USA: current developments hantavirus
5/22/2007
GREELEY – A 30-year-old man is recovering after catching hantavirus, the second case of the potentially deadly disease this year.
The Weld County Department of Public Health and Environment announced Tuesday the man is recovering from a case of hantavirus pulmonary syndrome.
The case was confirmed by a test at the Colorado Department of Public Health and Environment laboratory on May 18.
The man was exposed to the virus in northeast Colorado sometime during April. He was treated at North Colorado Medical Center.
The first case of hantavirus in Colorado resulted in the death of a 28-year-old woman from Alamosa County earlier this month.
Hantavirus is carried by deer mice and can spread to humans when people inhale dirt and dust contaminated with a mouse's urine and/or feces.
Before cleaning out buildings and areas that have accumulations of mouse droppings, authorities say you should take these precautions:
*If there are mice occupying the building, use rodent control before cleaning the area.
*Avoid stirring up dust by watering down the area with a mixture of water and bleach.
*Open doors or windows to ventilate the building at least 30 to 60 minutes before cleaning.
*Rodent-proof buildings by plugging holes or other places where mice come in.
*Store all food, such as pet food, animal feed and bird seed in covered containers and properly dispose of garbage in sealed containers.
*Eliminate places where mice can hide, wood and junk piles, abandoned vehicles and in construction materials.
The incubation period for hantavirus varies widely, but ranges from one to six weeks, with an average of two to three weeks.
Early symptoms of hantavirus include fever, headache and muscle pain, severe abdominal, joint and lower back pain, nausea and vomiting.
For more information or questions about hantavirus, contact the CO-HELP hotline at 1-877-462-2911. Additional information and a photograph of a deer or rural mouse can be viewed at www.cdphe.state.co.us/dc/zoonosis/hanta/.
http://www.9news.com/news/local/article.aspx?storyid=70613
Published Date 26-JUN-2007
Subject PRO/AH/EDR> Hantavirus update 2007 - Americas (08): USA (CO)
HANTAVIRUS UPDATE 2007 - AMERICAS (08): USA (COLORADO)
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A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: 23 Jun 2007
From: Charles Calisher <calisher@cybersafe.net>
[Dr Calisher's comments below are in response to the previous post
(20070621.2007) that reports an increase in populations of deer mice
(_Peromyscus maniculatus_), hosts of Sin Nombre hantavirus, in New Mexico,
United States. - Mod.TY]
Although the statements by Dr Terry Yates and Mr DiMenna regarding the
current situation regarding deer mouse (_Peromyscus maniculatus_)
populations, Sin Nombre virus, and the probability of the occurrence of
hantavirus pulmonary syndrome in New Mexico are no doubt correct for New
Mexico, those statements should be recognized as being pertinent to that
state, not necessarily to the entire south western US. Weather conditions
in the western US can be quite focal, and results of either very wet or
very dry conditions can be correspondingly focal.
Since 1994, we have been trapping rodents (emphasizing deer mice) and
testing them for antibody to Sin Nombre virus, the hantavirus recognized as
the principal etiologic agent of hantavirus pulmonary syndrome in the US
and Canada. Recently, we trapped at 2 locations where, in the past, we had
captured as many as 100 deer mice in 3 days, but we captured only 7 and 2
deer mice in 2 days each at those sites. We would have expected not only
many more deer mice but at least a few infected deer mice; none was found to be infected.
Because both of these sites are so close to the border between New Mexico
and Colorado, I called Terry Yates' laboratory and was surprised to hear
that they had a quite different set of results.
Were I to try to predict this season's [2007] overall number of cases of
hantavirus pulmonary syndrome in Colorado, it would not be a high number. I
am too experienced to make such predictions however, so, for now, let us
just say "we will have to see". The State of Colorado is large, and we have
trapped only at relatively few places. Nonetheless, our results and Terry's
may be useful in demonstrating the wide variation in not only rodent
population densities but virus prevalence from place to place. Our winter
(2006-2007) in Colorado was a wet but a very cold one (we have found that
increased rodent populations occur after warm and wet winters), which may
account for at least some of the difference. For further information
regarding the basis for these statements, see:
Calisher CH, Mills JN, Sweeney W, Root JJ, Reeder SA, Jentes ES, et al.
Population dynamics of a diverse rodent assemblage in mixed grass-shrub
habitat, southeastern Colorado, 1995-2000. J Wildl Dis 2005; 41: 12-28.
Calisher CH, Root JJ, Mills JN, Rowe JE, Reeder SA, Jentes ES, et al.
Epizootiology of Sin Nombre and El Moro Canyon hantaviruses, southeastern
Colorado, 1995-2000. J Wildl Dis 2005; 41: 1-11.
These ecologic differences provide evidence for the need for continuing
studies. If we are to understand epidemiologic parameters and events
leading to human disease caused by hantaviruses, a great deal more of the
epidemiologic mosaic must be taken into consideration and accounted for.
