Hantavirus

What is hantavirus infection? 

Hantavirus infection is a disease caused by a virus (hantavirus) transmitted by wild rodents. These animals shed the hantavirus in their urine, feces, and saliva, which can contaminate the environment and infect people. In Brazil, the most common form of the disease mainly affects the lungs and the heart and can cause symptoms such as shortness of breath and fever. In some cases, the condition can worsen and lead to respiratory and/or systemic complications.

 

Symptoms 

The symptoms of hantavirus infection may start mildly, similar to those of a common flu. The initial signs are:

• fever: increase in body temperature, usually accompanied by chills and a feeling of malaise
• headache: constant pain that may interfere with daily activities
• body and joint pain: sensation of fatigue and pain in the muscles, arms, legs, and joints
• back and abdominal pain: discomfort or pain in the lower back and abdominal region, which may range from mild to severe
• nausea and vomiting: nausea, loss of appetite, and episodes of vomiting or stomach discomfort
  
  
  The signs of the more severe phase are:
  
   
• shortness of breath: difficulty breathing, even at rest or with little effort
• rapid breathing: increased breathing rate due to lung involvement
• dry cough: persistent cough without phlegm, accompanied by chest discomfort
• rapid heartbeat: the heart beats faster than normal, causing a sensation of palpitations
• low blood pressure: drop in blood pressure, which may cause dizziness, weakness, and fainting
  intense fatigue: strong feeling of weakness and lack of energy to perform simple activities
  
   

Transmission 

Hantavirus infection is mainly transmitted when a person comes into contact with places contaminated by feces, urine, or saliva from these animals, especially in enclosed or poorly cleaned environments. It occurs mainly in rural areas, in places where wild rodents are present, such as silos, barns, sheds, and abandoned houses where these animals are found. Transmission is generally rural with higher prevalence among males. Person-to-person transmission is uncommon, but it can occur through secretions from an infected person and through prolonged close contact.

• breathing in dust contaminated with urine, feces, or saliva from infected rodents
• touching contaminated objects or places and then bringing the hand to the eyes, nose, or mouth
• suffering a rodent bite or having contact with the virus through skin injuries

In rare situations, transmission from one person to another may occur.

 

Diagnosis 

The diagnosis of hantavirus infection is made based on the epidemiological history and complementary tests that identify the presence of the hantavirus or antibodies produced by the body, and rule out diseases that may have similar symptoms, such as leptospirosis and yellow fever. The main tests requested by a healthcare professional are:

• blood test to detect antibodies (ELISA-IgM): identifies the body’s reaction to the virus from the first symptoms. It is the most commonly used test to confirm the disease
• tissue and organ test (immunohistochemistry): looks for signs of the virus in body samples and is mostly used in specific situations
• molecular test to detect the virus (RT-PCR): identifies the genetic material of the hantavirus and helps determine the type of infection
  
   

Treatment  

In hantavirus infection, there is no specific medication to eliminate the virus. Treatment is supportive, aimed at helping breathing and maintaining body function until patient recovery. The main methods are:

• hospitalization: many patients need constant monitoring by a healthcare professional due to the rapid progression of the disease
• respiratory support: in severe situations, the use of oxygen or machines to assist breathing may be necessary
• symptom control: the professional uses medications and care to reduce fever, pain, and other symptoms
• monitoring of the heart and lungs: the healthcare team monitors organ function to prevent respiratory and circulatory complications
   
   

Prevention

Prevention of hantavirus infection mainly depends on measures to avoid contact with wild rodents and places contaminated by their urine, feces, or saliva. The main approaches are:

• keeping the environment clean: removing garbage, debris, and accumulated materials prevents rodents from approaching homes
• cutting grass and vegetation around the residence or commercial buildings: helps reduce places where rodents can hide
• storing food in closed containers: prevents rodents from accessing food
• avoiding contact with rodent feces and urine: when cleaning enclosed areas, it is important to use protective equipment such as masks, gloves, and boots, and to avoid raising contaminated dust
• keeping storage areas and sheds ventilated: enclosed and non-ventilated places increase the risk of inhaling hantavirus
   
   

References 

Ministério da Saúde 
World Health Organization

Por Conselho Editorial Einstein