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Published Date: 2012-03-14 10:55:20
Subject: PRO/AH/EDR> Hantavirus update 2012 - Americas (09): USA, Chile
Archive Number: 20120314.1069616

HANTAVIRUS UPDATE 2012 - AMERICAS (09): USA, CHILE
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In this update:
[1] USA (Montana)
[2] Chile (Araucania region)
[3] Chile (O'Higgins region)
[4] Chile (national)

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[1] USA (Montana)
Date: Fri 9 Mar 2012
Source: KPAX [edited]
http://www.kpax.com/news/montana-sees-first-2012-hantavirus-case/

State health officials say the 1st confirmed case of hantavirus pulmonary syndrome (HPS) [in 2012], has shown up in Montana.

The Montana Department of Public Health and Human Services [DPHHS] says the Montana resident is expected to make a full recovery and it appears the person acquired the disease while in another state.

This marks the 33rd confirmed HPS case in the Treasure State since 1193 [sic., 1993] with DPHHS saying in a news release that the state typically sees one or 2 cases a year, making the state 2nd only to New Mexico in the number of cases when adjusted for the state's population.

"Montanans should be aware of the precautions they can take to avoid [a] hantavirus [infection] and the rodents that can carry it [the virus]," said DPHHS director Anna Whiting Sorrell. "People may be at risk when they come into contact with small rodents and their waste."

Health officials warn that hantavirus [infection] cases often increase as the weather warms in the spring. As people begin to clean their garages and sheds, nesting material contaminated with dried saliva, urine, or droppings from infected deer mice [_Peromyscus maniculatus_] is disturbed, becomes airborne, and inhaled. Infections may also occur when these materials are directly introduced into broken skin or into the eyes or mouth. Although rare, persons have also become infected after being bitten by rodents.

According to DPHHS State Medical Officer Dr Steven Helgerson, early symptoms of [a] hantavirus infection usually start with fever and muscle aches, and sometimes chills, headache, vomiting. Within a few days, symptoms progress to coughing and severe shortness of breath. The symptoms develop 1-6 weeks after exposure.

"Early recognition and immediate medical care are key to surviving the illness," Helgerson said. "If someone is exposed to rodents and experiences symptoms -- especially severe shortness of breath, they need to seek treatment right away." Be sure to tell your doctor that you have been around rodents. This will alert your physician to look closely for any rodent-carried disease [virus], such as hantavirus[es].

The best way to prevent hantavirus transmission is by controlling rodent populations in areas where one lives and works. When cleaning areas where rodents may nest, the following precautions should be followed:

- Wear rubber or plastic gloves
- Thoroughly spray/soak area with a disinfectant or mixture of bleach and water to reduce dry dusty conditions in the area being cleaned
- Wipe or mop the area with a sponge or paper towel (throw away items after use)
- Wash hands thoroughly with soap and warm water after removing gloves
- Never sweep or vacuum in these areas as this can stir up dust and aerosolize the droppings

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[The hantavirus most likely involved is Sin Nombre virus, although one cannot say with certainty, since the infection was acquired in another state, and other hantavirus found elsewhere in the USA can cause hantavirus pulmonary syndrome [HPS].

An image of _Peromyscus maniculatus_ can be accessed at http://www.wle.umaine.edu/faculty/Burns/burnsphoto6.jpg

A HealthMap/ProMED-mail interactive map showing the location of the state of Montana in the USA can be accessed at http://healthmap.org/r/1kJm. - Mod.TY]

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[2] Chile (Araucania region)
Date: Sat 10 Mar 2012
Source: Radio Bio-Bio [in Spanish, trans. & summ. Mod.TY, edited]
http://www.biobiochile.cl/2012/03/10/confirman-primera-victima-fatal-por-virus-hanta-en-la-araucania.shtml

A 7-year-old girl became the 1st fatal hantavirus [infection] case this year [2012, in Araucania region]. The girl died last Wednesday [7 Mar 2012] in the Carahue Hospital due to cardiorespiratory insufficiency [HPS] and multisystemic failure. [A] hantavirus was confirmed as the cause of death by the Institute of Public Health.

