Presentation
In the Southeast region, the cases were 60% less likely to present with thrombocytopenia or reside in rural areas compared to those who progressed to a cure. [ncbi.nlm.nih.gov]
The study was conducted with secondary data and is presented in a collective manner. [scielo.br]
The first stage that presents severe symptoms is the proteinuric stage. Nausea, vomiting, acute shock, and hypotension may occur in this stage. [microbewiki.kenyon.edu]
Synonym(s): Hantavirosis Hantavirus fever Prevalence: 1-5 / 10 000 Inheritance: - Age of onset: All ages ICD-10: A98.5 N08.0* OMIM: - UMLS: C0019101 C2930957 MeSH: C535630 D006480 GARD: - MedDRA: 10023484 The documents contained in this web site are presented [orpha.net]
The largest number of patients ( n 7) presented in 1997. Three patients each presented in the years 1994 and 1998. The most common months of presentation were June (six patients) and October (five patients). [ajronline.org]
Entire Body System
-
Fatigue
If the individual is experiencing fever, fatigue, and shortness of breath and has a history of potential rural rodent exposure, it would be strongly suggestive of HPS. [vdh.virginia.gov]
The symptoms of HCPS are characterised by fever, fatigue, muscle ache, headaches, nausea, vomiting and non-cardiogenic pulmonary oedema. HCPS can be fatal in 38% of reported cases. [thenativeantigencompany.com]
Early symptoms of HPS include Fatigue Fever Muscle aches, especially in the thighs, hips and back Headaches Chills Dizziness Nausea, vomiting, diarrhea or abdominal pain Later symptoms include coughing and shortness of breath. [medlineplus.gov]
Early symptoms Early symptoms include fatigue, fever and muscle aches, especially in the large muscle groups-thighs, hips, back, and sometimes shoulders. These symptoms are universal. [broomfield.org]
Hantavirus Symptoms Comparable to symptoms of the influenza virus, those infected by hantavirus experience chills, fatigue, fever, and muscle aches (notably in hips, thighs, and back) during the onset. [echealthinsurance.com]
-
High Fever
fever, malaise, headache, myalgia, arthralgia, backache, abdominal pain, oliguria/renal failure and systemic hemorrhagic manifestations. [orpha.net]
Typical symptoms include high fever, muscle aches, cough, and headache. There is a potential for severe illness, however, many cases can be mild and never identified. After several days, respiratory problems worsen rapidly. [ct.gov]
Typical symptoms include high fever, muscle aches, cough, and headache. After several days, severe respiratory distress develops. The lungs may fill with fluid and victims may die of respiratory failure and shock. [www1.nyc.gov]
These symptoms are high fever, muscle aches, cough, and headache. After a few days these symptoms quickly worsen. The lungs fill with fluid, which leads to severe respiratory problems. Most symptoms develop within two weeks of being exposed. [mass.gov]
In others, vague symptoms (such as a high fever, muscle aches, headache, and nausea) begin suddenly. People with mild symptoms recover completely. In others, symptoms become severe. Very low blood pressure ( shock ) develops in a few people. [msdmanuals.com]
-
Hypoxemia
Hypotensive phase This occurs when the blood platelet levels drop and symptoms can lead to tachycardia and hypoxemia. This phase can last for 2 days. [en.wikipedia.org]
The most severe symptoms, which begin on approximately the seventh day after the prodromic stage (early disease), primarily consist of a dry cough, tachycardia, tachydyspnea, hypoxemia, noncardiogenic pulmonary edema, hypotension and circulatory collapse [scielo.br]
-
Disability
"While I look okay today, the overwhelming fatigue and other aftereffects of HPS cause me to be disabled," Winter wrote in an email to ABCNews.com. [abcnews.go.com]
-
Severe Pain
Signs of hantavirus include: Fever and chills Muscle aches - including severe pain in the legs and back Headaches and dizziness Feeling very tired or fatigued Difficulty breathing Stomach issues, including nausea, vomiting, diarrhea and stomach pain Hantavirus [denverpublichealth.org]
Respiratoric
-
Pleural Effusion
