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Background:
There have only been 465 cases reported. Most in the west: 73 in NM, 53 in CO, 51 in AZ, 41 in Calif., 35 in WA, 33 in TX, 30 in UT, 21 in NV, ... 1 in NY, 1, MA, 0 in NJ, 0 in MI
Hantavirus which is spread by rodents can cause several diseases: Hantavirus pulmonary syndrome (HPS) is a deadly disease from rodents. All About Hantaviruses www.cdc.gov/ncidod/diseases/hanta/hps/ Symptoms: www.cdc.gov/ncidod/diseases/hanta/hps/noframes/symptoms.htm http://www.cdc.gov/ncidod/diseases/hanta/hps/noframes/phys/clinical.htm Clinical Disease Manifestations Presentation and First Evaluation Patients with HPS typically present in a very nonspecific way with a relatively short febrile prodrome lasting 3-5 days. In addition to fever and myalgias, early symptoms include headache, chills, dizziness, non-productive cough, nausea, vomiting, and other gastrointestinal symptoms. Malaise, diarrhea, and lightheadedness are reported by approximately half of all patients, with less frequent reports of arthralgias, back pain, and abdominal pain. Patients may report shortness of breath, (respiratory rate usually 26 - 30 times per minute). Typical findings on initial presentation include fever, tachypnea and tachycardia. The physical examination is usually otherwise normal. HPS Clinical Presentation
The diagnosis is seldom made at this stage, as cough and tachypnea generally do not develop until approximately day seven. Once the cardiopulmonary phase begins, however, the disease progresses rapidly, necessitating hospitalization and often ventilation within 24 hours. Signs that make a diagnosis of HPS unlikely include rashes, conjunctival or other hemorrhages, throat or conjunctival erythema, petechiae, and peripheral or periorbital edema. Clinical Assessment If a hantavirus infection is suspected, a CBC and blood chemistry should be repeated every 8 to 12 hours. Early symptoms of HPS include fatigue, fever and muscle aches, especially in the large muscle groups-thighs, hips, back, and sometimes shoulders. These symptoms are universal.There may also be headaches, dizziness, chills, and abdominal problems, such as nausea, vomiting, diarrhea, and abdominal pain. About half of all HPS patients experience these symptoms. Due to the small number of HPS cases, the "incubation time" is not positively known. However, on the basis of limited information, it appears that symptoms may develop between 1 and 5 weeks after exposure to urine, droppings, or saliva of infected rodents.
Hemorrhagic fever with renal syndrome (HFRS) is a group of clinically similar illnesses caused by hantaviruses from the family Bunyaviridae. HFRS includes diseases such as Korean hemorrhagic fever, epidemic hemorrhagic fever, and nephropathis epidemica. The viruses that cause HFRS include Hantaan, Dobrava-Belgrade, Seoul, and Puumala. Symptoms of HFRS usually develop within 1 to 2 weeks after exposure to infectious material, but in rare cases, they may take up to 8 weeks to develop. Initial symptoms begin suddenly and include intense headaches, back and abdominal pain, fever, chills, nausea, and blurred vision. Later symptoms can include low blood pressure, acute shock, vascular leakage, and acute kidney failure, which can cause severe fluid overload. The severity of the disease varies depending upon the virus causing the infection. Prevention:
CDC links: Sierra Nevada and Nevada State SpecificsI talked to the Tahoe Forest Hospital in Truckee and the Nevada County Environmental Health Organization, who is investinating Joe's case and neither had heard of any cases recently.Hantavirus Survey Data www.co.washoe.nv.us/health/ehs/vector/hantavirus.html 12-33% of deer mice tested in Washoe Co. NV in 2002-2004 had Hantavirus A hantavirus caused the death of Elko Co. (Northeastern) NV in June 2006. www.krnv.com/Global/story.asp?S=5081895 Nevada Co., CA Environmental Health Report Hantavirus has also been detected in the Sierra Nevada region. There have been two major hantavirus incidents in the past two years, involving one human death and one acute hospital stay. new.mynevadacounty.com/eh/index.cfm?ccs=790&cs=618
Environmental Health Truckee Office: 530-582-7884
Links: Hantavirus fact sheet at King's County Wash.
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