Journal
SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE
Volume 42, Issue 6, Pages 822-827Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0041-1733803
Keywords
Hantavirus; cardiopulmonary syndrome; zoonosis
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Hantaviruses are lipid-enveloped RNA viruses that can cause hemorrhagic fever with renal syndrome and hantavirus cardiopulmonary syndrome. The major pathogenic mechanisms include direct injury to microvascular endothelial cells and an exaggerated host immune response. Treatment focuses on high-quality supportive care, while management and preventative strategies are still under research.
Hantaviruses are tri-segmented lipid-enveloped RNA viruses belonging to the Bunyaviridae family. Human infection corresponds to a zoonosis associated with two different clinical syndromes: hemorrhagic fever with renal syndrome that occurs in Asia and Europe and hantavirus cardiopulmonary syndrome (HCPS) that occurs in the North America, Central America and South America. The major pathogenic mechanisms in HCPS include (1) direct microvascular endothelial injury leading to increased capillary permeability and the development of noncardiogenic pulmonary edema and acute respiratory distress syndrome, and (2) exaggerated host immune response leading to secondary organ damage. The incubation period for this disease is quite long (6-39 days, median: 18 days); however, rapid progression to respiratory failure and shock can occur highlighting the importance of high index of clinical suspicion. Management revolves around high-quality supportive care. Various management and preventative strategies are currently being explored and warrant further examination to improve the overall outlook following infection with hantavirus.
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