From the Guidelines
Hantavirus is a rare but potentially deadly virus that requires immediate medical attention if symptoms develop after suspected exposure, with a mortality rate of approximately 37% as of 2002 1. To prevent hantavirus infection, it is crucial to avoid contact with rodents, seal entry points in homes, and clean rodent-infested areas using wet methods with disinfectant while wearing gloves and masks. The primary strategy in preventing hantavirus infection is rodent control in and around the home, which can be achieved by inspecting the interior and exterior of the home at least twice per year for any openings where rodents could enter and for conditions that could support rodent activity 1. Some key measures to prevent infection include:
- Sealing all openings to the home and outbuildings, including holes or gaps around pipes, vents, and doors
- Cleaning up rodent-infested areas using wet methods with disinfectant
- Eliminating standing water and food sources that may attract rodents
- Maintaining cleanliness to discourage rodent presence
- Avoiding contact with rodents, their urine, droppings, or saliva If exposure is suspected and symptoms develop, seeking immediate medical attention is essential, as early supportive care in an intensive care setting significantly improves survival chances 1. It is also important to note that the virus cannot spread from person to person in North American strains, though some South American variants can. Given the high mortality rate associated with hantavirus, prevention is particularly important for those living or working in rodent-infested environments, and following the updated recommendations for risk reduction from the Centers for Disease Control and Prevention is crucial 1.
From the Research
Hantavirus Overview
- Hantaviruses are rodent-borne and transmitted to humans by direct contact with infected rodents or their secretions (urine, feces, and saliva) 2.
- The main clinical syndromes associated with hantaviruses are Hemorrhagic Fever with Renal Syndrome (HFRS) and Hantavirus Pulmonary Syndrome (HPS) 3, 4.
Clinical Aspects of Hantavirus Infection
- HFRS and HPS share some clinical aspects, but hemorrhage and renal failure are the hallmark of HFRS, while respiratory problems are distinctive signs and symptoms of patients with HPS 2.
- Both syndromes are accompanied by myocardial depression and hypotension or shock 3.
- HPS is characterized by a reversible increase in vascular permeability, leading to severe, noncardiogenic pulmonary edema 3.
Geographic Distribution and Transmission
- HFRS is primarily a Eurasian disease, whereas HPS appears to be confined to the Americas 3.
- Transmission to humans occurs by exposure to infected rodents in endemic areas, although Andes hantavirus can be transmitted from person to person 4.
Diagnosis and Management
- Diagnosis of Hantavirus infection can be confirmed by RT-PCR 5.
- No specific effective antiviral treatment is available, and clinical outcomes are highly associated with early clinical suspicion, access to rapid diagnostic testing, and prompt transfer to a facility with critical care units 4.
- Co-existence of HFRS and HPS has been reported in rare cases, highlighting the importance of considering Hantavirus in the differential diagnosis of patients presenting with both pulmonary and renal manifestations 5, 6.