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Published Date: 2013-05-24 22:48:03
Subject: PRO/AH/EDR> Hantavirus update - Americas (28): Costa Rica, susp.
Archive Number: 20130524.1736275

HANTAVIRUS UPDATE - AMERICAS (28): COSTA RICA, SUSPECTED
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Date: Thu 23 May 2013
Source: La Nacion [in Spanish, trans. Mod.TY, edited]
http://www.nacion.com/2013-05-23/ElPais/Hospital-de-Heredia-confirma-caso-sospechoso-de-hantavirus.aspx


A 28-year-old man from Spain is isolated in the intensive care unit of the San Vicente Hospital in Heredia, Costa Rica, as a suspected [case of infection with a] hantavirus..

This disease [virus that causes hantavirus pulmonary syndrome, HPS] is usually transmitted from rodent feces [also urine and saliva] and is characterized by high fever, respiratory difficulty and lung problems. Although the disease is very rare, it is highly contagious and very aggressive. For this reason, the patient is isolated with all the biosafety measures for the case. Only personnel in charge of attending him are admitted, and they use special clothing to avoid becoming infected [Except for Andes hantavirus in the southern cone of Andean South America, the other hantaviruses have not been shown to be contagious person-to-person. - Mod.TY].

"We know that he [the patient] is a biologist and has been in Africa, arriving in the country [Costa Rica] 20 days ago, and was admitted to hospital on Mon 20 May 2013 with dengue fever symptoms, and by the following Wednesday was supposed to improve, but that did not happen, and other diseases began to be suspected. Samples were taken and sent to Inciensa laboratories; that is the only one in the country that can carry out these studies [tests]. We hope to have the results in 6-10 days. The patient is in critical condition but has all the support measures necessary," explained Yamileth Obando, Director of the hospital.

Obando added that they have only seen 2 cases of this disease [HPS] in Costa Rica. The last case was 5 years ago involving a child, and the 1st case was 12 years ago involving an adult.

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[The USA CDC describes early symptoms of hantavirus infections as "...fatigue, fever and muscle aches, especially in the large muscle groups, thighs, hips, back, and sometimes shoulders. These symptoms are universal. There may also be headaches, dizziness, chills, and abdominal problems such as nausea, vomiting, diarrhea, and abdominal pain. About half of all HPS patients experience these symptoms. Late symptoms of HPS appear "4-10 days after the initial phase of illness. They include coughing and shortness of breath with the sensation of, as one survivor put it, "a tight band around my chest and a pillow over my face," as the lungs fill with fluid [see http://www.cdc.gov/hantavirus/hps/symptoms.html].

The above report only mentions a few of these symptoms, but it is possible that the newspaper account does not provide a complete description.

The incubation period is not well defined but probably ranges from 1-5 weeks. Thus, it is possible the patient acquired an infection of some other pathogen while in Africa. In situations such as this, it is prudent to send duplicate samples to WHO reference laboratories, where a wider range of etiological agents can be tested for. If a hantavirus is the etiological agent of this infection, it is most likely Choclo virus, which causes sporadic cases of HPS in neighboring Panama, including several this year (2013). The above report does not indicate where the patient had been in Costa Rica, a country with a wide variety of ecosystems with different rodent populations.

The rodent host of Choclo virus is the pygmy rice rat (_Oligoryzomys fulvescens_), a photograph of which can be accessed at http://www.medwave.cl/medios/perspectivas/Hantavirus/Actualiz/Fig2.jpg.

A HealthMap/ProMED-mail map showing the location of Costa Rica in Central America can be accessed at http://healthmap.org/r/1kdD. - Mod.TY]

See Also

Hantavirus update - Americas (27): USA (AZ) 20130523.1733548
Hantavirus update - Americas (26): Panama (VR) 20130521.1729225
Hantavirus update - Americas (25): Argentina (NE) USA (MT) 20130520.1724560
Hantavirus update - Americas (22): Bolivia (CB), USA (OK) 20130425.1672396
Hantavirus update - Americas (14): Uruguay (CO) 20130309.1579044
Hantavirus update - Americas (07): USA (CA) 20130202.1526708
Hantavirus update - Americas (06): Canada (BC) 20130131.1523793
Hantavirus update - Americas (01): Argentina (JU) 20130102.1478749
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