Hantavirus pulmonary syndrome in Texas: An update covering years 1993 through 2016

  • Kenneth Nugent
  • James Alexander The Texas Department of State Health Services in Canyon, TX (JLA)
Keywords: Hantavirus pulmonary syndrome, Texas, laboratory tests, outcomes

Abstract

Background: Hantavirus pulmonary syndrome continues to occur sporadically in Texas.
Rivers and coworkers published a summary of cases identified between 1993 and 2006. This
report updates the information on Hantavirus pulmonary syndrome cases identified between 2007
and 2016 to determine whether or not there are differences in clinical presentation or outcomes.
Methods: The Texas Department of State Health Services collects information on the Hantavirus
pulmonary syndrome using the Centers for Disease Control and Prevention, Special Pathogens
Branch case report form (OMB No.0920-0090). This form collects demographic information, patient
exposure information, timeline, clinical information, laboratory tests, and outcomes.
Results: This report summarizes information from the Texas Department of State Health
Services on 45 cases with Hantavirus pulmonary syndrome reported between 1993 and
2016. Most patients were men and were non-Hispanic white or Hispanics. Laboratory tests
revealed leukocytosis, an increased percentage of neutrophil bands, hemoconcentration,
thrombocytopenia, and variable acute kidney injury. The case fatality rate was 31%. Since
2007, the case fatality rate has decreased. The cases remain clustered in the Northwest Texas
(Public Health Region 1).
Summary: Hantavirus pulmonary syndrome continues to occur sporadically in Texas. The
clinical presentation has not changed since 1993, but outcomes appear to be improving. Public
health efforts need to focus on public education to reduce the risk of exposure.

References

Duchin JS, Koster FT, Peters CJ, et al. Hantavirus pulmonary

syndrome: a clinical description of 17 patients with a newly

recognized disease. The Hantavirus Study Group. N Engl J

Med 1994;330:949–55.

Khan AS, Khabbaz RF, Armstrong LR, et al. Hantavirus

pulmonary syndrome: the first 100 US cases. J Infectious

dDisease 1996;173:1297–303.

Rivers MN, Alexander JL, Rohde RE, Pierce JR. Hantavirus

pulmonary syndrome in Texas: 1993-2006. South Med J

;102:36–41.

de St. Maurice A, Ervin E, et al. Exposure chracteristics of

Hantavirus pulmonary syndrome patients, United States,

-2015. Emerg Infect Dis 2017;733–739.

Calisher CH, Mills JN, Root JJ, Doty JB, Beaty BJ. The relative

abundance of deer mice with antibody to Sin Nombre

virus corresponds to the occurrence of hantavirus pulmonary

syndrome in nearby humans. Vector Borne Zoonotic

Dis 2011;11:577–82.

Brocato RL, Hammerbeck CD, Bell TM, Wells JB, Queen

LA, Hooper JW. A lethal disease model for hantavirus

pulmonary syndrome in immunosuppressed Syrian hamsters

infected with Sin Nombre virus. J Virol 2014;88:

–9.

Safronetz D, Prescott J, Feldmann F, et al. Pathophysiology

of hantavirus pulmonary syndrome in rhesus macaques.

Proc Natl Acad Sci U S A 2014;111:7114–9.

Safronetz D, Falzarano D, Scott DP, Furuta Y, Feldmann

H, Gowen BB. Antiviral efficacy of favipiravir against

two prominent etiological agents of hantavirus pulmonary

syndrome. Antimicrob Agents Chemother 2013;57:

–80.

Haese N, Brocato RL, Henderson T, et al. Antiviral Biologic

Produced in DNA Vaccine/Goose Platform Protects

Hamsters Against Hantavirus Pulmonary Syndrome When

Administered Post-exposure. PLoS Negl Trop Dis 2015;

:e0003803.

Calisher CH, Sweeney W, Mills JN, Beaty BJ. Natural history

of Sin Nombre virus in western Colorado. Emerg Infect

Dis 1999;5:126–34.

Published
2018-01-19
How to Cite
Nugent, K., & Alexander, J. (2018). Hantavirus pulmonary syndrome in Texas: An update covering years 1993 through 2016. The Southwest Respiratory and Critical Care Chronicles, 6(22), 16-20. https://doi.org/10.12746/swrccc.v6i22.436