+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Hantavirus pulmonary syndrome: a clinical description of 17 patients with a newly recognized disease. The Hantavirus Study Group



Hantavirus pulmonary syndrome: a clinical description of 17 patients with a newly recognized disease. The Hantavirus Study Group



New England Journal of Medicine 330(14): 949-955



In May 1993 an outbreak of severe respiratory illness occurred in the southwestern United States. A previously unknown hantavirus was identified as the cause. In Asia hantaviruses are associated with hemorrhagic fever and renal disease. They have not been known as a cause of human disease in North America. We analyzed clinical, laboratory, and autopsy data on the first 17 persons with confirmed infection from this newly recognized strain of hantavirus. The mean age of the patients was 32.2 years (range, 13 to 64); 61 percent were women, 72 percent were Native American, 22 percent white, and 6 percent Hispanic. The most common prodromal symptoms were fever and myalgia (100 percent), cough or dyspnea (76 percent), gastrointestinal symptoms (76 percent), and headache (71 percent). The most common physical findings were tachypnea (100 percent), tachycardia (94 percent), and hypotension (50 percent). The laboratory findings included leukocytosis (median peak cell count, 26,000 per cubic millimeter), often with myeloid precursors, an increased hematocrit, thrombocytopenia (median lowest platelet count, 64,000 per cubic millimeter), prolonged prothrombin and partial-thromboplastin times, an elevated serum lactate dehydrogenase concentration, decreased serum protein concentrations, and proteinuria. Rapidly progressive acute pulmonary edema developed in 15 of the 17 patients (88 percent), and 13 patients, all of whom had profound hypotension, died (case fatality rate, 76 percent). Increases in the hematocrit and partial-thromboplastin time were predictive of death. Infection with a newly described hantavirus causes the hantavirus pulmonary syndrome, which is characterized by a brief prodromal illness followed by rapidly progressive, noncardiogenic pulmonary edema.

(PDF emailed within 0-6 h: $19.90)

Accession: 046211909

Download citation: RISBibTeXText

PMID: 8121458

DOI: 10.1056/nejm199404073301401


Related references

Time to revise the paradigm of hantavirus syndromes? Hantavirus pulmonary syndrome caused by European hantavirus. European Journal of Clinical Microbiology and Infectious Diseases 30(5): 685-690, 2011

A newly recognized virus associated with a fatal case of hantavirus pulmonary syndrome in Louisiana. Journal of Virology 69(3): 1980-1983, 1995

Utilization of autopsy RNA for the synthesis of the nucleocapsid antigen of a newly recognized virus associated with hantavirus pulmonary syndrome. Virus Research 30(3): 351-367, 1993

Characterization of human antibody responses to four corners hantavirus infections among patients with hantavirus pulmonary syndrome. Journal of Virology 68(5): 3000-3006, 1994

Newly recognized hantaviruses associated with hantavirus pulmonary syndrome in northern Brazil: partial genetic characterization of viruses and serologic implication of likely reservoirs. Vector Borne and Zoonotic Diseases 5(1): 11-19, 2005

An unusual hantavirus outbreak in southern Argentina: person-to-person transmission? Hantavirus Pulmonary Syndrome Study Group for Patagonia. Emerging Infectious Diseases 3(2): 171-174, 1997

Prevalence of anti-hantavirus antibodies in health care personnel in direct contact with patients with hantavirus pulmonary syndrome in Temuco, Chile 1997 to 1999. Revista Medica de Chile 128(7): 735-739, 2000

Hantavirus pulmonary syndrome, renal insufficiency, and myositis associated with infection by Bayou hantavirus. Clinical Infectious Diseases 23(3): 495-500, 1996

Hantavirus in human and rodent populations in an endemic area for hantavirus pulmonary syndrome in Argentina. Medicina (Buenos Aires) 62(1): 1-8, 2002

RIBA hantavirus strip immunoblot assay for rapid diagnosis of hantavirus pulmonary syndrome. Abstracts of the General Meeting of the American Society for Microbiology 96(0): 292, 1996

Phylogenetically distinct hantavirus implicated in a case of hantavirus pulmonary syndrome in the northeastern United States. Journal Of Medical Virology. 46(1): 21-27, 1995

Spectrum of hantavirus infection: hemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome. Annual Review of Medicine 50: 531-545, 1999

Epidemiologic linkage of rodent and human hantavirus genomic sequences in case investigations of hantavirus pulmonary syndrome. Journal of Infectious Diseases 173(4): 781-786, 1996

Hantavirus infection induces a typical myocarditis that may be responsible for myocardial depression and shock in hantavirus pulmonary syndrome. Journal of Infectious Diseases 195(10): 1541-1549, 2007

Discriminators between hantavirus-infected and -uninfected persons enrolled in a trial of intravenous ribavirin for presumptive hantavirus pulmonary syndrome. Clinical Infectious Diseases 34(3): 293-304, 2002