Hantavirus infection is an emerging disease in the United States. Late last year, a death was reported in Iowa due to a Hantavirus infection. Charles Grose. MD, pediatrician at UI Children’s Hospital, talks about the Hantavirus and any precautions we should take to avoid the infection:

What is the Hantavirus?

Hantavirus is one of many viruses. Most of us are familiar with viruses because we’ve had a lot of warnings this year about having influenza shots which protect us from influenza. Hantavirus does not usually infect humans, it’s actually a more common infection of mice, and that’s why we haven’t heard about it as much.

How is the virus spread or contracted?

That’s a very interesting story and it also does relate to Iowa. As I said, the virus only lives in mice and does not live in the common house mouse, which most of us have seen during our life. It lives, instead, in another mouse which is called the deer mouse. The deer mouse is called the deer mouse because it has very large ears—somewhat similar to the deer which we see occasionally in our backyards. Since the virus lives in the deer mouse, it requires contact with the Deer Mouse, usually found in rural areas. The people who are at risk would be farmers or hunters, and teenagers who like to roam the countryside. In Iowa, we’ve had seven cases over the last 15 years and all of the cases have been in males, either in adolescent boys or adult males. No girl or woman in Iowa has been infected with this virus, which I think is unique among the states.

Who is a likely candidate to become infected with a Hantavirus infection?

This, again, relates to the interesting story about these mice. As I said, the deer mice live in rural areas in Iowa—they do not like to live inside houses. They like to live where there might be grain storage, certainly on a farm where there were old granaries or where grain has been stored is one area at risk. Interestingly, we had one case in a teenager and he was playing along railroad tracks in a small town in Iowa. The interesting fact about his case was that the only purpose of the railroad tracks was to carry grain through that part of Iowa, so we’re sure that grain fell along the railroad tracks, and that’s where the mice lived. It would appear only hunters or farmers in rural areas—especially around abandoned buildings or places where grain had ever been stored, are at risk.

What are the initial symptoms of an infection?

This is one of the problems we have with diagnosis of the disease and one of the reasons that people occasionally die. The symptoms when the disease first begins are very nonspecific. The most common symptom is a fever, and then after a day or two of fever, general aches and pains and feeling very tired. It’s not easy to identify that you’ve contracted this illness. After about two to four days, you usually will get a shortness of breath. This means that you are developing pneumonia, the most serious complication of this infection.

When should someone who suspects he may have contracted a Hantavirus seek medical attention?

As I mentioned, most people will have these feelings and have a low-grade fever and feel achy. This is a rather common complaint. The main point is when one feels shortness of breath or more rapid breathing and for people who’ve had anything like asthma, it would be somewhat similar to early signs of asthma, but it would be with a fever.

How are Hantavirial infections treated?

The theory is about one-third of the people who have the disease have a fatal disease and the reason is because the pneumonia, the onset, is extremely rapid, and within about two days you’ll have a very severe pneumonia. As soon as the disease is suspected, then the most important point about this illness is have your physician admit you to an intensive care unit. The treatment consists of putting someone on a ventilator, which is called assisted breathing, and then the ventilator machine breathes for you during the period that you have pneumonia. That is usually around four days. As long as you’re on a ventilator, you will not have a fatal infection since the ventilator will breathe for you.

Is the virus curable?

That’s an interesting question. We don’t have any antibiotic that can treat the virus and we don’t have a vaccine that could prevent you from acquiring the virus, but the interesting point—if your body has about 5 to 6 days to make an immune response. The immune response—the antibodies that you make in your own body—will destroy the virus. But the human body takes about 5 to 6 days to make those antibodies, so that’s why you need to be on a ventilator during that time when you have your pneumonia from the virus, and then it gives your body time to make the antibodies and they will destroy the virus, and the virus is gone and you will never have the infection again.

Are there long lasting side effects from Hantavirus infection?

The only problem that people have had is future problems with their lungs. I think about half the people who’ve had this infection and survived, later on will say they just don’t have the ability to do exercises such as running. They say when they run they can’t run as far as they used to. So there’s some permanent damage done to the lung in some of the people who’ve had this infection.

Is there one strain of Hantavirus so that, if a person was infected and recovered, they would be immune from contracting the virus again?

Again, that’s another part that’s so interesting with this virus. The answer, again, is both a yes and a no. There is only one strain that’s found in Iowa, so yes if you would have been infected with this virus in Iowa, you would never have any risk again. There are, however, other strains around the world; there are strains in South America and strains in Korea. So if one had a type of occupation that required outdoor travel in many different continents, there is a possibility that you could come into contact with one elsewhere. But as far as in the United State, no, there is no risk as far as a second infection.

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Charles Grose. MD

UI Children’s Hospital