SECTION I - INFECTIOUS AGENT


NAME: Hantavirus Pulmonary Syndrome


SYNONYM OR CROSS REFERENCE: HPS, Hantavirus, Sin Nombre virus, Muerto Canyon virus.


CHARACTERISTICS: Family Bunyaviridae; genus Hantavirus; spherical enveloped virion; 90-100 rum; helical symmetry; ssRNA.

SECTION II - HEALTH HAZARD

PATHOGENICITY: Prodomal period of fever, achiness, and cough followed by a sudden onset of acute respiratory distress; headache, abdominal pain, nausea, and vomiting; bilateral pulmonary infiltrates, hypoxia, and hypertension develop as disease progresses, 50% or greater mortality rate - deaths associated with respiratory failure, shock, or severe lactic acidosis.

EPIDEMIOLOGY: Newly recognized manifestation; thus far only reported from the United States, mainly the southwest. All known cases were of rural residents or those who visited rural areas within 6 weeks of onset. (Other species of Hantavirus are present outside the United States, i.e. those causing Hantavirus Renal Syndrome).


HOST RANGE: Humans, rodents.


INFECTIOUS DOSE: Unknown


MODE OF TRANSMISSION: Inhalation of virus in aerosols from contaminated rodent feces or urine; through animal bites, disturbance of dried material contaminated with rodent excretia, wound contamination, conjunctival exposure, or ingestion.


INCUBATION PERIOD: Several days.


COMMUNICABILITY: Human-to-human transmission is not a feature of hantavirus infection. Rodents may shed virus secretions for many consecutive months.

SECTION III - DISSEMINATION

RESERVOIR: Primary - deer mouse (Peromyscus maniculatus); reservoirs may be rodent specific for each strain.


ZOONOSIS: Yes


VECTORS: None

SECTION IV - VIABILITY

DRUG SUSCEPTIBILITY: Intravenous ribavirin may be helpful if administered during the early stages of infection.


SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to 10% commercial bleach solution, 2% glutaraldehyde, formaldehyde and 70% EtOH.


PHYSICAL INACTIVATION: Resistant to desiccation.


SURVIVAL OUTSIDE HOST: Survives in rodent excreted body fluids such as fecal matter, urine, saliva, etc. Dried culture media has been shown to remain infective for 2 days or longer.

SECTION V - MEDICAL

SURVEILLANCE: Compatible history of HPS noted; confirmed by positive serologic test result and evidence of viral antigen in tissue.


FIRST AID/TREATMENT: All patients should receive broad spectrum antibiotic coverage until BPS is proven; early intensive care is important, with prompt correction of electrolytic, pulmonary, and hemodynamic abnormalities. Intravenous ribavirin may be helpful if administered early in infectious process. Treatment remains primarily supportive in nature.


IMMUNIZATION: None


PROPHYLAXIS: None

SECTION VI - LABORATORY HAZARDS

LABORATORY-ACQUIRED INFECTIONS: Well-documented cases of transmission from rodents to humans via aerosol route. Unprotected visitors to laboratory animal holding rooms have been shown to become infected after approximately five minutes of exposure to aerosols.


SOURCES/SPECIMENS: Infected laboratory rodents; infected cells or tissues, rodent excreta, fresh necropsy material and animal bedding.


PRIMARY HAZARDS: Inhalation of aerosols from rodent excretia, body fluids, bedding, etc. contact between infectious materials with mucous membranes or broken skin; animal bites.


SPECIAL HAZARDS: Possible transmission through cell cultures;(transmission through centrifugation?)

SECTION VII - RECOMMENDED PRECAUTIONS

CONTAINMENT REQUIREMENTS: BSL-2 facilities and practices recommended for handling infected sera from persons potentially infected with the agents of BPS; animal biosafety level 2 (ABSL-2) facilities and practices recommended for work with host species; BSL-2 facilities and BSL-3 practices recommended for handling infected tissue samples; BSL-3 facilities and practices recommended for cell-culture virus propagation; BSL-4 recommended for large-scale virus growth; ABSL-4 should be utilized when inoculating host species with virus-containing samples. **The use of a certified biological safety cabinet is recommended for all handling of potentially infected human body fluids when potential exists for splatter or aerosol generation.**


PROTECTIVE CLOTHING: Gloves and gowns; masks or respirators may be needed depending on type of work and BSL level; protective clothing as indicated by particular BSL standards.


OTHER PRECAUTIONS:
Avoid creating aerosols; avoid stirring up dust or excretia from infected animals.

SECTION VIII - HANDLING INFORMATION

SPILLS: Areas contaminated with rodent feces should be sprayed with a 20% commercial bleach solution (1% hypochlorite) before being cleaned to avoid creating aerosols; brooms or vacuum cleaners should not be used.


DISPOSAL: Use 10% bleach solution to disinfect dead rodents and wear rubber gloves before handling, gloves and traps should be disinfected after use.


STORAGE: In sealed containers that are appropriately labeled; infected carcasses are placed in double plastic bags for later incineration.

Information provided by the Colorado State University Office of Biosafety- January 4, 1999.

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