 :. 725) the victims are a married couple who really have acquired the infection in rural New Mexico home they. Had there not been a rapid identification and isolation of a disease, it is likely that health care workers and other contacts in New York may have contracted the disease.

Much of the disease died, the outbreak continues to be a modern threat. Specter plague being used as bioterrorism weapons further underscores the need for the emergency physician to recognize the disease and instituting appropriate disease control measures. Like it or not, we are the pioneers in preventing widespread disease outbreak, and we need to be vigilant in recognizing, treating and containing diseases such as plague.

The outbreak is infection by the bacterium Yersinia pestis, carried by rat fleas-infect. Rodent host serves as a silent reservoir of infection. While the great European plague outbreak caused by rat fleas are common, modern cases have been linked to sporadic infestation of rodents, including prairie dogs, chipmunks, and ground squirrels. Domestic cats can also serve as a source of human infection after being infected by ticks orafter eating infected mice.

untreated bubonic plague linked to the deaths of about 50% and can be fatal within a few days

People usually are exposed to plague through the bite of an infected tick, so that in the plague. Two to six days after the bite, individuals develop bubo, a, swollen lymph nodes beautifully painful heat in the armpits, groin, or neck, depending on the location of the initial tick bite. It buboes pathognomonic is 1 cm to 10 cm and not fluctuate. Patients severely ill with fever, extreme fatigue, and headache. Untreated, septicemic plague ensues, characterized by shock, abdominal pain, and disseminated intravascular coagulation with diffuse bleeding. the bacteria can spread to the lungs, causing pneumonia outbreak and further transmitted through infected respiratory droplets. The term refers to the Black Death purpura skin lesions that can become necrotic and resulted in local gangrene. Untreated bubonic plague is associated with a mortality of about 50 percent, and can be fatal within a few days.

In contrast to the bubonic plague, pneumonic plague refers to an infection acquired through inspiration from the infected respiratory droplets. One to three days after exposure, infected people develop fever, chills, and a cough with bloody sputum. Patients with pneumonic plague have more rapid disease progression and mortality is greater.

While the more obvious diseases can present with swollen glands and fever, bubonic plague uniquely associated with a rapid onset of fever, toxic appearance, and their painful, focus lymphadenitis without evidence of skin lesions or ride lymphangitis. pneumonic plague, on the other hand, has no pathognomonic features, and suspicion often require a history of exposure to individuals or other big mammals infected.

All patients suspected of having the plague should be placed in respiratory isolation, although there may be a risk of transmission if the patient does not have a cough or other signs of a respiratory infection. Public health officials should be notified emergently. blood culture and aspiration of buboes should be obtained and antibiotics are started as soon as possible. Treatment remains of choice streptomycin, tetracycline or chloramphenicol as an alternative.

Like the plague, hantavirus lurk in rodents of the desert Southwest, sporadically cause human disease and intermittently made an unexpected appearance away from endemic areas. Hantavirus pulmonary syndrome (HPS) first appeared in 1993 in the Four Corners area of ​​New Mexico, Arizona, Colorado, and Utah. The initial outbreak involving 24 people and led to the deaths of 50 percent. (New Engl J Med 1994; 330 :. 949) The causative agent was quickly identified as a previously unknown viruses that cause human disease in the western hemisphere, called the Sin Nombre virus (SNV), or “virus without a name.”

hantavirus continues to pose a very serious threat, with 384 cases proved over the last 12 years and the death of 36 percent overall. It is no longer limited to the desert Southwest. (Figure 1.) In addition, the disease has the potential to be transmitted from the patient to the doctor, and the doctor who infected their own families. emergency physicians throughout the US needs to be aware of the presentation of hantavirus.

hantavirus reservoir is the deer mouse, which despite healthy SNV may continue to issue his urine, feces, and saliva and contaminating everything it contacts. Inspiration from fomites aerosols, contact with contaminated objects, or consumption of contaminated food can lead to transmission of hantavirus to humans. Humans are at particular risk of infection when opening or cleaning cabins and outbuildings that had been closed for the winter, especially if the mice have set up housekeeping.

HPS begins with nonspecific prodrome lasts three to five days with fever, headache, malaise, and diarrhea. There are no pathognomonic signs of the disease at this time. After about a week of illness, the patient suddenly experienced a large increase in pulmonary vascular permeability, resulting pulmonary edema and shock. Patients present with dyspnea, cough, tachypnea, and hypotension. mechanical ventilation is usually required. Chest x-ray showed interstitial infiltrates forward to bilateral alveolar infiltrates and pleural effusion.

HPS can be difficult to diagnose. Hint hint that unexplained pulmonary edema in a previously healthy individual with no obvious cause of adult respiratory distress syndrome. The presence of thrombocytopenia raises further suspicion of HPS. Other infections with the same presentation in normal individuals including leptospirosis, Legionnaire’s disease, Mycoplasma, Q fever, and Chlamydia pneumonia, despite the sudden cardiovascular collapse is much more sudden, severe, and fireproof with HPS.

A definitive diagnosis is not possible in the ER, and require special testing by the Centers for Disease Control and Prevention. South American hantavirus infection has been shown to be transmitted to health workers, and respiratory and contact isolation is indicated for all suspected cases. There is no specific treatment or cure for HPS, and the only treatment is supportive. Antivirals and antibiotics are not effective.

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