Seventy-five percent (15/20) of the patients had small bilateral pleural effusions. One patient had a small right-sided pleural effusion, and three patients had no pleural effusion. [ajronline.org]
Chest x-ray may show increased vascular markings, Kerley B lines, bilateral infiltrates, or pleural effusions. If HPS is suspected, echocardiography should be done to exclude cardiogenic pulmonary edema. [merckmanuals.com]
In the South, death was significantly associated with clinical manifestations related to HCPS, hypovolemic shock, respiratory and cardiac failure, dyspnea, hypotension, pleural effusion, hematocrit greater than 45%, pulmonary infiltrates and the use of [scielo.br]
Pleural effusion is seen in the late phase. The heart size is normal. ECG helps rule out myocardial infarction. Sinus tachycardia is common. Death usually occurs with pulseless electrical activity (electro-mechanical dissociation). [patient.info]
Bilateral infiltrates develop rapidly, sometimes associated with pleural effusions. Neutrophilic leukocytosis, hemoconcentration, thrombocytopenia, and circulating immunoblasts are observed. [jasn.asnjournals.org]
-
Tachypnea
A cough and tachypnea develop before pulmonary edema and signs of hypoxia. Cardiac abnormalities might present such as myocardial depression, and after that the illness usually gets worse. Hospitalization may be required along with ventilation. [microbewiki.kenyon.edu]
Typical findings on initial presentation include fever, tachypnea and tachycardia. The physical examination is usually otherwise normal. [ehso.com]
[…] tests for identification can be identified by serological tests and PCR [4] Signs and symptoms of disease Early symptoms include fatigue, fever, muscle aches, headaches, chills, dizziness, nausea, vomiting, diarrhea or abdominal pain, tachycardia, tachypnea [austincc.edu]
Typical findings on initial presentation include fever, tachypnea and tachycardia, with usually a normal physical exam. [ncbi.nlm.nih.gov]
Gastrointestinal
-
Nausea
Initial symptoms begin suddenly and include intense headaches, back and abdominal pain, fever, chills, nausea, and blurred vision. Individuals may have flushing of the face, inflammation or redness of the eyes, or a rash. [en.wikipedia.org]
Nausea, vomiting, acute shock, and hypotension may occur in this stage. The following stage is the oliguric, and kidney function improves in the stage that follows, the diuretic stage. [microbewiki.kenyon.edu]
They can include: intense headaches back and stomach pain fever chills nausea blurred vision Additional symptoms may include: flushed face inflamed or red eyes rash low blood pressure Serious cases may result in internal bleeding. [canada.ca]
Early symptoms of both HRFS and HPS include fever, chills, headaches, nausea, abdominal pain, and muscle soreness. [arupconsult.com]
Hemorrhagic Fever with Renal Syndrome Early Symptoms Intense headache Back and abdominal pain Fever and chills Nausea Blurred vision Flushed face Redness of the eyes Rash Late Symptoms Low blood pressure Acute shock Acute kidney failure Vascular leakage [dhs.wisconsin.gov]
-
Abdominal Pain
pain, oliguria/renal failure and systemic hemorrhagic manifestations. [orpha.net]
Initial symptoms begin suddenly and include intense headaches, back and abdominal pain, fever, chills, nausea, and blurred vision. Individuals may have flushing of the face, inflammation or redness of the eyes, or a rash. [en.wikipedia.org]
The second phase lasts 2 to 8 days and includes rapid development of fever, dry cough, body aches, headaches, diarrhea, and abdominal pain. Heart and lung failure can develop during this phase. [lung.org]
Infected persons experience fever, intense headaches, back and abdominal pain, chills, nausea, blurred vision, red eyes, or a rash. The disease may progress into uncontrolled bleeding, kidney failure, and shock. [iamat.org]
Symptoms include abrupt onset of fever, chills, weakness, nausea, vomiting, and abdominal pain followed by difficulty breathing. HPS can be rapidly fatal if not identified and treated promptly. [foundation.chestnet.org]
-
Melena
The hemorrhagic part of the disease name comes from petechiae, hematuria, and melena that may develop in more severe cases. [microbewiki.kenyon.edu]
