1997 - Hantavirus Pulmonary Syndrome in the Americas
02 October 1997 Disease Outbreak Reported The number of cases and the geographical spread of hantavirus pulmonary syndrome (HPS)
has increased in the Americas since the syndrome was first identified in 1993 in the USA and
has now been reported in Argentina, Bolivia, Brazil, Canada, Chile, Paraguay, Peru and
Uruguay in addition to the USA. Facing the possibility of further spread of HPS, the
ministers of health of all countries in the Americas joined in a resolution to intensify the
surveillance of, and fight against, hantavirus infection during the Directing Council of the Pan
American Health Organization (PAHO) in September 1997. A total of 350-400 HPS cases have been confirmed in the Americas, most of them in
Argentina and the USA. About 45% of the reported cases were fatal. The high fatality rate is
associated with the sudden onset of pulmonary oedema and respiratory distress. There is no
specific treatment for HPS, although prompt diagnosis is important for appropriate
management of respiratory distress. HPS is caused by several distinct hantaviruses which are each associated with a specific
rodent host. Once infected, rodents shed the virus throughout their lifetime. Humans are
infected by inhaling aerosols of fresh or dried rodent excreta (faeces, urine and saliva).
Investigation of an epidemic in Argentina in 1995 provided strong evidence for
person-to-person transmission, not observed in studies in the USA. In any event, strict barrier
nursing techniques are now recommended for management of suspected or confirmed cases. Control measures in endemic areas focus on rodent control with particular emphasis on
excluding rodents from buildings and reducing suitable habitats around inhabited dwellings. Many infections have resulted from cleaning rodent-infested areas. The use of readily
available disinfectants such as chlorine bleach is recommended to decontaminate potentially
infectious droppings and debris prior to cleaning. If available, respiratory protection should
be used during this high risk activity. Improved laboratory diagnostic capacity in endemic areas is important for prompt recognition
of HPS cases. Furthermore, identification of the rodent reservoir of each hantavirus is
important to detect potential HPS endemic regions and to understand the risk of
rodent-human interaction. (For further information on HPS see web pages at PAHO - http://www.paho.org/english/DPI/rl970925.htm and the US Center for Disease Control and
Prevention at http://www.cdc.gov/ncidod/diseases/hanta/hantvrus.htm )
02 October 1997 Disease Outbreak Reported The number of cases and the geographical spread of hantavirus pulmonary syndrome (HPS)
has increased in the Americas since the syndrome was first identified in 1993 in the USA and
has now been reported in Argentina, Bolivia, Brazil, Canada, Chile, Paraguay, Peru and
Uruguay in addition to the USA. Facing the possibility of further spread of HPS, the
ministers of health of all countries in the Americas joined in a resolution to intensify the
surveillance of, and fight against, hantavirus infection during the Directing Council of the Pan
American Health Organization (PAHO) in September 1997. A total of 350-400 HPS cases have been confirmed in the Americas, most of them in
Argentina and the USA. About 45% of the reported cases were fatal. The high fatality rate is
associated with the sudden onset of pulmonary oedema and respiratory distress. There is no
specific treatment for HPS, although prompt diagnosis is important for appropriate
management of respiratory distress. HPS is caused by several distinct hantaviruses which are each associated with a specific
rodent host. Once infected, rodents shed the virus throughout their lifetime. Humans are
infected by inhaling aerosols of fresh or dried rodent excreta (faeces, urine and saliva).
Investigation of an epidemic in Argentina in 1995 provided strong evidence for
person-to-person transmission, not observed in studies in the USA. In any event, strict barrier
nursing techniques are now recommended for management of suspected or confirmed cases. Control measures in endemic areas focus on rodent control with particular emphasis on
excluding rodents from buildings and reducing suitable habitats around inhabited dwellings. Many infections have resulted from cleaning rodent-infested areas. The use of readily
available disinfectants such as chlorine bleach is recommended to decontaminate potentially
infectious droppings and debris prior to cleaning. If available, respiratory protection should
be used during this high risk activity. Improved laboratory diagnostic capacity in endemic areas is important for prompt recognition
of HPS cases. Furthermore, identification of the rodent reservoir of each hantavirus is
important to detect potential HPS endemic regions and to understand the risk of
rodent-human interaction. (For further information on HPS see web pages at PAHO - http://www.paho.org/english/DPI/rl970925.htm and the US Center for Disease Control and
Prevention at http://www.cdc.gov/ncidod/diseases/hanta/hantvrus.htm )