[Hantavirus pulmonary syndrome in southern Argentina].

M E Lázaro, A J Resa, C M Barclay, L Calanni, L Samengo, L Martinez, P J Padula, N Pini, M B Lasala, B Elsner, D A Enria
Author Information
  1. M E Lázaro: Hospital Zonal Bariloche, Río Negro. melazaro@cpsarg.com

Abstract

Andes virus was identified in 1995 as the etiologic agent of Hantavirus Pulmonary Syndrome (HPS) in Southern Argentina. We describe herein the main clinical characteristics of 25 HPS confirmed cases acquired in this area between 1993 and September 1999. The mean age was 34 years (range 11-70), with 72% males. Clinical characteristics were similar to those previously reported for Sin Nombre virus (SNV) cases. However, in this group of patients we also observed conjuntival injection in 10/25 (42%), facial flushing in 8/25 (33%), pharyngeal congestion in 7/25 (29%) and petechiae in 3/25 (12%). On the other hand, BUN was increased in 83% of cases (mean 0.77 g/l range 0.31-2.01). Mean serum creatinine concentration was 26.8 mg/l (range: 8.1-110 mg/l) with serum creatinine being higher than 20 mg/l in 8/15 patients (53%). Urinalysis was abnormal in 12/12 cases and was characterized by presence of proteins, red blood cells and granular casts. Aminotransferases were increased in 90% of cases with levels 5-10 times over normal values in 50% of cases. Serum creatine kinase concentration was elevated in 11/14 cases. Two patients required hemodialysis. Case fatality rate was 44% (11/25) and 10 of these cases died among the first 10 days of illness. Mononuclear myocarditis was observed in two cases, a finding that has not been reported for SNV cases. During the 1996 HPS outbreak in Southern Argentina due to Andes virus, there were epidemiological and molecular evidences of person-to-person transmission, a feature not previously shown for other members of the hantavirus genus. These data would also be indicative of some distinctive clinical characteristics of HPS caused by Andes virus, with more frequent renal involvement than in SNV cases.

MeSH Term

Adolescent
Adult
Aged
Argentina
Child
Disease Outbreaks
Enzyme-Linked Immunosorbent Assay
Female
Orthohantavirus
Hantavirus Pulmonary Syndrome
Humans
Male
Middle Aged
RNA, Viral
Reverse Transcriptase Polymerase Chain Reaction

Chemicals

RNA, Viral

Word Cloud

Created with Highcharts 10.0.0casesvirusHPSAndescharacteristicsSNVpatientsmg/lSouthernArgentinaclinicalmeanrangepreviouslyreportedalsoobservedincreased0serumcreatinineconcentration810identified1995etiologicagentHantavirusPulmonarySyndromedescribehereinmain25confirmedacquiredarea1993September1999age34years11-7072%malesClinicalsimilarSinNombreHowevergroupconjuntivalinjection10/2542%facialflushing8/2533%pharyngealcongestion7/2529%petechiae3/2512%handBUN83%77g/l31-201Mean26range:1-110higher208/1553%Urinalysisabnormal12/12characterizedpresenceproteinsredbloodcellsgranularcastsAminotransferases90%levels5-10timesnormalvalues50%Serumcreatinekinaseelevated11/14TworequiredhemodialysisCasefatalityrate44%11/25diedamongfirstdaysillnessMononuclearmyocarditistwofinding1996outbreakdueepidemiologicalmolecularevidencesperson-to-persontransmissionfeatureshownmembershantavirusgenusdataindicativedistinctivecausedfrequentrenalinvolvement[HantaviruspulmonarysyndromesouthernArgentina]

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