Any period of extreme bradycardia, pulseless electric activity Active GI bleeding, with hematemesis, melena or hematochezia or documented by upper or lower endoscopy or by gastric aspiration. [clinicaltrials.gov]
-
Hematemesis
Any period of extreme bradycardia, pulseless electric activity Active GI bleeding, with hematemesis, melena or hematochezia or documented by upper or lower endoscopy or by gastric aspiration. [clinicaltrials.gov]
Cardiovascular
-
Tachycardia
Hypotensive phase This occurs when the blood platelet levels drop and symptoms can lead to tachycardia and hypoxemia. This phase can last for 2 days. [en.wikipedia.org]
[2] Key tests for identification can be identified by serological tests and PCR [4] Signs and symptoms of disease Early symptoms include fatigue, fever, muscle aches, headaches, chills, dizziness, nausea, vomiting, diarrhea or abdominal pain, tachycardia [austincc.edu]
Comparator: Placebo Placebo Drug: Placebo Placebo Primary Outcome Measures : The Proportion of Subjects Who Develop Death, PaO2/FiO2 Ratio Less Than or Equal to 55, Cardiac Index Less Than or Equal to 2.2, Pulseless Electrical Activity, Ventricular Tachycardia [clinicaltrials.gov]
Typical findings on initial presentation include fever, tachypnea and tachycardia. The physical examination is usually otherwise normal. [ehso.com]
Sinus tachycardia is common. Death usually occurs with pulseless electrical activity (electro-mechanical dissociation). [patient.info]
-
Hypertension
Longer-lasting complications are rare, and include glomerulonephritis, Guillain-Barré syndrome, hypopituitarism, and hypertension. [ecdc.europa.eu]
Midwest, compared to the controls, the cases were more likely to present with HCPS rather than the prodromic form; to have been hospitalized; and to have presented with signs and symptoms of dyspnea, acute respiratory failure, heart failure, arterial hypertension [scielo.br]
There is oliguria, hypertension, bleeding tendency, uraemia and oedema. Urea and serum creatinine rise. Patients may develop pulmonary oedema. The diuretic stage lasts 2-3 weeks. Diuresis of 3-6 L daily. [patient.info]
Sequelae are rare but include chronic renal failure and hypertension. [jasn.asnjournals.org]
-
Chest Pain
If you or someone in your care has chest pains, difficulty breathing, or severe bleeding, it could be a life-threatening emergency. Call 9-1-1 or the local emergency number immediately. [healthlinkbc.ca]
HPS Clinical Presentation Most Frequent Frequent Other fever headaches shortness of breath chills nausea, vomiting dizziness myalgias abdominal pain arthralgia diarrhea back or chest pain cough sweats malaise The diagnosis is seldom made at this stage [ehso.com]
Late symptoms of HPS symptoms occur about four to 10 days after the early symptoms and include coughing, chest pain, and shortness of breath that can become severe. [medicinenet.com]
10(100) Cough 9(90) Nausea or vomiting 9(90) Chills 3(30) Diarrhea 4(40) Shortness of breath 8(80) Dizziness or lightheadedness 3(30) Back pain 5(50) Abdominal pain 5(50) Chest pain 3(30) Sore throat 4(40) Table 6 Clinical findings at the time of admission [ncbi.nlm.nih.gov]
Liver, Gall & Pancreas
-
Liver Dysfunction
HFRS should be suspected in patients with acute febrile flu-like illness, kidney failure of unknown origin and sometimes liver dysfunction. [6] Treatment [ edit ] There is no cure or vaccine for HFRS. [en.wikipedia.org]
Skin
-
Petechiae
The hemorrhagic part of the disease name comes from petechiae, hematuria, and melena that may develop in more severe cases. [microbewiki.kenyon.edu]
Tiny pinpoint hemorrhages, called petechiae, may appear on the upper body and the soft palate in the mouth. The patient's face, chest, abdomen, and back often appear flushed and red, as if sunburned. [medical-dictionary.thefreedictionary.com]
Signs that make a diagnosis of HPS unlikely include rashes, conjunctival or other hemorrhages, throat or conjunctival erythema, petechiae, and peripheral or periorbital edema. [ehso.com]
Bleeding is usually confined to petechiae, and significant haemorrhage only occurs in 10% of cases. Death occurs in 5-10% of cases and usually result from shock and renal failure. [virology-online.com]
