Hantavirus causes the hantavirus cardiopulmonary syndrome which was first reported in the U.S. in 1993.
Epidemiology
Incidence – <50 cases/year in U.S.
Gender – M>F
Transmission – infected aerosols from rodents
Organism
Hantavirus is the only member of the Bunyaviridae family that is not arthropod-transmitted.
Identified as the causative agent in hemorrhagic fever with renal syndrome (HFRS) in the 1930s
Sin Nombre, Bayou, Black Creek Canal and New York strains of Hantavirus, as well as their Sigmodontine rodent reservoirs, have been identified as definitive causes of hantavirus pulmonary syndrome (HPS) in the U.S. and Central and South America
Clinical Presentation
Infection begins with the inhalation of excreta from rodents harboring the virus
After incubation of 1-2 weeks the patient develops fever, myalgia, headache, chills, abdominal pain and a nonproductive cough
Rapid development of dyspnea and pulmonary edema; diffuse infiltrates on chest X-ray
Thrombocytopenia is common
If hospitalization does not occur, hypotension and shock may follow, resulting in death within 3-6 days
Diagnosis
Indications for testing
Consider diagnosis in thrombocytopenic patients with febrile illness
Detect Hantavirus-specific IgG and IgM in serum samples in which there is a clinical suspicion of hantavirus pulmonary syndrome (HPS) or hemorrhagic fever with renal syndrome (HFRS)
False-positives occur in cytomegalovirus (CMV), influenza and Mycoplasma pneumoniae infection
If test results are equivocal, repeat testing in 10-14 days
Additional Tests Available
Click on number for test-specific information in the ARUP Laboratory Test Directory
Mills JN, Corneli A, Young JC, Garrison LE, Khan AS, Ksiazek TG.Hantavirus pulmonary syndrome--United States: updated recommendations for risk reduction. Centers for Disease Control and Prevention.MMWR Recomm Rep. 2002;51(RR-9):1-12. (Link to PubMed)
General References
Bartholomew DM, Hansen LA, Frank JJ, Farver DK.Case report of hantavirus pulmonary syndrome and review.S D Med. 2007;60(5):189-5. (Link to PubMed)
Clement JP.Hantavirus.Antiviral Res. 2003;57(1-2):121-127. (Link to PubMed)
Ferres M, Vial P.Hantavirus infection in children.Curr Opin Pediatr. 2004;16(1):70-75. (Link to PubMed)
Klein SL, Calisher CH.Emergence and persistence of hantaviruses.Curr Top Microbiol Immunol. 2007;315:217-252. (Link to PubMed)
Maes P, Clement J, Gavrilovskaya I, Van Ranst M.Hantaviruses: immunology, treatment, and prevention.Viral Immunol. 2004;17(4):481-497. (Link to PubMed)
Mertz GJ, Hjelle B, Crowley M, Iwamoto G, Tomicic V, Vial PA.Diagnosis and treatment of new world hantavirus infections.Curr Opin Infect Dis. 2006;19(5):437-442. (Link to PubMed)
Miedzinski L.Community-acquired pneumonia: new facets of an old disease--Hantavirus pulmonary syndrome.Respir Care Clin N Am. 2005;11(1):45-58. (Link to PubMed)
Ulrich R, Hjelle B, Pitra C, Kruger DH.Emerging viruses: the case 'hantavirus'.Intervirology. 2002;45(4-6):318-327. (Link to PubMed)
Reviewed by
Litwin, Christine, M.D. Medical Director, Immunology at ARUP Laboratories; Professor, Clinical Pathology, University of Utah
Comprehensive Review: March 2008
Last Update: March 2008