HANTA VIRUSHANTA VIRUSInfectionsInfections

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Hanta VirusesHanta Viruses

Hanta virus belong to Hanta virus belong to family - Bunyaviridaefamily - Bunyaviridae

Found GloballyFound Globally

Causes serious diseases, Causes serious diseases, can be fatalcan be fatal

It is estimated there are It is estimated there are 100,000 to 200,000 100,000 to 200,000 infections occur infections occur worldwide.worldwide.

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Hanta Virus diseasesHanta Virus diseases

Hantavirus infections are caused by a Hantavirus infections are caused by a group of viruses known as hantaviruses. group of viruses known as hantaviruses. These viruses cause two serious illnesses These viruses cause two serious illnesses in humans. They are hemorrhagic in humans. They are hemorrhagic (pronounced heh-meh-RA-jik) fever with (pronounced heh-meh-RA-jik) fever with renal syndrome (HFRS) and hantavirus renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). pulmonary syndrome (HPS).

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Hanta virusHanta virus

Source of Hanta Virus InfectionsSource of Hanta Virus Infections

There are several distinct There are several distinct Hanta viruses, each Hanta viruses, each

associated with specific associated with specific Rodent HostRodent Host

The Infection in Rodents The Infection in Rodents are life long without are life long without deleterious effects. deleterious effects.

Humans get infected by Humans get infected by inhaling aerosols of inhaling aerosols of

Rodent excreta.Rodent excreta. ( Urine, Feces, Saliva )( Urine, Feces, Saliva )

Spread of Hanta Virus Spread of Hanta Virus InfectionsInfections

Breeding of Rodents Breeding of Rodents have relation to spread have relation to spread

of Infectionof Infection

Diseases produced by Diseases produced by Hanta virus InfectionsHanta virus Infections

1 Hemorrhagic fever with Renal Syndrome 1 Hemorrhagic fever with Renal Syndrome ( HFR )( HFR )

2 Hanta virus pulmonary Syndrome ( HPS )2 Hanta virus pulmonary Syndrome ( HPS ) Infection with Hanta virus is associated Infection with Hanta virus is associated

with Geographic distribution of Rodents with Geographic distribution of Rodents and nature of the Virus.and nature of the Virus.

Hemorrhagic Fever with Renal Hemorrhagic Fever with Renal SyndromeSyndrome

The virus were first isolated in The virus were first isolated in 1976 in Korea from a Rodent 1976 in Korea from a Rodent Apodemus AgrarisApodemus AgrarisUrban Rats are to be Urban Rats are to be persistently infected with persistently infected with Hanta virusHanta virusRats migrate on trading ships Rats migrate on trading ships and disperse the virus world and disperse the virus world widewideHanta virus infection has Hanta virus infection has occurred in persons whose occurred in persons whose occupations place them in occupations place them in contact with Ratscontact with Rats

Hemorrhagic Fever – Renal Hemorrhagic Fever – Renal syndromesyndrome

Acute Hanta viral infection causes a Acute Hanta viral infection causes a Interstitial nephritisInterstitial nephritisLead to acute renal insufficiency and renal Lead to acute renal insufficiency and renal failure in severe formfailure in severe formGeneralized hemorrhage and shock may Generalized hemorrhage and shock may occur with case fatalities upto 5 – 15 %occur with case fatalities upto 5 – 15 %

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MangementMangement

Hemorrhagic fever, and Hemorrhagic fever, and renal failure are managed renal failure are managed with supportive treatment.with supportive treatment.

Rodent controlRodent control

Protection from exposure Protection from exposure to rodent droppings and to rodent droppings and contaminated material.contaminated material.

Hanta virus – Pulmonary Hanta virus – Pulmonary syndromesyndrome

Caused by novel Hanta virus Caused by novel Hanta virus ( Sin Nombre virus )( Sin Nombre virus )First case was reported from North First case was reported from North

AmericaAmericaPrimarily an Primarily an adult respiratory adult respiratory

disease syndromedisease syndromeThe deer mouse ( Peromyscus The deer mouse ( Peromyscus

maniculats) is the primary rodent maniculats) is the primary rodent for Sin Nombre virusfor Sin Nombre virus

10 % of the deer mouse are infected.10 % of the deer mouse are infected.Other viruses resembling novel Other viruses resembling novel

Hantavirus can cause Hanta viral Hantavirus can cause Hanta viral pulmonary syndromepulmonary syndrome

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Other viruses causing HPSOther viruses causing HPS

New York virusNew York virus

Black Creek canal Black Creek canal virusvirus

Bayou virusBayou virus

and each type of virus and each type of virus has a different Rodent has a different Rodent hosthost

Clinical ManifestationsClinical ManifestationsInfections and subclinical infections are not common.Infections and subclinical infections are not common.Hantavirus pulmonary syndrome is generally severe with Hantavirus pulmonary syndrome is generally severe with reported mortality rate of > 30 % or greater.reported mortality rate of > 30 % or greater.Present withPresent with

Fever, Headache,MyalgiaFever, Headache,Myalgia Prolonged pulmonary edemaProlonged pulmonary edema Leading to respiratory compromiseLeading to respiratory compromise No signs of hemorrhageNo signs of hemorrhage Dr.T.V.Rao MDDr.T.V.Rao MD

PathogenesisPathogenesis

Hanta viral antigens are found in Hanta viral antigens are found in endothelial cells.endothelial cells.

In macrophages in lung, heart, In macrophages in lung, heart, Spleen,LymphnodesSpleen,Lymphnodes

Leads to functional impairment of vascular Leads to functional impairment of vascular endotheliumendothelium

Person to person transmission is rarePerson to person transmission is rare

Laboratory DiagnosisLaboratory Diagnosis

Detection of antigens by immuno Detection of antigens by immuno histochemistry,histochemistry,RT – PCR for viral antigen detectionRT – PCR for viral antigen detectionSpecific antibodies by recombinant Specific antibodies by recombinant proteinsproteinsA four fold rise of IgM antibody titer A four fold rise of IgM antibody titer between acute and convalescent serum is between acute and convalescent serum is diagnosticdiagnostic

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ManagementManagement

Maintenance of adequate Maintenance of adequate OO22

Supporting homodynamic Supporting homodynamic functioningfunctioning

Antiviral drug Ribavirin is Antiviral drug Ribavirin is some benefitsome benefit

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Control and PreventionControl and Prevention

Rodent controlRodent controlAvoiding control of Avoiding control of Rodents and Rodent Rodents and Rodent droppingsdroppingsCare must be taken to Care must be taken to avoid inhaling aerolized avoid inhaling aerolized dried excreta when dried excreta when cleaning Rodent infected cleaning Rodent infected structures.structures.

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