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Public Health Solutions
District Health Department
995 East Hwy 33, Ste 1
Crete, NE 68333-2562
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Hantavirus Pulmonary Syndrome
What is Hantavirus Pulmonary Syndrome?
It is a severe life-threatening illness cause by a hantavirus now named Sin Nombre virus. It causes acute respiratory disease, and is carried in wild rodents such as deer mice.
Is this a new disease?
This virus was first recognized and identified in 1993 when a cluster of cases was reported in the four corners area of the southwestern U.S. Investigations completed since the virus was first identified in 1993 indicate the presence of Sin Nombre virus throughout most of the continental U.S. and the presence of the virus has now been documented as far back as 1959.
How does a person get a hantavirus infection?
Rodents are the natural hosts for all hantaviruses. Humans are thought to be infected from exposure to rodent droppings, urine, saliva, either through aerosols or direct inoculation. Rodents may be chronically infected with hantavirus and shed the virus for months.
Can this disease be spread from person to person?
No, there is no evidence of person-to-person transmission for any of the known hantaviruses. There are no documented cases of hantavirus being transmitted from infected patients to health care workers.
What are the symptoms of a hantavirus infection?
The first symptoms of HPS associated with Sin Nombre virus in the U.S. usually occur 2-3 weeks after exposure and are flulike in nature. Most cases experience fever, myalgias, and chills; other common initial symptoms include cough, headaches, nausea or vomiting, diarrhea and malaise. Within 3-4 days, rapid onset of severe respiratory failure may follow. This is characterized by high mortality despite mechanical ventilation and intense care. The fatality rate for the first 227 cases of HPS was 42%.
Who can be affected by HPS?
The first 227 cases reported in the U.S. affected individuals of white, Hispanic, and Native American racial/ethnic groups, ranging in age from 10 to 71 years of age.
How does the virus exist in nature?
Rodents are the primary reservoir hosts of all recognized hantaviruses. Each hantavirus appears to have a preferential rodent host, but other small mammals can be infected as well, The primary reservoir for Sin Nombre virus appears to be the deer mouse, Peromyscuc maniculatus. The deer mouse is highly adaptable and is found in different habitats throughout the U.S. including human residences in rural and semirural areas, but generally not in urban centers. Hantaviruses do not cause apparent illness in their reservoir hosts.
What appear to be identified risk factors?
Known infections are associated with domestic, occupational, or leisure activities that bring humans into contact with infected rodents, usually in a rural setting. To date, cases have been epidemiologically associated with the following situations:
- planting or harvesting field crops
- occupying previously vacant cabins or other dwellings
- cleaning barns or other outbuildings
- disturbing rodent-infested areas while outdoors
- inhabiting dwellings with indoor rodent populations
How should a suspected case of hantavirus be handled?
Any individual with a suspected case should see their physician. If the physician suspects a patient may have Hantavirus Pulmonary Syndrome, he or she should call their local health department or Tom Safranek, M.D., State Epidemiologist, at the Nebraska Department of Health and Human Services Regulation and Licensure (402-471-0550) for further assistance on testing or treatment. Blood samples (red top tube) should be drawn immediately from suspected cases and any biopsy or autopsy specimens saved. Other laboratory test for potential cases should include a chemistry panel, urinalysis, CBC, coagulation studies, pulse oximetry, chest X-ray and possibly arterial blood gas.
Can animals transfer HPS?
Cat and dogs are not known to have spread hantaviruses from rodents to people but they may bring rodents into contact with humans. Predators such as snakes, hawks, owls, and coyotes help control rodents and are not thought to spread the disease.
How should I get rid of dead rodents, droppings, or nests?
Removing rodents from your home will decrease your risk for HPS. Follow these standard rodent removal and cleanup guidelines:
- Set spring traps that will kill mice
- Use rubber gloves and spray the nest or dead rodent until soaked with a household disinfectant solution or 3 tablespoons of bleach in 1 gallon of water. Other disinfectants can also be used as directed. Let the area soak thoroughly for 10-15 minutes.
- Remove the nest or rodent using a long-handled shovel or rubber gloves.
- Double-bag the rodent or nest securely with plastic bags and dispose of them in the trash. Persons in rural areas may bury the waste 2-3 feet deep.
- Clean up the rodent area and traps by spraying with disinfectant solution. Let the area soak for 10-15minutes. While still wearing gloves, wipe up the area with paper towels or rags. Double-bag all paper towels, rags, and gloves used in the cleanup. Dispose of them in a tightly covered trash container.
- Wash your hands with soap and water after completing the cleanup.
How should I clean my home after rodents are removed?
Floors, countertops, cabinets and other surfaces should be cleaned with a solution of 3 tablespoons of household bleach in 1 gallon of water, or by a commercial disinfectant. Do not sweep floors with a broom, or vacuum, until area has been disinfected. Rugs can be steam cleaned, dirt floors should be sprayed with a disinfectant solution.
How can I prevent rodents from entering my home?
- Seal, cover or screen all holes in walls or floors larger than one-quarter inch.
- Keep food (including pet food) and water covered and stored in rodent-proof metal or thick plastic containers with tight-fitting lids.
- Clean up spilled food.
- Keep dishes clean.
- Store garbage in rodent-proof metal or thick plastic containers with tightfitting lids. Keep containers at least 12 inches off the ground.
- Place three inches of gravel under the base of mobile homes to discourage rodent burrowing.
- Place woodpiles 100 feet or more away from the house and elevate wood at least one foot.
- Remove any food sources near buildings that might attract rodents.
What do we know about the occurrence of hantaviruses in Nebraska?
At the time of this publication there has been one confirmed case of HPS in Nebraska. This case occurred in a rural Dundy county resident in 1998. Human cases have been recorded in most of the surrounding state (Colorado, Wyoming, South Dakota, Minnesota, Iowa and Kansas).
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