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HANTAVIRU S

BUNYAVIRUS
Genus Hantavirus (Hantaviruses) HFRS and HPS Transmissions: inhaling aerosols rodent excreta (urine,feces,saliva)

TRANSMISSION

TRANSMISSION

HEMORRHAGIC FEVER WITH RENAL SYNDROME (HFRS)

Hantaan Virus (Apodemus agrarius) and Dobrava virus Acute viral infection Interstitial nephritis, acute renal insufficiency and renal failure (severe form) Nephropathia epidemica (Puumala virus) Treatment: supportive therapy Prevention: rodent control

HANTAVIRUS PULMONARY SYNDROME (HPS)


Novel hantavirus (Sin Nombre virus) Severe (>30%) Reservoir: deer mouse (Peromyscus maniculatus) New York Virus, Black Creek Canal virus & Bayou virus(U.S.A) Andes virus (Argentina and Chile) Choclo virus (Panama)

HPS RADIOGRAPHIC FINDINGS

Bilateral interstitial infiltrates


Moderate

to rapid progression

Bilateral alveolar infiltrates Pleural effusion Normal heart size

CLINICAL MANIFESTATIONS:

Fever, headache, and myalgia Progressive pulmonary edema, severe respiratory compromise No hemorrhage Hantaviral Ag: endothelial cells and macrophages in heart, lung, spleen, and lymph nodes Pathogenesis: impairment of vascular endothelium

LABORATORY DIAGNOSIS:

Detection of viral nucleic acid (reverse transcriptase-PCR) Immunohistochemistry of viral Ag (fixed tissues) Detection of specific Ab (recombinant proteins) ELISA (IgM) Fourfold rise in titer (IgG) [diagnostic]

THERAPY
adequate oxygenation of hemodynamic functioning Ribavirin (HPS)

Prevention:

Rodent/Vector control Avoid inhalation of aerosolized dried excreta Hygiene

QUESTIONS

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