Hantavirus Pulmonary Syndrome

Hantavirus Pulmonary Syndrome (HPS) is a severe, sometimes fatal, respiratory disease in humans caused by infection with hantavirus. Anyone who comes into contact with rodents that carry hantavirus is at risk of HPS. The deer mouse is the host for Sin Nombre virus, which is the hantavirus strain that is the primary causative agent of HPS in the United States. Deer mice are common and widespread in rural areas throughout the United States. The virus is shed in the urine, droppings and saliva of infected rodents. The virus is mainly transmitted to people when they breathe in air contaminated with the virus.

Any activity that puts you in contact with rodent droppings, urine, saliva or nesting materials can place you at risk for infection. Certain activities can put you at an increased potential risk for HPS, such as opening and cleaning unused buildings (e.g., cabins or barns that have been closed during the winter); housecleaning activities; work-related exposures where individuals work in crawl spaces, under houses or in vacant buildings that have a rodent population; and camping and hiking when using infested trail shelters or camps in rodent habitats.

The North Dakota Department of Health offers the following tips for preventing rodent infestation from occurring and for properly disinfecting areas contaminated by rodents:

• For severe or persistent infestations, contact a pest-control professional for rodent eradication or a building contractor for rodent exclusion (rodent proofing).

• 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 with evidence of rodent infestation, such as nests or fecal droppings.  This action may stir up and aerosolize the viral particles.  Wear rubber latex vinyl or nitrile gloves. 

• Thoroughly wet contaminated area with disinfectant or bleach solution before wiping up with a paper towel. Soiled cleaning materials may be double bagged and discarded in the trash or disinfected before reuse.

Early symptoms of HPS include flu-like symptoms with fever, headache, muscle ache and malaise. Nausea, diarrhea and vomiting may also occur. Four to 10 days after the initial phase, the late symptoms appear including coughing and shortness of breath. HPS can be fatal. The North Dakota Department of Health Division of Laboratory Services offers hantavirus testing when other testing to rule out other potential diagnoses has been exhausted (e.g., influenza). Testing criteria include patient's that are hospitalized, acutely ill (<1-1 1/2 weeks) with a respiratory infection. Each sample is assessed on a case-by-case basis by looking at the following: (1) Does the patient have a low platelet count (97% of patients with HPS will have thrombocytopenia)?; (2) Is the patient requiring oxygen and/or intubated?; (3) Is there an accumulation of fluid seen on chest X-rays; and (4) Did the patient have a history of exposure to rodents and/or their droppings? Treatment is supportive with attention to fluids, electrolytes and blood pressure management. Additional information regarding the clinical management of HPS can be found at www.cdc.gov/hantavirus/technical/hps/treatment.html.

For more information on laboratory testing for hantavirus, please call the NDDoH Division of Laboratory Services at 701.328.6272. For more information on HPS, please call the NDDoH Division of Disease Control at 701.328.2378 or 800.472.2180 or visit www.ndhealth.gov/disease.

Copyright © 2010 North Dakota Department of Health

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