HANTAVIRUS PULMONARY SYNDROME
Hantavirus pulmonary syndrome (HPS) is caused by a member of the Hantavirus family of viruses. In the United States, the Sin Nombre hantavirus causes severe cardiopulmonary illness with a case mortality rate of approximately 50%. Cases occur most fre-quently in the western U.S. states, but the rodents known to carry the virus are found throughout the country (Vaheri & Calisher, 2002).
The diagnosis of HPS should be suspected in patients who live in rural areas, who may have had exposure to rodents, and who report fever, aching muscles, and nausea. Thrombocytopenia and hemoconcentration are also common.
Although no specific treatment for HPS has been approved, early treatment with ribavirin (Virazole) may reduce mortality. Early identification, assessment, and maintenance of respiratory status are the most important aspects of care for these patients. Intake and output should be monitored closely, because overhy-dration is possible with resultant cardiopulmonary compromise.
Reduction of risk requires strategies to reduce human contact with rodents and their droppings. Public health programs and clinics in rural areas should regularly teach people to eliminate food sources of rodents in areas close to humans. Openings in walls or cabinets should be sealed. Traps should be used in areas such as sheds and barns in which rodents may enter and in which humans work. Gloves should be worn when removing the animal from the trap. The trap should be disinfected with a 1:10 bleach solution. People entering such areas should be taught to avoid stirring up dust or breathing potentially contaminated dust. Brooms and vacuum cleaners should be used with caution; areas that may emit dust while being cleaned should be first dampened with a bleach solution to reduce viral contaminants and the po-tential for dust dispersion.
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