Simply keeping track of numerators, a relatively passive approach, as so
many public health organizations do, is not useful and is no longer acceptable.
--
Charles H Calisher, PhD
Professor, Arthropod-borne and Infectious Diseases Laboratory
Department of Microbiology, Immunology and Pathology
College of Veterinary Medicine and Biomedical Sciences
Colorado State University
Ft. Collins, CO 80523
calisher@cybersafe.net
[ProMED-mail thanks Dr Calisher for reminding us that weather effects on
ecosystems, including wild hosts of pathogens, can be dramatically
different from one place to another. These changes can occur even within a
given state in the USA, so generalizations in the absence of good field
data should be made with considerable caution, particularly for small
mammal hosts with limited mobility. The point made about the need for long
term field studies in order to understand dynamics of host populations and
their endemic viruses is well taken. - Mod.TY]
http://www.promedmail.org/pls/askus/f?p=2400:1001:78987::NO::F2400_P1001_BACK_PAGE,F24 00_P1001_PUB_MAIL_ID:1000,38110
Hantavirus Disease
People who are cleaning cabins or other buildings that were closed for the winter should protect themselves against hantavirus, a disease transmitted by infected mice.
Hantavirus pulmonary syndrome (HPS) is a viral infection that causes severe lung disease. Mice carry the disease and can transmit the virus to people through bites, urine and fecal droppings. The disease is not transmitted from person to person. Symptoms of HPS usually occur two to three weeks after infection. Early symptoms commonly include fever, muscle and body aches, fatigue, headache, dizziness, chills, nausea and vomiting. The illness worsens within a short period of time to include coughing and severe shortness of breath when lungs fill with fluid.
Nine cases of HPS have been reported to the North Dakota Department of Health since 1993; the most recent was reported in December 2006. Five of the cases were fatal. Nationwide, 465 cases have been reported since 1993, of which 35 percent were fatal.
"Hantavirus infection has been associated with cleaning or occupying previously vacant cabins or other dwellings," Goplin said. "It's important to take precautions while cleaning buildings that are infested with rodents. Preventing infection is important since there is no cure for the disease."
Tips for preventing rodent infestation from occurring and properly disinfecting areas that become contaminated by rodents include:
• For severe or persistent infestations, contact a pest-control professional for rodent eradication or a building contractor for rodent exclusion (rodent proofing), or consult with the state health department by calling 800.472.2180.
• Seal all entry holes through which a rodent can enter.
• Clear clutter and tall grass away from buildings to eliminate sources of nesting materials.
• Do not sweep or vacuum areas that have evidence of rodent infestation, such as nests or fecal droppings. This action may stir up and cause the virus to become airborne.
• Wear rubber, latex, vinyl or nitrile gloves.
• Thoroughly wet contaminated areas with a detergent or bleach solution.
By Sue Vorenberg (Contact)
Wednesday, June 20, 2007
Warning to you outdoorsy New Mexicans: Please don't pet the bunnies.
Abundant rains have left the state's wild areas teeming with rodents - including rats, squirrels and rabbits - raising the threat for a host of rodent-borne disease, said Mark DiMenna, environmental health supervisor for the city.
There have been four cases of plague in the state since May, including a 3-year-old East Mountains boy who died.
There were eight in all of 2006, DiMenna said.
Plague - a bacterial disease that causes swollen and tender lymph glands, high fever and bloody sputum - is spread by infected fleas that live on rodents.
Another disease, tularemia, is rapidly moving through the growing rabbit population, killing them in droves - although it's not making a big dent in their populations, said DiMenna and Paul Ettestad, the state public health veterinarian.
"There's been a lot of rabbit die-off in our north central counties here," Ettestad said. "We've had dead rabbits in several counties, including Santa Fe and Bernalillo, and dogs and cats have tested positive in seven counties."
Tularemia, also known as rabbit fever, is a potentially fatal flulike disease in humans characterized by sudden fever, chills, headache, diarrhea, muscle aches, joint pain, dry cough and progressive weakness.
It can spread by handling an infected carcass; being bitten by an infected tick or flea; eating or drinking contaminated food or water; or breathing in the bacteria.
On the plus side, at least, it doesn't spread from person to person. And so far, there haven't been any human cases this year in New Mexico, Ettestad said.
But don't let the lack of cases fool you. Tularemia and other diseases are out there, Ettestad and DiMenna said.
In the Albuquerque area, tularemia-infected rabbits and plague-infected animals, such as rats, have been found in areas east of Tramway Boulevard and northeast of Eubank Boulevard, DiMenna said.
"We have picked up so many rabbits this year, we've lost count," DiMenna said.
Hantavirus is also starting to crop up around the state, said Terry Yates, an expert on the disease at the University of New Mexico.
