HPS; Hantavirus cardiopulmonary syndrome (HCPS); Hantavirus ARDS; Sin Nombre, Black Creek Canal, Bayou, Laguna Negra, New York, Monongahela, or Andes virus infection;
Flu-like syndrome (fever, myalgia, headache, nausea & vomiting, diarrhea & abdominal pain) followed by cough & dyspnea; [ID] 30% of patients have radiographic pulmonary edema at presentation & about 100% within 48 hours; [Cecil, p. 2152]
Hantavirus pulmonary syndrome (HPS) was first identified in 1993 in the Four Corners region of New Mexico as a flu-like illness followed by respiratory distress, shock, and a mortality rate as high as 50%. Workers are infected by inhaling aerosols of rodent excreta. The hantaviral diseases share the following: febrile prodrome, thrombocytopenia, leukocytosis, and capillary leakage. [CCDM, p. 245-9] Only the Andes virus is suspected of human-to-human transmission. [Harrison ID, p. 1048]
A flu-like illness (fever, myalgias and gastrointestinal symptoms) is followed by respiratory distress and hypotension rapidly progressing to pulmonary edema and shock. Renal disease and hemorrhagic manifestations are absent except in severe cases. [CCDM, p. 245-9] Renal failure may develop. Large amounts of pleural fluid are present in fatal cases of HPS. Delirium is a symptom of patients in shock. Bleeding diathesis occurs in a minority of patients infected with Sin Nombre virus. [Guerrant, p. 475-6]
For updated text and symptoms of infectious diseases, see iddx.com.
Almost all patients have IgM antibodies at the time of hospitalization, and most have IgG detectable; PCR preferred over culture; [CCDM] Serology; Hantavirus-specific RNA (PCR) or antigen; Viral culture: rarely isolated; [ABX Guide]