What do we want know about Hantavirus Pulmonary

Syndrome (HPS)?

Susan RedwoodPUBH 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-pulmonary-syndrome/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-fungal-and-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.earthend-newbeginning.com/page/32/