Hantavirus illness in humans: review and update

Hantavirus is a rodent-borne pathogen that has been well characterized since the 1950s in Asia and Northern Europe. The classic hantaviral illnesses hemorrhagic fever with renal syndrome and nephropathia epidemica are indistinguishable from the hantaviral pulmonary syndrome (HPS) in early symptoms and laboratory data, but HPS goes on to produce the adult respiratory distress syndrome (ARDS) and usually spares the kidney. HPS is the first hantaviral disease reported in humans in the Western Hemisphere and has a tenfold higher mortality than its Eurasian counterparts. The predominant serogroup causing the Four Corners epidemic of the summer of 1993 is the Sin Nombre virus, previously called the Muerto Canyon virus. It is a unique virus but shares some genetic similarity to the nonpathogenic Prospect Hill serogroup, which has been found in North American rodents for decades. Several new serotypes that also cause HPS are now appearing. This paper will review the three hantaviral diseases with emphasis on HPS, its diagnosis, treatment, and prevention.