Hantavirus pulmonary syndrome (HPS) is an acute infectious disease caused by hantavir that can cause severe respiratory symptoms and high mortality. It enters the human body through contact with excreta of infected rodents, most commonly their feces, urine, or saliva. The incubation period ranges from one to six weeks, after which the patient develops initial symptoms, including fever, myalgia, headache, and dyspnea. As respiratory distress increases, further complications associated with the development of pulmonary edema and shock are possible. HPS is predominantly found in North America, but cases have also been reported in other regions of the world.
History of the disease and interesting historical facts
Hantavirus was first isolated in the 1950s in Korea, when the war began, leading to an increase in cases of hemorrhagic fever associated with these viruses. However, it was not until 1993 that the first cases of HFS were reported in the United States, when two deaths from an unknown cause were reported in Finlab County, later identified as hantavirus. In the following years, different strains of the virus began to emerge, and researchers realized that the disease could have serious consequences, including death, especially in people predisposed to severe infections.
Epidemiology
According to the Centers for Disease Control and Prevention (CDC), over the past two decades, HSV has been found as an endemic and sporadic infection in the United States. The average number of reported cases ranges from 20 to 60 per year, but sudden outbreaks are possible due to climate change and increased rodent populations. In 2017, a record high was recorded, with 73 cases reported in different states. Epidemiological analysis shows that the risk of the disease increases in rural and forested areas where rural infrastructure is located, with insufficient sanitation.
Genetic predisposition to this disease
Research suggests that certain genetic markers may increase the risk of severe hantavirus pulmonary syndrome. In particular, associations have been found with polymorphisms of genes responsible for the immune response, including genes of the HLA system. People with certain alleles associated with the immune response have more pronounced and severe forms of the disease. However, genetic predisposition is still a subject of active research and requires further study.
Risk factors for the development of this disease
Risk factors associated with hantavirus pulmonary syndrome can be divided into several categories:
- Environmental: presence of wild rodents (especially mice, which can carry the virus).
- Professional: work in agriculture, logging or construction, where there is the possibility of contact with similar ecosystems.
- Permanent living conditions: evaporation of rodent excrement in closed spaces or insufficient ventilation.
Diagnosis of this disease
The main symptoms of CHS include:
- Fever, often accompanied by chills.
- Myalgia, especially in the back and pelvis.
- Moderate to severe headache.
- Cough and shortness of breath, which indicates the development of pulmonary syndrome.
Laboratory tests include serologic tests to detect antibodies to the virus, PCR to detect viral RNA, and a complete blood count that may show leukopenia and thrombocytopenia. Radiologic examinations usually show interstitial changes in the lungs. It is important to differentiate the disease from diseases such as pneumonia, viral influenza, and other viral infections.
Treatment
General treatment of hantavirus pulmonary syndrome is symptomatic and supportive care. This ranges from intravenous fluids to correct hypovolemia to oxygen therapy. Pharmacological treatment includes the use of drugs such as ribavirin, although its effectiveness in treating hantavirus pulmonary syndrome has not yet been fully established. Surgical treatment may be required if secondary problems such as pulmonary edema develop, which may require mechanical ventilation. Additional treatments include the use of antihistamines and corticosteroids to reduce the inflammatory response.
List of medications used to treat this disease
- Ribavirin;
- Corticosteroids;
- Antihistamines;
- Infusion solutions.
Disease monitoring
Monitoring of the patient with CPS includes regular in-hospital follow-up visits to assess respiratory function, hemodynamic status, and overall clinical progress. Prognosis may vary depending on the severity of the disease: mild cases may lead to complete recovery, while severe forms may lead to serious complications and high mortality (up to 40%). Common complications include pulmonary insufficiency and shock requiring intensive care.
Age-related features of the disease
The presentation of CLS varies depending on age group. Children tend to have a milder course of the disease, although severe cases can occur. Older people and those with pre-existing conditions such as diabetes and cardiovascular disease are more likely to have a severe course of the disease with a poor prognosis.
Questions and Answers
- What causes hantavirus pulmonary syndrome? HLS is caused by infection with hantavirus, which is transmitted through contact with excreta from infected rodents.
- What is the mortality rate for hantavirus pulmonary syndrome? The mortality rate of the disease reaches 40% in the absence of timely treatment.
- How does the disease progress? The initial stage is characterized by flu-like symptoms, a pronounced inquisitive cough and shortness of breath are possible.
- What is the prevention of the disease? Prevention includes control of the rodent population and maintaining sanitary standards in the home.
- Can CHL be cured? Treatment is mainly symptomatic, and patients with mild forms can make a full recovery with adequate support.
Advice from Dr. Oleg Korzhikov
Dr. Oleg Korzhikov notes that prevention of hantavirus pulmonary syndrome should begin with awareness of the possibility of contact with rodents: "If you work or live in areas where they are common, be careful. Most cases of exacerbation are observed during the rainy season, when rodents become active and can enter human dwellings. You should avoid contact with places where their nests are known, and always follow safety rules when cleaning premises." In addition, to prevent infection, it is important to carry out regular disinfection and monitor sanitary cleanliness.
