Infectious Disease Compendium

Hantavirus

Microbiology

A virus. They are world wide in distribution and include Andes virus, Amur virus, Asama virus, Azagny virus, Bayou virus, Black Creek Canal virus, Bloodland Lake virus, Blue River virus, Bruges virus, Cano Delgadito virus, Calabazo virus, Carrizal virus, Catacamas virus, Choclo virus, Dobrava-Belgrade virus, El Moro Canyon virus, Gou virus, Hantaan River virus, Huitzilac virus, Imjin virus, Isla Vista virus, Khabarovsk virus, Laguna Negra virus, Limestone Canyon virus, Magboi virus, Maripa virus, Monongahela virus, Montano virus, Mouyassue virus, Muleshoe virus, Muju virus, New York virus, Nova virus, Oran virus, Oxbow virus, Playa de Oro virus, Prospect Hill virus, Puumala virus, Rockport virus, Rio Mamore virus, Rio Segundo virus, Sangassou virus, Saaremaa virus, Seoul virus, Serang virus, Sin Nombre virus, Soochong virus, Tanganya virus, Thailand virus, Thottapalayam virus, Topografov virus, Tula virus, Xuan Son virus.

Epidemiologic Risks

Contact with rodent urine, saliva, or feces especially inhaling mouse urine. One presumes inadvertently. Often exposure occurs cleaning mice infected areas.

There was also an outbreak in a US rattery of pet Norwegian rats of Seoul virus (PubMed). Rattery: a place where they breed rats.

Rare human-to-human transmission.

Syndromes

Hemorrhagic fever with renal syndrome (Hantaan, Puumala and Seoul viruses) in  Europe, Asia, and Africa.

Hantavirus pulmonary syndrome (Sin Nombre virus, New York virus, Bayou virus, Black Creek Canal virus in in North, Central and South America.

Hantavirusest that can induce hemorrhagic fever with renal syndrome (HFRS) oinclude Hantaan virus, Dobrava-Belgrade virus, Seoul virus, Tula virus, and Puumala virus (PUUV). PUUV, transmitted by the bank vole is the most common hantavirus in central and north Europe and frequently causes a mild form of HFRS nephropathia epidemica (PubMed): high-grade fever, headache, visual probmens, gi irregularities, low back pain, and kidney dysfunction.

Fevers, severe myalgias followed by non-cardiac pulmonary edema, volume contraction with hemoconcentration, lactic acidosis, shock, and death.

A hint is immature myelocytes and immunoblasts on the differential and low platelets.

There are serologies and PCR through the CDC: call them for assistance (CDC).

Treatment

Supportive. Steroids do nothing (PubMed) so don't give them. I know you want to. Resist.

Notes

Besides the four corners of the US, there are strains of Hanta viruses in mice all over the world.

The big outbreak in the US SW years ago may have been due in part to El Nino. More rain lead to more grain lead to more mice lead to more Hanta (PubMed).

It has been suggested as a cause of the English Sweating Sickness and the Picardy Sweat of the 1400's (PubMed).

Last update: 05/05/18