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Published Date: 2012-01-10 11:33:12
Subject: PRO/AH/EDR> Hantavirus update 2012 - Americas (02): Panama, Argentina
Archive Number: 20120110.1005115

HANTAVIRUS UPDATE 2012 - AMERICAS (02): PANAMA, ARGENTINA
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In this update:
[1] Panama (Veraguas province)
[2] Argentina (Buenos Aires and Santa Fe provinces)

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[1] Panama (Veraguas province)
Date: Wed 4 Jan 2012
Source: Prensa Latina [in Spanish, trans. Mod.TY, edited]
http://www.prensa-latina.cu/index.php?option=com_content&task=view&id=465038&Itemid=1

A possible case of [a] hantavirus [infection] was detected in Chitre, Panama in a 48-year-old patient in the intensive care unit [ICU] of the Gustavo Nelson Collado Hospital in that locality.

This information was provided by the Regional Health Director of Herrera province, Tomas Higuera, who stated that the patient is from Montijo, Veraguas province, and was 1st attended to in the Luis Fabrega Hospital, where he was treated as with an influenza clinical picture. Since he continued to feel ill, Higuera added, this ill person went to a private clinic in Chitre and from there was referred to the Cecilio Castillero Hospital. But the patient continued to grow worse and was moved to the ICU of the Gustavo Nelson Collado Hospital, where he remains in critical condition.

The Regional Health Director of Herrera province stated that the problem with these clinical pictures is that they [hantavirus infections] are very similar to colds, influenza, dengue [?] and A H1N1 [influenza infections]. For this reason, the physician must apply all his or her experience in the [clinical] evaluation, and those patients who do not improve in 3 days, with associated respiratory difficulty, must seek immediate medical attention.

Higuera indicated that they await confirmation [of the etiologic agent] by the Gorgas Commemorative Institute but stated that clinically, all indications are that they have a case of [a] hantavirus [infection].

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[The hantavirus most likely responsible for this case of hantavirus pulmonary syndrome is Choclo virus. As mentioned in ProMED-mail archive number 20081027.3389, hantaviruses (and their rodent hosts) recognized in Panama include Rio Segundo (_Reithrodontomys mexicanus_), Choclo (_Oligoryzomys fulvescens (costaricensis)_), and Calabazo (_Zygodontomys brevicauda (cherriei)_). Of these 3 viruses, only Choclo is a known human pathogen, causing HPS, which can have a high case fatality rate, especially when victims come to hospital late in the course of their disease.

A photograph of the pygmy rice rat (_Oligoryzomys fulvescens_) can be accessed at http://www.medwave.cl/medios/perspectivas/Hantavirus/Actualiz/Fig2.jpg.

A HealthMap/ProMED-mail interactive map showing the location of Montijo, Veraguas province, where the patient was from, can be accessed at http://healthmap.org/r/1COx. - Mod.TY]

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[2] Argentina (Buenos Aires and Santa Fe provinces)
Date: Sun 8 Jan 2012
Source: Diario Popular [in Spanish, trans. Mod.TY, edited]
http://www.diariopopular.com.ar/dp001.php?nId=64304&src=UM

A 33-year-old woman who died this past Tuesday [3 Jan 2012] in the Rossi Hospital in La Plata with symptoms similar to those of [a] hantavirus [infection] has been confirmed to have had this acute infectious disease, the Executive Director of the assistance center, Liliana Echazu confirmed today [8 Jan 2012].

This [health] professional told DyN that the results of the samples sent to the Instituto Malbran were positive [for a hantavirus infection], and at that time stated that the adult family members of the woman were given an appointment to carry out "serological studies" in order to "determine if they had come into contact with the virus," which is transmitted by rodents. Echazu added that the child relatives of the woman will be submitted to the same tests but in the Sor Maria Ludovica Pediatric Hospital, also located in La Plata.

The woman, a resident of the Ensenada area of Buenos Aires [province] and mother of 2 girls, aged 9 and 12, was admitted to the Rossi Hospital with a severe respiratory picture on the past Monday night [2 Jan 2012]; a few hours later, she suffered serious respiratory deficiency and finally died the following day, around 20:00 hours [8:00 PM].

The woman and her family had been celebrating Christmas in a house in Punta Indio, Buenos Aires [province], located 86 km [53 mi] from La Plata and 150 km [93 mi] from the federal capital. On the night of 25 Dec [2011], these visitors saw rodents on the roof and, due to this, spent the night in the automobile in which they had come.

After the death of the woman, the Punta Indio municipality took measures to combat the rodents.

The hantavirus[es] are a disease [infection] transmitted by the long-tailed rat [yellow pygmy rice rat] _Oligoryzomys flavescens_. The virus, which does not affect the carrier animals, is present in urine and excrement of the rodents.

This past Monday [2 Jan 2011], the Office of the Director of the Santa Fe [province] Health Promotion and Prevention confirmed a hantavirus [infection] case in a young man from the Tortugas locality who died in Canada de Gomez [in Santa Fe province].

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Communicated by:
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[Cases of hantavirus infections were reported from various parts of Argentina last year (2011). The specific hantaviruses involved in these cases, including the current ones above, are not specified.

As noted in ProMED-mail archive number 20110430.1348, several hantaviruses have been associated with human infection in Argentina: Andes virus (western Argentina, in the long-tailed pygmy rice rat host, _Oligoryzomys longicaudatus_); related Andes-like viruses Hu39694 (in central Argentina; rodent host unknown); Lechiguana (in central Argentina in the yellow pygmy rice rat _O. flavescens_); Oran (in northwestern Argentina in _O. longicaudatus_); and Bermejo (western Argentina in _O. flavescens_) virus. Without laboratory confirmation, it is not possible to say with certainty which hantavirus was involved, although Andes virus seems unlikely. If indeed _O. flavescens_ is the rodent present in both cases and localities, Lechiguana virus is the possible hantavirus involved in these cases.

A HealthMap/ProMED interactive map showing the location of Punta Indio in Buenos Aires province can be accessed at http://healthmap.org/r/1COA, and one showing the location of Tortugas in Santa Fe province can be accessed at http://healthmap.org/r/1COy. - Mod.TY]

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