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Published Date: 2012-05-01 22:16:43
Subject: PRO/AH/EDR> Hantavirus update 2012 - Americas (14) USA, Brazil
Archive Number: 20120501.1119924

HANTAVIRUS UPDATE 2012 - AMERICAS (14): USA, BRAZIL
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In this update:
[1] USA (Cascade County, Montana)
[2] Brazil (Uberaba, Minas Gerais)

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[1] USA (Cascade County, Montana)
Date: Wed 18 Apr 2012
Source: KPAX [edited]
http://www.kpax.com/news/2nd-case-of-hantavirus-confirmed-in-cascade-county/

The Montana Department of Public Health and Human Services has confirmed the 2nd case of Hantavirus Pulmonary Syndrome (HPS) in Cascade County resident for 2012. This is the 4th confirmed case in Montana so far this year [2012], and one of 35 HPS cases reported in Montana since 1993; Montana typically sees 1 to 2 cases a year with this being the 3rd in 2012.

The Cascade City-County Health Department (CCHD) urges residents to take steps to protect themselves from Hantavirus.

CCHD health officer Alicia Thompson said in a press release, "Our thoughts are with those who have been affected by hantavirus [infections]. It [Hantavirus pulmonary syndrome] is a very serious illness that is present [caused by a virus] in the environment and residents must take steps to protect themselves. For your safety, take all recommended steps to control rodent populations and clean up rodent waste properly. If you have been around rodents and start to exhibit symptoms is it crucial to seek medical care immediately and let your provider know you have been exposed to rodent waste."

[Sin Nombre] Hantavirus is carried by infected deer mice [_Peromyscus maniculatus_] and can be passed on through their urine, saliva, or droppings. The percentage of infected deer mice is highly dependent on environmental factors and can vary greatly between seasons.

Because Cascade County has recently seen 2 cases, it is likely that other infections could occur if people don't take steps to protect themselves.

Common tasks such as sweeping and moving boxes can disturb areas that have dried saliva, urine, or droppings from infected deer mice. As infected material is moved around, tiny particles with the virus in them get kicked up into the air. It is these tiny particles [contain viruses] that can make you sick when they are breathed in or get into your eyes, mouth, or broken skin.

Symptoms can begin 1-6 weeks after being exposed to the virus. The illness typically starts with 3-5 days of "flu-like" symptoms including fever, sore muscles, headaches, nausea, vomiting and fatigue. Within a few days the illness rapidly progresses to severe shortness of breath [hantavirus pulmonary syndrome].

CCHD officials say that early diagnosis of [a] hantavirus [infection] and immediate medical care increase the likelihood of a full recovery. Individuals exposed to rodents or their waste who experience symptoms should immediately seek medical treatment and notify their provider that they have been around rodents or rodent wastes.

Providing this information to your provider will help him or her to look closely for any rodent-carried disease [agent], such as [a] hantavirus.

The best way to prevent hantavirus transmission is by controlling rodent populations in areas where you live and work.

- Seal up cracks and gaps in buildings that are larger than 1/4 inch, including window and door sills, under sinks around the pipes, in foundations, attics and any rodent entry hole.
- Trap indoor rats and mice with snap traps, and remove rodent food sources.
- Keep food (including pet food) in rodent-proof containers.

If you find places where rodents have nested, or if you find rodent droppings or waste, follow these steps to help to prevent exposure to hantaviruses while cleaning:

- 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 (Ask for a Public Health Nurse for specific mixing instructions)
- 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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Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[Although not stated, the hantavirus involved in this case is most likely Sin Nombre virus.

An image of _Peromyscus maniculatus_, the rodent host of Sin Nombre virus, can be accessed at
http://www.ask.com/wiki/Peromyscus_maniculatus.

The state of Montana can be located on the HealthMap/ProMED-mail interactive map at http://healthmap.org/r/2c16.
A HealthMap/ProMED-mail interactive map showing the location of Cascade county in Montana can be accessed at http://healthmap.org/r/2c16. - Mod. TY]

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[2] Brazil (Uberaba, Minas Gerais]
Date: Sat 28 Apr 2012
Source: Correio [in Portuguese, transl. Mod.TY, edited]
http://www.jornalcco.com.br/noticia/1680/Secretaria-da-Saude-confirma-dois-casos-de-hantavirose-em-Uberaba--MG

The Secretariat of Health confirmed 2 cases of hantavirus infections in Uberaba, Minas Gerais. 2 young people, one 22 years old and the other 18, were infected and died. Zoonoses began action to combat [the disease] this Friday (27 [Apr 2012]). The 2 cases were confirmed in Uberaba, in the Minas Triangle, by the municipal Secretariat of Health. The deaths occurred in 2 months, in March and April of this year [2012], and were reported this Friday (27 Apr 2012). The laboratory tests were done at Fundacao Ezequiel Dias, in Belo Horizonte.

The Secretariat of Health received the report this past Thursday (26 Apr 2012), and then communicated with Zoonoses Control in order to initiate control actions in the localities where the acquisition of the infection was suspected. Field work began this Friday (27 Apr 2012). In addition, the Secretariat of Health informed the Center for Zoonoses Control to maintain continuous action throughout the year in the rural area where there is risk [of virus transmission] from presence of wild rats, vector of hantaviruses.

The 1st case occurred in March, a 22 year old young person who died. Then a 2nd case occurred in the beginning of April, in this instance an 18 year old young man who died hours after being attended to the the Sao Benedito Immediate Attention Unit.

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Communicated by:
ProMED-PORT
<promed-port@promedmail.org>

[There have been cases of hantavirus infections in this area previously. The Regional Directorate of Health (GRA) technical report for 2009 indicated that there were 6 confirmed cases in the region, of which 2 died, and one reported non-fatal case in Uberaba. In 2010, the GRS reported 14 confirmed cases of the disease, 3 of whom were women. 50 per cent died (see ProMED-mail archive no. 20110115.0170).

There are various hantaviruses in Brazil that could cause fatal infections in Minas Gerais state. Unfortunately, this report does not indicate which ones were responsible for the cases. The ProMED-mail report of cases in Brazil dated 23 Feb 2008 (ProMED-mail archive no. 20080223.07412) indicated that hantaviruses circulating in Mato Grosso included: Laguna Negra, which has the _Calomys callosus_ rodent host, and Castelo dos Sonhos, which had previously been found in Para state but without a known host there. Field research found that, in Mato Grosso, the rodent _Oligoryzomys moojeni_ was the host of the Castelo dos Sonhos virus.

A brief description of other hantaviruses that occur in Brazil and their rodent hosts is given in ProMED-mail archive no. 20080702.2020, which comments that Anajatuba virus is a possible etiological agent of HPS (hantavirus pulmonary syndrome) in Brazil. Its rodent host is _Oligoryzomys fornesi_. Araraquara virus infection has also caused HPS in Brazil. Its rodent host is _Necromys [Bolomys] lasiurus_. Newly recognized hantaviruses associated with hantavirus pulmonary syndrome in northern Brazil: partial genetic characterization of viruses and serologic implication of likely reservoirs (Vector Borne Zoonotic Dis 5(1): 11-9; abstract available at http://www.ncbi.nlm.nih.gov/pubmed/15815145).

An Interactive HealthMap/ProMED-mail interactive map showing the location of Uberaba in Minas Gerais state can be accessed at http://healthmap.org/r/1sbo. - Mod.TY.]

See Also