(none)

[Ruben Donis]

----------------------------------------VIROLOGY NEWS--------------------------

FROM MORBIDITY AND MORTALITY WEEKLY REPORT (CDC)
Thanks to David Dodell and his HICnet Medical News. 
 <david at stat.com>
Date: Mon, 28 Feb 94 18:21:54 MST
From: mednews (HICNet Medical News)
To: hicnews
Subject: [MMWR] Newly Identified Hantavirus
Message-ID: <8yiHic3w165w at stat.com>

                         Emerging Infectious Diseases
                 Newly Identified Hantavirus -- Florida, 1994

     On October 22, 1993, a previously healthy 33-year-old resident of Dade
County, Florida, was hospitalized for an illness associated with hypotension,
bilateral pulmonary infiltrates, rhabdomyolysis, thrombocytopenia, and an
elevated serum creatinine level; onset of severe manifestations followed a 4-
day febrile prodrome. His azotemia rapidly resolved, but he required prolonged
ventilatory and circulatory support before discharge.
     Routine bacterial cultures were negative. A serum sample collected 11
days after onset of illness contained immunoglobulin G (IgG) antibody when
tested with Muerto Canyon virus (MCV) antigen, but no antibody could be
detected by immunoglobulin M (IgM) capture enzyme-linked immunosorbent assay
(ELISA); moreover, the IgG titer was unchanged when a serum sample obtained 6
weeks later was tested at CDC. The patient had not traveled outside of Dade
County within 6 months of onset of illness, but previously had lived in a
state where cases of hantavirus pulmonary syndrome (HPS) and MCV-infected
Peromyscus maniculatus have been confirmed (1).
     The state, district, and county health departments and CDC initiated an
investigation to fully characterize the illness and the prevalence of
hantavirus seropositivity in the local rodent population. Preliminary
serologic findings indicated the presence of hantavirus antibody in 12 (13%)
of 90 Sigmodon hispidus (cotton rat) trapped in Dade County as part of the
investigation. Hantavirus sequences were amplified by polymerase chain
reaction (PCR) from lung tissues of three cotton rats. Nucleotide sequence
analysis of amplified viral genetic material indicates that this is a
previously unrecognized hantavirus most closely related to but distinct from
both MCV (2,3) and the hantavirus identified in Louisiana (4).

Reported by: H Anapol, MD, R Greenman, MD, M Kolber, MD, Jackson Memorial
Hospital, Univ of Miami School of Medicine; ED Sfakianaki, MD, M Fernandez,
MD, M Ares, MD, W Livingstone, MPH, L Rivera, Dade County Public Health Unit,
Miami; AM Bock, AR Neasman, MS, District XI, WG Hlady, MD, RS Hopkins, MD,
State Epidemiologist, Florida Dept of Health and Rehabilitative Svcs. GE
Glass, PhD, Johns Hopkins Univ, Baltimore. Hantavirus Task Force, Special
Pathogens Br, Div of Viral and Rickettsial Diseases, National Center for
Infectious Diseases, CDC.

Editorial Note: The findings in this report indicate that evidence of
infection with a newly recognized strain of hantavirus is present in rodents
in Dade County. Although the prodrome and clinical illness in the patient in
Dade County resembled HPS, the laboratory findings were not diagnostic of an
acute hantavirus infection. Molecular studies are ongoing to determine whether
the lack of IgM ELISA reactivity at CDC potentially resulted from use of
available heterologous hantavirus antigens.
     Since the identification of the first pathogenic U.S. hantavirus in June
1993, HPS has been well characterized, its etiologic agent (MCV) isolated, its
primary rodent reservoir (P. maniculatus) identified, and specific diagnostic
assays developed (1,5). In addition, in August 1993, the sequence of a second
unique hantavirus was identified in tissues of a Louisiana resident who died
of HPS-like illness (4); however, the reservoir associated with this
hantavirus has not been determined. The results of the PCR analysis described
in this report are consistent with a third new U.S. hantavirus from a distinct
rodent reservoir, S. hispidus, with an ecologic range extending throughout the
southeastern and the southcentral United States (6).
     The pathogenicity of the new hantavirus to humans is unknown. Therefore,
residents of the southeast as well as persons residing within range of P.
maniculatus (7) should minimize exposure to rodents and their excreta (8).
Suspected cases of HPS should be reported to CDC through state health
departments (1).

References

1. CDC. Hantavirus pulmonary syndrome--United States, 1993. MMWR 1994;43:45-8.

2. Hjelle B, Jenison S, Torrez-Martinez N, et al. A novel hantavirus
associated with an outbreak of fatal respiratory disease in the southwestern
United States: evolutionary relationships to known hantaviruses. J Virol
1994;68:592-6.

3. Nichol ST, Spiropoulou CF, Morzunov S, et al. Genetic identification of a
hantavirus associated with an outbreak of acute respiratory illness. Science
1993;262:914-7.

4. CDC. Update: hantavirus disease--United States, 1993. MMWR 1993;42:612-4.

5. Feldmann H, Sanchez A, Morzunov S, et al. Utilization of autopsy RNA for
the synthesis of the nucleocapsid antigen of a newly recognized virus
associated with hantavirus pulmonary syndrome. Virus Res 1993;30:351-67.

6. Cameron GN, Spencer SR. Sigmodon hispidus. Mammalian Species 1981;158:1-9.

7. Hall RE. Peromyscus maniculatus. In: Mammals of North America. 2nd ed. New
York: Wiley, 1981;670-83.

8. CDC. Hantavirus infection--southwestern United States: interim
recommendations for risk reduction. MMWR 1993;42(no. RR-11).
==============================================================




Dr. Ruben Donis                                                 
Dept. of Veterinary and Biomedical Sciences  
202 VBS
University of Nebraska,                                                  
Lincoln, NE 68583-0905                                   
Phone: 402-472-6063                                     
FAX to 402-472-9690                                     
E-mail RDONIS at UNL.EDU