Petechiae may occur in the axilla and the soft palate. Subconjunctival haemorrhage is present in one third. Bradycardia may be noted. There is thrombocytopenia, which relates to prognosis and severity of renal failure. [patient.info]
Musculoskeletal
-
Arthralgia
[…] disease Hemorrhagic fever-renal syndrome Disease definition Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne potentially severe hemorrhagic disease caused by Old World Hantaviruses characterized by high fever, malaise, headache, myalgia, arthralgia [orpha.net]
Malaise, diarrhea, and lightheadedness are reported by approximately half of all patients, with less frequent reports of arthralgias, back pain, and abdominal pain. [ehso.com]
A 30-yr-old man was admitted to hospital with a 5-d history of flu-like symptoms: Headache, shivers, nausea, vomiting, backache, arthralgias, myalgias, and blurred vision. [jasn.asnjournals.org]
Eyes
-
Visual Impairment
General symptoms of HFRS include: fever, chills, prostration, headache, backache, nausea, vomiting and abdominal pain, rash, and possibly a type of temporary visual impairment. All these symptoms may not show through in each person afflicted. [microbewiki.kenyon.edu]
Urogenital
-
Kidney Failure
"[Acute kidney failure caused by Hantaviruses]". Ther Umsch. 51 (12): 824–31. PMID 7784996. Peters, C.J. (2006). "Emerging Infections: Lessons from the Viral Hemorrhagic Fevers". [en.wikipedia.org]
Possible Complications Complications of hantavirus may include: Kidney failure Heart and lung failure These complications can lead to death. Prevention Avoid exposure to rodent urine and droppings. Drink disinfected water. [account.allinahealth.org]
Complications of hantavirus may include: Kidney failure Heart and lung failure These complications can lead to death. [medlineplus.gov]
Death is most common in the oliguric stage, and some severe cases result in kidney failure. The hemorrhagic part of the disease name comes from petechiae, hematuria, and melena that may develop in more severe cases. [microbewiki.kenyon.edu]
Possible Complications Complications of hantavirus may include: Kidney failure Heart and lung failure These complications can lead to death. [ufhealth.org]
-
Oliguria
Disease definition Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne potentially severe hemorrhagic disease caused by Old World Hantaviruses characterized by high fever, malaise, headache, myalgia, arthralgia, backache, abdominal pain, oliguria [orpha.net]
Acute renal failure with oliguria caused by HFRS often lasts for several days before spontaneously resolving. [5] All known New World hantaviruses pathogenic to humans, including SNV and Andes virus, cause HPS, in which the primary organ affected is the [medscape.com]
There is oliguria, hypertension, bleeding tendency, uraemia and oedema. Urea and serum creatinine rise. Patients may develop pulmonary oedema. The diuretic stage lasts 2-3 weeks. Diuresis of 3-6 L daily. [patient.info]
The hemorrhages are accompanied by oliguria, azotemia, proteinuria, and hematuria. Within 3 d, the rash disappears and the patients develop polyuria. The convalescent phase extends over several weeks, and sequelae are rare. [jasn.asnjournals.org]
-
Hematuria
The hemorrhagic part of the disease name comes from petechiae, hematuria, and melena that may develop in more severe cases. [microbewiki.kenyon.edu]
Proteinuria, hematuria, and pyuria may develop; renal failure may occur. Hemorrhagic fever with renal syndrome is suspected in patients with possible exposure if they have fever, a bleeding tendency, and renal failure. [merckmanuals.com]
The urinary sediment reveals hematuria and atypical gross proteinuria (in some cases 3 g/24 h). The hypotensive phase ranges 3 to 6 d after onset of fever. Shock or hypotension may occur. [jasn.asnjournals.org]
-
Flank Pain
In the Midwest region, the cases were 60% less likely to present with flank pain, and the time between the beginning of symptoms and death was shorter than the time between the beginning of symptoms and a cure. [ncbi.nlm.nih.gov]
However, the patients who died were 60% less likely to have presented with flank pain compared to those who were cured. [scielo.br]
Neurologic
-
Headache
