Published Date: 2012-02-13 15:07:24
Subject: PRO/AH/EDR> Hantavirus update 2012 - Americas (05): Chile, Peru
Archive Number: 20120213.1039499
HANTAVIRUS UPDATE 2012 - AMERICAS (05): CHILE, PERU
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
In this update:
 Chile national
 Santiago Chile
 Iquitos Peru, suspected
 Chile national
Date: Wed 8 Feb 2012
Source: La Tercera [in Spanish, trans. & summ. Mod.TY, edited]
In the past 5 years, there have been 246 cases of hantavirus pulmonary syndrome [HPS] in the country. Of those infected, 58 have occurred in the Bio Bio region, followed by Los Lagos with 42, according to figures provided by the Ministry of Health.
So far in 2012, 8 cases have occurred, a figure similar to the previous year , and the fatality rate reached nationally is 37.5 per cent. That signifies that one in 3 infected people die of the virus [infection]. The cases in Bio Bio, which has been on health alert since Monday [6 Feb 2012], are in La Araucania and Maule.
"If one compares this period over the past 5 years with the current period, one sees that cases have increased by about 20 per cent. Historically, there have been 6, and we have [currently] 8; that is an excess of cases this year  that have accumulated during the same period," the subsecretary of public health, Jorge Diaz, explained. [With these small numbers of cases, the difference between years is not significant. - Mod.TY]
The infections of the contract workers of the Sodexo company, [who work in] the interior of the El Manzano II prison, are yet to be confirmed. These individuals are currently interned in the Clinico del Sur Hospital. The tests administered on them have yielded negative results for the virus. However, definitive confirmation is awaited from the Public Health Institute.
Also, tests have been done on 37 people who were exposed to the [prison] hantavirus outbreak in order to maintain medical surveillance [on them]. Of this total, 9 have given negative results, and in coming days, the results from the rest of the people tested are awaited.
Up to now, there are 3 fatal confirmed hantavirus [infection] cases. Of these, 2 are inmates of the El Manzano prison. The investigation of these deaths is under way. The 3rd [fatal case] is of an adult man who died in the Potrero Grande area in Curico while camping in the Las Buitreras sector, with activities in little visited places.
To these cases one can add a 4th, a man who died last Saturday [4 Feb 2012] in Los Angeles, which is being investigated. In this regard, the subsecretary indicated that he died of a rapidly progressing pulmonary disease that was suspicious clinically of [a] hanta [virus infection]. But the laboratory tests, up to the moment, have not confirmed that. We have requested that the Institute of Public Health study this cases, but it is complex. The results will probably be in tomorrow [today, 8 Feb 2012]."
He indicated that during 2011, 65 people were confirmed as infected with [a] hanta [virus infection] nationally, who were concentrated in Bio Bio, La Araucania, Los Lagos, and Aysen. This figure is above the mean of the last 5 years, which is 56 cases. Of the infected individuals, 74 per cent are male between the ages of 3-73 years, and the number of deaths has reached 21.
Among the causative factors is the phenomenon of the abundance of rodents. This is due to the flowering of quila [a flowering bamboo (_Chusquea culeou_)] , which generates an increase and overpopulation of wild rodents [due to the abundance of food]. Another of the factors is the change in habitat of the long-tailed rodents [long-tailed pygmy rice rats], due to numerous forest fires that occurred at the beginning of the year.
The La Araucania Health SEREMI, Gloria Rodriguez, yesterday [7 Feb 2012] confirmed a health alert for the northern part of the region, along the border with Bio Bio. The campaign for prevention will be intensified with flyers and personalized information. To date, 3 cases have been registered in this area.
The minister of justice, Patricia Perez, said that the weeds around the periphery of the prison had been eliminated, chlorine bleach used, and water drainage pipes sealed in the area. In Temuco, brochures were distributed of preventive measures to be adopted [by the populace].
[byline: P Cesped, A Hernandez]
[Over the past 2 weeks, the press in Chile and other South American countries has carried numerous reports on the hantavirus outbreak in the Concepcion prison that are essentially the same. The deaths have been confirmed due to a hantavirus infection, doubtless Andes virus. It is stated in this and the following report from Chile that there are rodent hosts -- the long-tailed pygmy rice rat, _Oligoryzomys longicaudatus_ -- involved in these cases, although there is no mention made of any rodents being captured and tested for Andes virus. Andes virus can be transmitted directly from person to person, but only among individuals in very close physical contact.