The Araucania Health SEREMI [regional governmental ministerial unit], Gloria Rodriguez, confirmed this situation and said that the initial examination done on the girl did not detect the presence of the virus.

[Byline: Ivan Oliveros, Susana Gallardo]

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[Although not specified, the hantavirus involved in this HPS case and the ones below is most likely Andes virus.

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 the Araucania region can be accessed at http://healthmap.org/r/1ZWP. - Mod.TY]

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[3] Chile (O'Higgins region)
Date: Fri 9 Mar 2012
Source: El Tipografo [in Spanish, trans. Mod.TY, edited]
http://eltipografo.cl/2012/03/confirmado-nuevo-caso-de-virus-hanta-en-la-region/

The Institute of Public Health (ISP) confirmed this Wednesday (7 Mar 2012] a new case of [a] hantavirus [infection] in the O'Higgins region. The individual is a 19-year-old man who lives in Lolol.

The Health SEREMI, Michael Casson, stated that "the patient has had a frank deterioration of his health and in a few hours has evolved so that support in the intensive care unit is necessary. The Rancagua Regional Hospital and the O'Higgins Health Service are doing everything possible to remedy his situation."

Casson added that "within the scope of Health Action and Public Health, the initial epidemiological work has already been done to determine the areas that the 19-year-old man visited. These are Valdivia, Talca, and Lolol. In Valdivia we have a history that the youth was on vacation in the Niebla area and in Talca in a rural area, which apparently are areas with a certain grade of risk of acquiring [a] hantavirus [infection]. But since these are in other jurisdictions, they are not within our areas of responsibility to investigate," he said.

In Lolol, where the youth lives, we have jurisdiction and he frequently visited the Los Robles area, an area where we carry out work to correct environmental factors or behavior of the people. Basically, the idea is to minimize the risks of the people to contact a hantavirus [infection]," he stated.

The ISP indicated that with this case the reference laboratory confirmed that the number of people infected with the disease [virus] increases to 22 in the country so far in 2012. This year [2012] cases of hantavirus [infection] have increased by 61 percent in comparison to 2011.

[Byline: Jaime Castaneda]

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[A HealthMap/ProMED-mail interactive map showing the location of the O'Higgins region can be accessed at http://healthmap.org/r/1ZWQ. - Mod.TY]

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[4] Chile (national)
Date: Tue 6 Mar 2012
Source: Radio Bio-Bio [in Spanish, trans. & summ. Mod.TY, edited]
http://www.biobiochile.cl/2012/03/06/contagios-por-virus-hanta-se-incrementan-en-un-61-en-lo-que-va-del-2012.shtml

There is a 61 percent increase in the number of hantavirus infections in 2012, in respect to the same period last year [2011]. However, despite the increase in the number of people infected, the fatality rate declined from 39 percent in 2011 to 24 percent so far this year [2012].

This [reduction in fatalities] is due to the Ministry of Health disbursing virus detection to a laboratory network, distributed among the regions of Valparaiso, Maule, Bio-Bio, La Araucania, and Los Lagos, connected in turn with 3 confirmatory centers in the Universidad Austral, the Universidad Catolica, and the Institute for Public Health. With this [network] we seek to accelerate the study of suspicious samples that permits the confirmation of the diagnosis for possible infection in a maximum interval of 48 hours.

[Byline: Daniel Torres, Rocio Rodriguez]

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[For a disease (HPS) that can progress very rapidly, acceleration of diagnosis can be a major benefit to affected patients. The Ministry of Health is to be congratulated for accomplishing the decentralization of diagnostic capability while maintaining quality control through reference laboratories.

A map showing the regions of Chile can be accessed at http://www.cybertruffle.org.uk/chilfung/chile_regions.gif. - Mod.TY]

See Also