"We had a case at UNM Hospital just this past weekend," Yates said. "The rodent numbers last month when we sampled were extremely high - and virtually all the deer mice we caught were pregnant."
Hantavirus is carried mainly by deer mice and a handful of other rodents. It spreads to humans through contact with infected urine, droppings and saliva.
Symptoms include fatigue, fever, muscle aches, chills, abdominal problems and eventually shortness of breath as the lungs fill with fluid.
The number of cases of the disease will likely grow in coming months and appear in a broader range of counties, Yates said.
"Plague and hantavirus are still in the moderate range, but we're seeing it in a larger geographic area," Yates said.
But next year, unless something dramatic happens with the weather, we could see the situation get much worse, Yates said.
"We think it's going to escalate substantially," Yates said. "It's likely to be a much higher risk next year."
That's true with all the rodent-borne diseases - as rodents continue to grow fat on plants brought out by the wet spring, DiMenna said.
"It's almost monsoon season, and we'll probably get even more rodents," DiMenna said. "If we don't have a prolonged drought or a very cold winter, we could have hordes of rodents out there by next spring."
But so far, it's not looking good for less moisture - or for a particularly cold winter, said Ted Sammis, state climatologist.
"The prediction is we're getting early monsoons, there's more rain than normal, and it's probably going to stay that way," Sammis said. "And winter? I can tell you that it's going to be warmer than normal. But that's nothing new."
http://www.abqtrib.com/news/2007/jun/20/university-new-mexico-experts-warning-rash-rodents/
By Ivan Moreno, Rocky Mountain News
July 17, 2007
Four people have died from the hantavirus in Colorado this year, including three this week, tying the record of fatalities from the disease set in 1993.
The three most recent victims lived in rural Custer, Costilla and Park counties, the Colorado Department of Public Health and Environment said Tuesday.
Officials would not release the ages or genders of the victims. The fourth death was in Alamosa in May.
There have been 61 documented cases of hantavirus pulmonary syndrome since the department began tracking the virus in 1993. Of those cases, 23 have been fatal.
"This is not a virus you want to get," said John Pape, an epidemiologist specializing in animal-related diseases for the CDPHE.
Hantavirus is a respiratory disease that spreads when people inhale dirt or dust that has been contaminated with urine and feces of deer mice. Pape said the virus strikes mostly in rural areas, where deer mice live.
People usually contract hantavirus after working in cabins, sheds, barns and buildings that can get infested with the deer mice, which have white bellies, brown backs, and large ears.
Symptoms, on average, begin two to three weeks after exposure and include vomiting, high fever, and flu-like body aches. Within days, the lungs fill with fluid, causing shortness of breath and difficulty breathing.
Besides the four deaths, two non-fatal cases have been documented this year, matching the number reported last year. In 2005, 11 cases were documented, with one death.
May, June and July are the peak months for people to contract the virus, but Health Department officials said the recent outbreak of fatalities is cause for concern.
"It was time to remind folks there might be an elevated risk in some of the rural areas of Colorado and time to remind people of the precautions," Pape said.
Precautions include ventilating buildings that have a large population of mice before cleaning them. Pape said a mix of one cup of bleach in a gallon of water should be used to spray down mice-infested areas and prevent stirring up dust.
No effective treatment exists for the hantavirus, so early detection and admission to a hospital is key. But Pape said the best approach is to prevent sickness by looking for the "big red flag" — a surge in the mice population at home.
"You need to take precautions at that point," he said.
Source: Colorado Department of Public Health and Environment
Protecting against hantavirus
© Rodent-proof buildings by plugging holes or other mouse entryways.
© In rural areas, conduct year-round rodent control using traps or poisons, or hire a professional exterminator.
© Keep indoor areas clean, especially kitchens. Store food in rodent-proof containers. This includes pet, livestock and bird food. Properly dispose of garbage in sealed containers.
© Store firewood at least 100 feet from the house. Keep vegetation around the house short and well trimmed.
© Open doors or windows to provide good ventilation for 30 to 60 minutes before cleaning out rooms. Avoid stirring up dust by watering down areas of mouse infestation with a mixture of bleach and water.
Symptoms
© Begins with high fever, severe body aches, a headache and vomiting. The onset of these symptoms begins from one week to six weeks after exposure.
© No respiratory symptoms initially, but within one to five days, illness quickly progresses to respiratory distress, including shortness of breath and difficulty breathing, caused by the lungs filling with fluid.
No effective treatment exists for the disease, so prevention is key.
Tell your doctor if you've been exposed to deer mice or rodent infestations. If you're infected, get to a hospital immediately.
Deer mouse description
Deer mice are brown on top and white underneath, with a very distinct separation of these colors. They have large ears. House mice, which don't carry the disease, are all gray and have small ears.
http://www.rockymountainnews.com/drmn/local/article/0,1299,DRMN_15_5633667,00.html
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