What do we want
know about
Hantavirus
Pulmonary
Syndrome (HPS)?
Susan Redwood
PUBH 6165
Walden University
A global public health problem
Stakeholders
 Community members
 Immunocompromised patients including those with HIV/AIDS,
cancers and other blood borne diseases
 Government at all levels (local, state, national)
 Healthcare facilities (Clinics, hospitals, nursing home, group home etc)
 Education institutions (primary schools, colleges, universities,
libraries)
 Community centers
 CDC, EPA, FDA, WHO
Stakeholders contd.
 Landlords and people who live in poor and overcrowded
environment
 Local businesses (restaurants, shopping malls, place of
employment)
 Homeless shelters
 Mass media (Internet, TV, Radio, Twitter, Face book, Cell
phones)
 Doctors office
 Churches
Should you be afraid of a mouse in your
house?
What is Hantavirus Pulmonary
Syndrome?
 A severe and sometimes fatal respiratory disease in humans caused by
infection with a hantavirus.
 Lipid-enveloped, spherical viruses approximately 80-110 in diameter
 From Bunyaviridae family with 3 RNA segment (small, medium, large
which encode
 Viral nucleocapsid (N)
 Glycoproteins (G1and G2)
 RNA polymerase (Pol)
(Skehan,n.d.)
Molecular Structure
(Infection landscape, 2012)
History
 First discovered in Asia during the Korean War

Virus was not isolated until 1976
 Classified under its own genus "hantavirus”
 First American outbreak occurred in May of 1993 among healthy
members of the Navajo Nation in New Mexico who died within a short
period of time
(Hantavirus info, 1998)
Etiology
 Deer mouse
 White-tailed mouse
 Cotton rat
 Rice rat
How is the virus transmitted
Cases reported by race
 Caucasians 78%
 American Indians 18%
 African Americans 2%
 Asian 1%
(CDC, 2014)
Diagnosis
 Physical examination difficult to diagnose in early stage because
symptoms mimic influenza
 Serological testing immunofluorescent antibody test (IFA),
enzyme-linked immunosorbent assays (ELISA), immunoblotting
and virus neutralization
 Obtain tissue samples for antigens with immunohistochemistry
 Chest X-Ray
 Pulse oximetry to measure oxygen saturation
(Cfsph, 2009)
Early Signs and Symptoms

Fatigue

Fever

Muscle aches

Headache

Dizziness

Chills

Nausea

Vomiting

Diarrhea

Abdominal pain
(Health crafter, 2013)
Late Signs and Symptoms
 Cough
 Shortness of breath with or without chest tightness
 Fluid filled lungs
http://www.cdc.gov/hantavirus/technical/hps/clinical-manifestation.html
Complications
 Acute Respiratory Distress Syndrome (ARDS)
 Kidney failure
 Hypoxia
 Hypotension
 Death
http://media.victoriaadvocate.com/img/photos/2013/09/28/hanta_virus_ew_092913_04_221015.jpg
Treatment
 Confirmed diagnoses admission to hospital
 Intravenous fluids
 Medication administration
 Oxygen
 Ventilator support for respiratory complication
Prevention
 No vaccine available at present
 Avoid contact with rodents in home, worksite, camp, barn, shed
 Seal gaps and holes
 Set up rodent traps
 Keep all area clean and free of food
 Use gloves and mask for contact with rodents
 Avoid the use of vacuum for rodent debris
 Decontaminate surface areas with detergent and bleach solution
Challenges
 Prognosis is fair to poor:
 Misdiagnosis
 Recovery rate 62%
 Mortality rate 38%
 Prolonged hospitalization
 Poverty
 Lack of or inadequate access to medical care
http://www.cdc.gov/hantavirus/surveillance/annual-cases.html
Future Research
 Combine ecology and change in other host-virus ecosystems via
modeling and hypothesis-driven research

Concentrate on risk of exposure, multidirectional transmission, and
human disease (Johnson, Figueiredo, &Vapalahti, 2010)
(CDC, 2012)
The future of vaccination
(Medcity News, 2012)
References

Centers for Disease Control and Prevention. (2012). Hantavirus. Retrieved from
http://www.cdc.gov/hantavirus/technical/hanta/ecology.html

Centers for Disease Control and Prevention. (2013). CDC, Hantavirus Pulmonary Syndrome.
Retrieved from http://www.cdc.gov/hantavirus/hps/index.html

Centers for Disease Control and Prevention. (2014). Reported cases of HPS. Retrieved from
http://www.cdc.gov/hantavirus/surveillance/index.html

Center for Food Security and Public Health. (2009). Hantavirus. Retrieved from
http://www.cfsph.iastate.edu/Factsheets/pdfs/hantavirus.pdf

Hantavirusinfo. (1998). Basic facts about HPS and the hantivirus. Retrieved from
http://www.hantavirus.net/info1.html

Healthcrafter. (2013). Step to avoid hantivirus outbreak. Retrieved from
http://healthcrafter.net/steps-to-avoid-hantavirus-outbreak/3069

Hepojoki,J., Strandin,T., Lankinen,H., & Vaheri,A. (2012). Hantavirus structure—molecular
interactions behind the scene. Journal of General Virology, 93(8), 1631-44.

Infection Landscape. (2012). Hantaviruses. Retrieved from
http://www.infectionlandscapes.org/2012/09/hantaviruses.html
References

Johnson,C., Figueiredo, L., & Vapalahti, A. (2010). A global perspective on hantavirus ecology,
epidemiology and disease. Clinical Microbiology Reviews, 23(2), 412-441.

Mayo Clinic. (2014). Hantavirus pulmonary syndrome cause- disease and conditions. Retrieved
from http://www.mayoclinic.org/diseases-conditions/hantavirus-pulmonarysyndrome/basics/causes/con-20030129

Medcity News. (2012). Cross-kingdom vaccine may protect against fungal and bacterial infection.
Retrieved from http://medcitynews.com/2012/05/cross-kingdom-vaccine-may-protect-against-fungaland-bacterial-infections/

Skehan, E. (n.d). Hantavirus Pulmonary Syndrome (HPS). Retrieved from
http://www.austincc.edu/microbio/2421c/hps.htm

Worthy, S. (2009). Earth end: New beginning. Retrieved from http://www.earthendnewbeginning.com/page/32/