Search for a rare disease Hemorrhagic fever-renal syndrome Disease definition Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne potentially severe hemorrhagic disease caused by Old World Hantaviruses characterized by high fever, malaise, headache [orpha.net]
Initial symptoms begin suddenly and include intense headaches, back and abdominal pain, fever, chills, nausea, and blurred vision. Individuals may have flushing of the face, inflammation or redness of the eyes, or a rash. [en.wikipedia.org]
Fever, headache myalgia, chills, dizziness, vomiting, and other symptoms are common for the initial phase, which lasts for 3 to 5 days. The illness takes a severe turn when hypotension and respiratory distress appear suddenly. [microbewiki.kenyon.edu]
The second phase lasts 2 to 8 days and includes rapid development of fever, dry cough, body aches, headaches, diarrhea, and abdominal pain. Heart and lung failure can develop during this phase. [lung.org]
They can include: intense headaches back and stomach pain fever chills nausea blurred vision Additional symptoms may include: flushed face inflamed or red eyes rash low blood pressure Serious cases may result in internal bleeding. [canada.ca]
Workup
X-Ray
-
Pulmonary Infiltrate
In the multivariate analysis, flank pain, diffuse pulmonary infiltrates and the use of vasoactive drugs were associated with death. [scielo.br]
infiltrates and respiratory compromise requiring supplemental oxygen. [ehso.com]
infiltrates on chest X-ray. [clinicaltrials.gov]
Eleven of twelve patients (ninety two percent) who underwent chest radiography and arterial measurement of oxygen saturation at the time of admission had either pulmonary infiltrates or arterial oxygen saturation under 90 mm Hg. [ncbi.nlm.nih.gov]
Pleura
-
Pleural Effusion
Seventy-five percent (15/20) of the patients had small bilateral pleural effusions. One patient had a small right-sided pleural effusion, and three patients had no pleural effusion. [ajronline.org]
Chest x-ray may show increased vascular markings, Kerley B lines, bilateral infiltrates, or pleural effusions. If HPS is suspected, echocardiography should be done to exclude cardiogenic pulmonary edema. [merckmanuals.com]
In the South, death was significantly associated with clinical manifestations related to HCPS, hypovolemic shock, respiratory and cardiac failure, dyspnea, hypotension, pleural effusion, hematocrit greater than 45%, pulmonary infiltrates and the use of [scielo.br]
Pleural effusion is seen in the late phase. The heart size is normal. ECG helps rule out myocardial infarction. Sinus tachycardia is common. Death usually occurs with pulseless electrical activity (electro-mechanical dissociation). [patient.info]
Bilateral infiltrates develop rapidly, sometimes associated with pleural effusions. Neutrophilic leukocytosis, hemoconcentration, thrombocytopenia, and circulating immunoblasts are observed. [jasn.asnjournals.org]
Treatment
Treatment involves supportive therapy including renal dialysis. [en.wikipedia.org]
Because of the nonspecific signs and symptoms associated with hantavirosis, which are easily confused with other diseases, appropriate supportive treatment (there is no specific treatment) is necessary to control the lethality rate of hantavirosis 13. [scielo.br]
Treatment There is not a specific treatment that kills the infecting virus for either HPS or HFRS. Supportive therapy is the main course of action when a patient is in the hospital. [microbewiki.kenyon.edu]
The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment. [orpha.net]
Treatment Treatment of hantavirus infections is primarily supportive, because there are no agents available to kill the viruses and interrupt the infection. Broad-spectrum antibiotics are given until the diagnosis is confirmed. [medical-dictionary.thefreedictionary.com]
Prognosis
[…] cause the skin to turn a blue color The following tests may be done: Blood tests to check for signs of hantavirus Complete blood count ( CBC ) Complete metabolic panel Kidney and liver function tests X-ray of the chest CT scan of the chest Outlook (Prognosis [account.allinahealth.org]
