On Tuesday, China’s national English language newspaper, Global Times, reported that a person from Yunnan Province died while on his way back to Shandong Province for work on a chartered bus on Monday, March 23, after he tested positive for Hantavirus.

“Other 32 people on [the] bus were tested,” said Global Times on Twitter.

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The tweet by the newspaper at 4:12am on Tuesday East Africa Time, received over 7, 000 retweets, with many users wondering whether Hantavirus could be another disease that has devastating effects similar to that of the now-dreaded coronavirus.

The information shared in this article is courtesy of the European Centre for Disease Prevention and Control:

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Name and nature of infecting organism

Hantaviruses are rodent-borne viruses causing clinical illness in humans of varying severity.

Rodents are gnawing mammals of an order that includes rats, mice, squirrels, hamsters, porcupines, and their relatives, distinguished by strong constantly growing incisors and no canine teeth. They constitute the largest order of mammals.

There are several different Hantaviruses, with a different geographical distribution and causing different clinical diseases. Each Hantavirus is specific to a different rodent host. Transmission of the virus to humans occurs through the inhalation of infected rodent urine, droppings, or saliva.

There is no curative treatment for Hantavirus infection, and eliminating or minimising contact with rodents is the best way to prevent infection.

Clinical features

Clinical illness results in haemorrhagic fever with renal syndrome and causes less than 0.5% mortality.

Overall, three syndromes are caused by Hantaviruses:

(1) Haemorrhagic fever with renal syndrome (HFRS), mainly in Europe and Asia;

(2) Nephropathia epidemica (NE), a mild form of HFRS, caused by Puumala Hantavirus, and occurring in Europe;

(3) Hantavirus cardiopulmonary syndrome (HCPS), in the Americas.

The clinical features in patients with Hantavirus disease are quite variable, from asymptomatic to severe. The incubation period is relatively long, mostly 2 to 3 weeks, but may be up to six weeks. In endemic areas Hantavirus infection should be suspected if acute fever is accompanied by low blood platelet count, headache, often very severe, and abdominal and back pains without clear respiratory tract symptoms.

The fatality rate ranges between less than 0.1 and 0.4%. Recovery usually begins during the second week of illness and is accompanied by improvement of urinary output. Full recovery may, however, take weeks. Longer-lasting complications are rare, and include inflammation of kidney parts, your body’s immune system attacking your nerves, hypopituitarism, and hypertension.

Transmission

Rodents like the yellow-necked mouse are the reservoir for Hantaviruses. Carrier rodents often invade the human settlements thus increasing risk. During rodent peak years, a high proportion of rodents can be seropositive. After being infected, the rodents start to shed the virus after 5 to 6 days, and the excretion continues for about two months.

Transmission mode

The rodents excrete Hantaviruses in the urine, faeces and saliva, and human infection takes place mostly via inhalation of virus-contaminated rodent excretion. Therefore rodent-infested dusty places are risk sites. No human–to-human transmission is known for European Hantaviruses.

Risk groups

Occupations such as forestry workers and farmers have an increased risk of exposure.

Prevention measures

Avoidance of virus-contaminated dust during work or leisure time is of prime importance; for people with underlying disease, face masks could be used. Creation of air-borne dust should be avoided when areas containing rodent droppings are cleaned, and moist cleaning with disinfectants is recommended. Wild rodents taken into homes as pets or to laboratories for research purposes have caused infections.

Since the virus remains infective outside the host for an unexpectedly long period (for two weeks at room temperature), the risk of infection can persist after rodents have been removed.

The diagnosis of Hantavirus disease mainly relies on the detection of antibodies, through immuno-fluorescent assays (IFA) or Enzyme Immuno Assays (EIA).

Management and treatment

The treatment of Hantavirus disease is mainly symptomatic.

Maintaining the fluid balance, while avoiding over-hydration in a potentially oliguric patient (a patient with reduced urine excretion) is of critical importance. In case of renal insufficiency, dialysis may be required. Because European Hantaviruses do not spread from human to human, no isolation is needed.

Ribavirin is the only drug used in severe Hantavirus infections in Europe. There is currently no vaccine available.

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