An image of the long-tailed pygmy rice rat (_Oligoryzomys longicaudatus_), the sigmodontine rodent host of Andes hantavirus, can be seen at http://www.bios.niu.edu/frayjorge/rod6.jpg.
A HealthMap/ProMED-mail interactive map showing the location of Concepcion in the Bio Bio region can be accessed at http://healthmap.org/r/006I. - Mod.TY]
 Santiago Chile
Date: Fri 10 Feb 2012
Source: Terra [in Spanish, trans. Mod.TY, edited]
The subsecretary of health, Jorge Diaz, gave information about 2 suspected cases of hantavirus [infection] in Santiago, one of them interned in the intensive care unit of the Clinica Alemana.
"The case that has us most concerned is a 22 year old young man who is in serious condition in the intensive care unit of the Clinica Alemana. He belongs to a group of boy scouts that traveled in the south to various localities. It is difficult to know in which place they were at risk [of infection]. So this is the group that we most want to review, " he said.
The news arrived through a surveillance system that permits daily receipt of information, Diaz indicated, who discarded another suspected case in the Coquimbo region.
"The discarding of the suspected [cases] in Region IV makes us at ease again and confirms what we have maintained, that in this area, the rodent carrier [of the virus] is not present. In all its history, we have never had cases there, but we keep looking in 3 places in Bio Bio. In that list, we have 9 suspected [cases], " he explained to ADN.
"What has us most concerned is that we have 2 suspected cases in Santiago. Their histories show that they traveled to the south of Chile and are under treatment. Both are in private clinics. It is unlikely that other people have the same problem, but we put them in the surveillance system once we identified the entire group. It is unlikely that several people are infected, but we will follow them during the time of the incubation period, which is 45 days, " he said.
Efforts are concentrated from the Valparaiso region to Los Lagos, which is the area of the habitat of this rodent, said the professional, who stated that: "We are working with around 3000 families that we have to visit. Our teams have been working in the area that is defined; we hope that this process will last one or 2 weeks, since we now have to go to places that are not exactly in the urban area, rather are rural and semirural. Because of this, it is slow work that must be accompanied by education."
ProMED-mail from HealthMap Alerts
[The exact location in which the infection was acquired is not possible to determine, just a broad geographic area in southern Chile.
A HealthMap/ProMED-mail map of Chile showing the southern region mentioned can be accessed at http://healthmap.org/r/1Mo9. - Mod.TY]
 Iquitos Peru, suspected
Date: Thu 9 Feb 2012
Source: La Region [in Spanish, trans. Mod.TY, edited]
Since last week, a young man of 18 years has been interned in the intensive care unit [ICU] of the Loreto Regional Hospital, due to his having all the symptoms of the terrible dengue hemorrhagic fever. But the tests yielded negative results [for dengue virus infection], so new tests were done in order to rule out [a] hantavirus [infection].
The director of the regional hospital, Martin Casapia, said that currently, there are 2 patients in the ICU, with the case of the young man the more complicated. The hospital director said, moreover, that the young man is on an artificial respirator and under the care of various specialists. He stated that the physicians await the [test] results to know whether they are seeing a new case of [a] hantavirus [infection].
Meanwhile, at his home located on 100 Mile Street in the La Pradera neighborhood [Iquitos], his mother said that there have been many rats since the beginning of the high water season, and due to that, she requested that health personnel come to rule out the presence of hantaviruses in this place.
[byline: G Ross]
ProMED-mail from HealthMap Alerts
[The hantavirus involved in this suspected case is not specified. A hantavirus that causes HPS (hantavirus pulmonary syndrome) that is found in the Amazon basin is Araraquara, and its rodent host is (_Necromys (Bolomys) benefactus_).
A map showing the departments of Peru can be seen at http://www.lib.utexas.edu/maps/americas/peru_pol91.jpg. A HealthMap/ProMED-mail interactive map showing the location of Iquitos, Loreto can be accessed at http://healthmap.org/r/1hcM. - Mod.TY]