OF MICE AND MEN

BRUCE TEMPEST MD MACPUSPHS Indian Health ServiceGallup NM

Chronology Friday 5/14/93- 5 index cases May 17- cultures neg; pathology unclear May 23- brother-in-law admitted May 27- death in Zuni June 6- preliminary serology suggestive June 8- first positive patient PCR June 9-unique hantavirus; IHS,NM DOH,CDC, UNM meeting June 11- Karl Johnson

Hantaviruses

RNA virus, family Bunyaviridae Chronic, asymptomatic infection in rodents Horizontal transmission among rodents Excreted in rodent urine, feces, saliva No person to person transmission

Hantaviruses

RNA virus, family BunyaviridaeChronic, asymptomatic infection in rodentsHorizontal transmission among rodentsExcreted in rodent urine, feces, salivaNo person to person transmission

Ecologic Characteristics

• Specific rodent host • Susceptible to many disinfectants and UV • Transmission- aerosol, direct contact, bite • Infections in lab workers with 5 min. exposure

in room with infected rodents

Thursday Thursday

Hantaviruses

RNA virus, family BunyaviridaeChronic, asymptomatic infection in rodentsHorizontal transmission among rodentsExcreted in rodent urine, feces, salivaNo person to person transmission

Hantaviruses

RNA virus, family BunyaviridaeChronic, asymptomatic infection in rodentsHorizontal transmission among rodentsExcreted in rodent urine, feces, salivaNo person to person transmission

Case Fatality Ratio By Year

Cumulative cases by month of onset

MacNeil et al. HPS, United States, 1993–2009. Emerg Infect Dis 2011, 17:1195

0

5

10

15

20

25

Month of onset for Four Corners HCPS cases, 1993-Feb 2014