HANTAVIRUS INFECTION

Wisconsin Division of Public Health Disease Surveillance Manual (EpiNet, February 2005)

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I. IDENTIFICATION

A. CLINICAL DESCRIPTION: Hantavirus pulmonary syndrome (HPS), commonly referred to as hantavirus disease, is a febrile illness characterized by bilateral interstitial pulmonary infiltrates and respiratory compromise usually requiring supplemental oxygen and clinically resembling acute respiratory disease syndrome (ARDS). The typical prodrome consists of fever, chills, myalgia, headache, and gastrointestinal symptoms. Typical clinical laboratory findings include hemoconcentration, left shift in the white blood cell count, neutrophilic leukocytosis, thrombocytopenia, and circulating immunoblasts.

B. REPORTING CRITERIA: A febrile illness characterized by bilateral diffuse interstitial edema that may radiographically resemble ARDS, with respiratory compromise requiring supplemental oxygen, developing within 72 hours of hospitalization, and occurring in a previously healthy person. OR
An unexplained respiratory illness resulting in death, with an autopsy examination demonstrating noncardiogenic pulmonary edema without an identifiable cause

C. LABORATORY CRITERIA FOR CONFIRMATION:

1) Detection of hantavirus-specific immunoglobulin M or rising titers of hantavirus-specific immunoglobulin G, OR
2) Detection of hantavirus-specific ribonucleic acid sequence by polymerase chain reaction in clinical specimens, OR
3) Detection of hantavirus antigen by immunohistochemistry.

D. WISCONSIN CASE DEFINITION: A clinically compatible case that is laboratory confirmed

II. ACTIONS REQUIRED / PREVENTION MEASURES

 A. WISCONSIN DISEASE SURVEILLANCE CATEGORY I: Report IMMEDIATELY BY TELEPHONE to the patient's local health officer upon identification of a case or suspected case. Complete and mail an Acute and Communicable Disease Case Report (DPH 4151) to the local health officer within 24 hours.

B. EPIDEMIOLOGY REPORTS REQUESTED:

  1. Acute and Communicable Diseases Case Report (DPH 4151)
  2. CDC HPS Case Report Form (OMB 0920-0009)

C. PUBLIC HEALTH INTERVENTIONS: Contact and work with DPH staff. Ascertain all contact with rodents or rodent-contaminated areas during the six weeks preceding onset. Obtain detailed travel history. Environmental assessment may be indicated.

III. CONTACTS FOR CONSULTATION

A. BCDP / COMMUNICABLE DISEASE EPIDEMIOLOGY SECTION: (608) 267-7321.

B. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.

C. WSLH: Viral and Rickettsial Serology, 608/262-0248.

IV. RELATED REFERENCES

  1. “Hantavirus” DPH Disease Fact Sheet Series: View a list of all current Communicable Disease Fact Sheets
  2. Heymann DL, ed. Hantavirus Pulmonary Syndrome. In: Control of Communicable Diseases Manual. 18 th ed. Washington , DC : American Public Health Association, 2004:243-245.
  3. Pickering LK, ed. Hantavirus Pulmonary Syndrome. In: Red Book: 2003 Report of the Committee on Infectious Diseases. 26 th ed. Elk Grove Village, IL: American Academy of Pediatrics, 2003:301-304.

V. DISEASE TRENDS

There has been only one case of hantavirus pulmonary syndrome reported in Wisconsin . That case occurred in 1997, and the patient survived the illness.