Thrombocytopenia relates to prognosis. Falling haematocrit, coagulopathy, falling fibrinogen, and electrolyte imbalances may all be present. Confirmation of diagnosis is by serological testing (eg, for virus-specific IgM) and/or RT-PCR. [patient.info]
There are limited treatment options for HPS, and both the CDC and Mayo Clinic state that because of this, the earlier the victim receives medical attention the better the long term prognosis. [grainger.com]
What is the prognosis of hantavirus pulmonary syndrome? The prognosis of HPS is fair to poor because currently, about 62% of patients recover, while about 38% will die. [medicinenet.com]
Treatments include: Oxygen Breathing tube or breathing machine in severe cases Special machines to add oxygen to the blood Other supportive care to treat symptoms Outlook (Prognosis) Hantavirus is a serious infection that gets worse quickly. [ufhealth.org]
Etiology
Before than, hantaviruses were known as the etiologic agents of hemorrhagic fever with renal syndrome, a disease that occurs almost entirely in the Eastern Hemisphere. [ncbi.nlm.nih.gov]
Isolation of Hantaan virus, the etiologic agent of Korean hemorrhagic fever, from wild urban rats. 1982 Nov;146(5):638-44 3 CDC. Tracking a Mystery Disease: The Detailed Story of Hantavirus Pulmonary Syndrome (HPS). Hantavirus. [microbewiki.kenyon.edu]
Sin Nombre orthohantavirus ( SNV ) (from the Spanish meaning "the nameless virus") is the prototypical etiologic agent of hantavirus cardiopulmonary syndrome (HCPS). [1] Because it was discovered near in Canyon del Muerte on the Navajo Reservation, it [en.wikipedia.org]
The infection of Hantavirus is called hemorrhagic fever with renal syndrome (HFRS) relating with high mortality, and several other Hantaviruses are associated with the etiologic agents causing Hantavirus pulmonary syndrome (HPS) or Hantavirus cardiopulmonary [prospecbio.com]
Epidemiology
According to the Epidemiological Surveillance Guide, during the first week of illness, laboratory confirmed cases of hantavirus present with fever ( 38 C), myalgia, cephalgia and respiratory failure of unknown etiology. [scielo.br]
Avoid direct contact with rodent droppings and wear a mask to avoid inhalation of aerosolized rodent secretions. [8] Epidemiology [ edit ] HFRS is primarily a Eurasian disease, whereas HPS appears to be confined to the Americas. [en.wikipedia.org]
Epidemiology Each hantavirus is specific to a different rodent host, and the epidemiology of each virus is therefore closely linked to the ecology of its host. [gov.uk]
Since the discovery of the HPS-causing hantaviruses, intense investigation of the ecology and epidemiology of hantaviruses has led to the discovery of many other novel hantaviruses. [ncbi.nlm.nih.gov]
Epidemiological Alert Hantavirus Pulmonary Syndrome (HPS). 17 October 2013. Hantavirus in the Americas: Guidelines for diagnosis, treatment, prevention and control. [who.int]
Pathophysiology
Pathophysiology The basic pathophysiological lesion of HPS, and indeed of all Hantavirus infections, is a generalized increase in capillary permeability that results from endothelial damage. [emedicine.medscape.com]
PATHOPHYSIOLOGY It is well documented that hantaviruses are not cytopathic for most cells. They replicate in macrophages and endothelial cells, entering the host cell via β 3 integrin surface molecules. [jasn.asnjournals.org]
Prevention
Prevention There is no fully effective vaccine available for either HPS or HFRS. However, preventative measures can be taken to prevent infection. Reducing contact with rodents as much as possible is the best course of action. [microbewiki.kenyon.edu]
Treatment with ribavirin in China and Korea, administered within 7 days of onset of fever, resulted in a reduced mortality as well as shortened course of illness. [7] Prevention [ edit ] Rodent control in and around the home remains the primary prevention [en.wikipedia.org]
visit CDC Hantavirus Prevention Additional resources History of Hantavirus (CDC) "Facts about HPS" Brochure (CDC) HPS Fact Sheet (CDC) Prevent HPS Brochure (CDC) Controlling Mice in and Around Structures (MT Department of Agriculture) Officials warn [dphhs.mt.gov]
Persons associated with such situations should avoid inhaling dust and otherwise follow CDC prevention recommendations. [floridahealth.gov]