Hantavirus Pulmonary Syndrome in the Americas

C. J. Peters

doi:10.1128/9781555816957.ch2

2 : Hantavirus Pulmonary Syndrome in the Americas

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Affiliations: 1: Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Mail Stop A26, 1600 Clifton Road, Atlanta, GA 30333

Content Type: Monograph

Publication Year: 1998

Category: Clinical Microbiology

Book DOI: 10.1128/9781555816957

Chapter DOI: 10.1128/9781555816957.ch2

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Abstract:

The hantaviruses of the Americas are being recognized as a numerous and growing group of rodent-borne viruses that cause a disease called hantavirus pulmonary syndrome (HPS). The American viruses all belong to the genus Hantavirus of the family Bunyaviridae. There are recent general reviews of hantaviruses and their molecular genetics, but this chapter emphasizes some of the recent findings in the Americas. Only two hantaviruses were known in the Americas before 1993: Prospect Hill virus from the meadow vole Microtus pennsylvanicus and Seoul virus from the Old World rodent Rattus norvegicus. In 1993 an epidemic of unexplained adult respiratory distress syndrome in the southwestern U.S. was serologically linked to hantaviruses. The most commonly used serological tests are the indirect fluorescent antibody (IFA) test and more recently the enzyme-linked immunosorbent assay (ELISA). Hantavirus vaccine development faces some formidable tasks. There is no animal model of HPS or hemorrhagic fever with renal syndrome (HFRS) to measure attenuation or to study possible immunopathological interactions with vaccines. The diversity of the rodent taxon (Muridae and subfamily Sigmodontinae) suggests that there will be variation in the epidemiology and clinical presentation of HPS according to the individual causative virus, although to date the syndrome has been recognizable as HPS, and the epidemiology can be largely understood by patterns of rodent-human interactions.

Citation: Peters C. 1998. Hantavirus Pulmonary Syndrome in the Americas, p 17-64. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch2

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Hantavirus Pulmonary Syndrome in the Americas

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Figure 1

Recognized hantaviruses associated with sigmodontine rodents. These are provisional viral species and may be revised in the future. The dot indicates site of identification. but the potential range of the viruses will depend on the distribution of the rodent hoot (compare SNV in Fig. 4 ). (Courtesy of Jim Mills.)

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Figure 2

Phylogenetic tree of rodent-borne hantaviruses derived from maximum parsimony analysis of the open reading frame on the M RNA segment that codes for the glycoprotein precursor, GPC. The viruses are all associated with rodents in the family Muridae. The upper branch shows Hanlaan (HTN), Seoul (SEO), Thailand (THAI), and Dobrava (DOB) viruses from rodents of the subfamily Murinae: these are known only from Europe and Asia with the exception of Seoul virus which has a worldwide distribution with the spread of its reservoir. R. norvegicus, from its origins in Asia (91), The middle branch has Puumala (PUU), Tula (TUL), and Prospect Hill (PH) viruses from rodents of the subfamily Arvicolinae or voles; these are present in Europe. Asia, and the Americas. The lower branch contains Bayou (BAY), Black Creek Canal (BCC). Laguna Negra (LN), Sin Nombre (SN), NY (New York), and El Moro Canyon (ELMC) viruses from American rodents of the subfamily Sigmodontinae, The inset shows a magnified analysis of Laguna Negra isolates based on a smaller RNA fragment amplified from tissues of humans and rodents. Note the distinctly different LN855H strain from a Chilean patient thought to be have been infected in Bolivia. The LN855H virus differs from the Paraguayan viruses by 16% of the 521 nucleotides examined. but has a 100% identical predicted amino acid sequence. The sigmodontine hantaviruses often show a pattern of much greater variation of nucleotides than amino acids, both within and among virus species. (From reference 80.)

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Figure 2

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Figure 3

HPS in the United States showing secular trend. The epidemic was recognized in the Four Corners states in 1993. and there was increased transmission there in 1994 as well. More recently a greater proportion of cases have occurred in other states. There is a tendency for greater transmission in summer months, but cases are seen all year. (Courtesy of Joni Carson.)

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Figure 3

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Figure 4

HPS in North America. Shaded area indicates the recognized range of the deer mouse, Peromyscus maniculatus, and triangles identify cases known or thought to be from SNV. Infections acquired outside the range of the deer mouse are caused by other viruses. (Courtesy of Joni Carson; rodent distribution is from reference 9a.)

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References

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Tables

Hantavirus Pulmonary Syndrome in the Americas

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Table 1

Hantaviruses of sigmodontine rodents in the Americas

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Table 1

Hantaviruses of sigmodontine rodents in the Americas

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Table 2

HPS recognition in South America

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Table 2

HPS recognition in South America

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Table 3

Estimates of HPS cases identified in the Americas as of March, 1998, by country of infection a

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Table 3

Estimates of HPS cases identified in the Americas as of March, 1998, by country of infection a

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Table 4

Clinical features of hantavirus infections a

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Table 4

Clinical features of hantavirus infections a