What are the basic characteristics of Hantavirus?
Spherical, lipid enveloped particles; negative RNA
Is hantavirus segmented?
Yes. It's trisegmented
What are the different segments of the virus?
1. Nucleocapsid protein
2. RNA-dep RNA polymerase
3. G1/G2 envelope proteins
How is the virus transmitted?
It's airborne and transmitted through breathing air containing aerosolized rosent saliva, urine, and feces.
NOT transmitted human-human
What is the epidemiology?
Rural USA( farms, fields, forrests). Several hantaviruses can cause HPS; each virus is carried by a specific rodent
What diseases can the virus cause?
HPS, which is severe and sometimes fatal respiratory disease
What is the process of HPS disease?
1. Inhaled rodent saliva/urine/feces
2. Viral load recruits lymphoblasts +macros to pulm tissue
3. Activated immune cells -> increase cytokine release
4. endothelium is activated
5. increased capillary permeability, which leads to pulm edema
What's the presentation?
Flu like symptoms, which can cause life threatening pneumonia
How many stages of the disease are there?
1. Rapid onset of pulm edema; increased viremia at onset of disease and flu like illness
2. Respiratory failure and cardiogenic shock; cough, SOB, fluid accumulation, decreased BP
How do you make the Dx?
Early phase is often confused with influenza. Rural rodent exposure is key +tetrad:
2. Leukocytosis (left shift)
3. Abnormal lymphoblasts
4. increased HCT b/c of ultraflitration into the lungs
5. (less important) serological testing (IgM and IgG) or RT PCR
What is the Tx?
No tx, cure, or vaccine. Give supportive care. Even though the pts are hypotensive, don't give fluids! Give B1-adrenergic cardiostimulation to increase BP