Hantavirus Pulmonary Syndrome (cont.)

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What causes hantavirus pulmonary syndrome?

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As stated above, the cause of HPS is infection of the patient by hantavirus. Currently, about 14 subtypes of hantaviruses have been identified. Many subtypes have been named (for example, Sin Nombre, Black Creek hantavirus, and New York hantavirus); some investigators simply lump them under the term of "New World hantaviruses." The Sin Nombre subtype has caused the majority of current HPS disease. The virus apparently damages cells that compose blood vessel capillaries, causing them to leak fluids. This fluid leak, if it is profound in the lungs, causes the pulmonary syndrome that can lead to death.

Hantaviruses live their lifecycle in rodents but apparently do no harm; the viruses multiply and are shed in the rodent's urine, feces, and saliva. A recent study in California suggested about 15% of all deer mice examined tested positive for hantavirus. Although the deer mouse has been the source of most HPS infections, many other rodents may carry a different hantavirus subtype virus (for example, the white-footed mouse, the cotton rat, and the rice rat).

How is the hantavirus pulmonary syndrome diagnosed?

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Currently, there are no readily available tests to diagnose HPS or even hantavirus infection in the early stage of the infection or disease mainly because the early symptoms are so nonspecific and the disease syndrome of HPS so infrequent. There has been no pressing need or use for a test. However, if the more severe HPS disease develops, the disease is presumptively diagnosed by the patient's association with an area where rodents proliferate or areas where HPS is known to occur (for example, the Four Corners area and recently the Yosemite National Park recreational area, especially certain tent-cabins rented to the public). Sequential chest X-rays may show worsening changes and fluid buildup. Definitive diagnosis is usually done by the CDC labs using special immunological tests that can distinguish hantavirus from Ebola, Marburg, and other viruses.

Medically Reviewed by a Doctor on 9/18/2012

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