Hantavirus Infections Health Article

Diagnosis

The diagnosis of infection by a hantavirus uses serologic techniques. The patient's blood is drawn, and the ELISA (enzyme-linked immunosorbent assay) is done in a laboratory to identify the presence of specific immune substances (antibodies)—substances which an individual's body would only produce in response to the hantavirus.

It is very difficult to demonstrate the actual virus in human tissue, or to grow cultures of the virus within the laboratory, so the majority of diagnostic tests use indirect means to demonstrate the presence of the virus.

Treatment

Treatment of hantavirus infections is primarily supportive, because there are no agents available to kill the viruses and interrupt the infection. Broad-spectrum antibiotics are given until the diagnosis is confirmed. Supportive care consists of providing treatment in response to the patient's symptoms. Because both HFRS and HPS progress so rapidly, patients must be closely monitored, so that treatment may be started at the first sign of a particular problem. Low blood pressure is treated with medications. Blood transfusions are given for both hemorrhage and shock states. Hemodialysis is used in kidney failure. (Hemodialysis involves mechanically cleansing the blood outside of the body, to replace the kidney's normal function of removing various toxins form the blood.) Rapid respiratory assistance is critical, often requiring intubation.

The anti-viral agent ribavirin has been approved for use in early treatment of hantavirus infections.

Prognosis

The diseases caused by hantaviruses are extraordinarily lethal. About 6–15% of people who contract HFRS have died. Almost half of all people who contract HPS will die. It is essential that people living in areas where the hantaviruses exist seek quick medical treatment, should they begin to develop an illness that might be due to a hantavirus.

Prevention

There are no immunizations currently available against any of the hantaviruses. The only forms of prevention involve rodent control within the community and within individual households. The following is a list of preventative measures:

• Avoiding areas known to be infested by rodents is essential.
• Keep a clean home and keep food in rodent-proof containers.
• Dispose of garbage and empty pet food dishes at night.
• Set rodent traps around baseboards and in tight places. Dispose of dead animals with gloves and disinfect the area with bleach.
• Use rodenticide as necessary.
• Seal any entry holes 0.25 inch wide or wider around foundations with screen, cement, or metal flashing.
• Clear brush and junk from house foundations.
• Put metal flashing around house foundations.
• Elevate hay, woodpiles, and refuse containers.
• Air out all sealed outbuildings or cabins 30 minutes before cleaning for the season.
• When camping, do not sleep on the bare ground; sleep on a cot or in a tent with a floor.

BOOKS

Harper, David R. and Andrea S. Meyer. Of Mice, Men, and Microbes: Hantavirus. San Diego: Academic Press, 1999.

Stoffman, Phyllis. The Family Guide to Preventing and Treating 100 Infectious Diseases. New York: John Wiley and Sons, Inc., 1995.

PERIODICALS

Jones, Amy. "Setting a Trap for Hantavirus." Nursing (September 2000): 20.

Monroe, Martha C., Sergey P. Morzunov, Angela M. Johnson, Michael De. Bowen, et al. "Genetic Diversity and Distribution of Peromyscus-Borne Hantaviruses in North America." Nursing (January-February 1999): 75-86.

Naughton, Laurie. "Hantavirus Infection in the United States: Are We Prepared?." Physician Assistant (May 2000): 33.

Rhodes III, Luther V., Cinnia Huang, Angela J. Sanchez, Stuart T. Nichol, et al. "Hantavirus Pulmonary Syndrome Associated with Monongahela Virus, Pennsylvania." Emerging Infectious Diseases (November 2000): 616.

Van Bevern, Pamela A. "Hantavirus Pulmonary Syndrome." Clinician Reviews (July 2000): 108.

ORGANIZATION

Centers for Disease Control and Prevention. (404) 332-4559. <http://www.cdc.gov/travel/travel.html>.

Janie F. Franz

KEY TERMS

Hemodialysis—A method of mechanically cleansing the blood outside of the body, in order to remove various substances which would normally be cleared by the kidneys. Hemodialysis is used when an individual is in relative, or complete, kidney failure.

Hemorrhagic—A condition resulting in massive, difficult-to-control bleeding.

Petechiae—Pinpoint size red spots caused by hemorrhaging under the skin.

Platelets—Circulating blood cells which are crucial to the mechanism of clotting.

Prodrome—Early symptoms or warning signs

Pulmonary—Referring to the lungs.

Renal—Referring to the kidneys.

Shock—Shock is a state in which blood circulation is insufficient to deliver adequate oxygen to vital organs.