Will Hantavirus cause another outbreak?
A man in China has reportedly died not from the coronavirus disease but from a different one - hantavirus.
The Global Times, an English-language Chinese newspaper, reported on March 24 that a passenger from Yunnan Province died while on a chartered bus heading to Shandong Province for work on Monday.
“He was tested positive for #hantavirus," the tweet said. “Other 32 people on the bus were tested.”
Amid a current pandemic caused by COVID-19, the news immediately caused panic and worries over a possible new outbreak.
According to the Centers for Disease Control and Prevention, hantaviruses are not as new as the novel coronavirus.
“Hantaviruses are a family of viruses spread mainly by rodents and can cause varied disease syndromes in people worldwide. Infection with any hantavirus can produce hantavirus disease in people,” CDC stated.
Humans can be infected with hantavirus from close contact with a rat's contaminated urine, feces, or saliva and less frequent instances involved a bite from an infected host.
While hantavirus can be fatal, CDC noted that person-to-person cases are rare.
New World and Old World
There are two types of hantaviruses, the New World and the Old World.
Common in America, the New World hantaviruses, may cause a severe respiratory disease called Hantavirus Pulmonary Syndrome (HPS). CDC sets the fatality rate for HPS to 38%.
The “Old World” hantaviruses, on the other hand, mostly found in Europe and Asia, may cause Hemorrhagic Fever with Renal Syndrome (HFRS). The viruses that cause HFRS include Hantaan, Dobrava, Saaremaa, Seoul, and Puumala. Depending on the virus, the mortality rate for HFRS can range from 1% to 15%.
Signs & Symptoms
For HPS cases, symptoms may develop between one to eight weeks after exposure to contaminated wastes of infected rodents.
- Early symptoms: Fatigue, fever, and muscle aches, especially in the large muscle groups--thighs, hips, back, and sometimes shoulders. There may also be headaches, dizziness, chills, and abdominal problems, such as nausea, vomiting, diarrhea, and abdominal pain.
- Late symptoms: Coughing and shortness of breath, with the sensation of, as one survivor put it, a “…tight band around my chest and a pillow over my face” as the lungs fill with fluid.
Source: Centers for Disease Control and Prevention
For HFRS cases, symptoms usually develop within one to two weeks after exposure to infectious material. CDC also noted that in rare cases, “they may take up to eight weeks to develop.”
- Early symptoms: Intense headaches, back, and abdominal pain, fever, chills, nausea, and blurred vision. Individuals may have flushing of the face, inflammation or redness of the eyes, or a rash.
- Late symptoms: Low blood pressure, acute shock, vascular leakage, and acute kidney failure, which can cause severe fluid overload.
Source: Centers for Disease Control and Prevention
Treatment
For HPS, no specific treatment, cure, or vaccine is currently available.
However, infected individuals are advised to receive medical care in an intensive care unit where they can be intubated and given oxygen therapy to help them through the period of severe respiratory distress.
“The earlier the patient is brought to intensive care, the better. If a patient is experiencing full distress, it is less likely the treatment will be effective,” CDC stated.
On the other hand, supportive therapy is the mainstay of care for patients with HFRS.
According to CDC, this includes “careful management of the fluid (hydration) and electrolyte (e.g., sodium, potassium, chloride) levels, maintenance of correct oxygen and blood pressure levels, and appropriate treatment of any secondary infections.
“Dialysis may be required to correct severe fluid overload.”
Furthermore, CDC says that an antiviral drug called the intravenous ribavirin has been shown to decrease illness and death associated with HFRS if used in the early onset of the disease.