History and exam
Key diagnostic factors
common
exposure to rodent excreta/bite
A history of peridomestic exposure to rodents or cleaning rodent-infested enclosures is an epidemiological clue to diagnosing hantavirus infection.
dyspnoea
Early in infection, may not be associated with hypoxaemia and is non-specific. The patient may rapidly progress to severe respiratory distress.
hypotension
A feature of moderate to severe disease. May progress to cardiogenic shock.
Other diagnostic factors
common
fever
A non-specific feature of the viraemic prodrome.
myalgias
A non-specific feature of the viraemic prodrome.
gastrointestinal symptoms
headache
Non-specific symptoms during the viraemic prodrome.
normal or low oxygen saturation
Oxygen saturation is normal in the early phase of the disease, but patients become hypoxic as the disease progresses.
lung rales
A sign of pulmonary oedema. Typical of moderate to severe disease and heralds the onset of the cardiopulmonary phase.
Risk factors
strong
exposure to rodent excreta/bite
The deer mouse, host for Sin Nombre virus (SNV), is widely distributed in the US, excluding the southeast Atlantic coastal states.
Numerous rodents have been identified as hosts for different hantavirus subtypes in Central and South America.
Early in the recognition of HCPS, viral identity was determined between patient isolates and isolates from deer mice captured in and around the patients' dwellings.[42]
Risk is related to rodent exposure, particularly peridomestic activities such as cleaning in and around homes with evidence of infestation, and cleaning or inhabiting seasonally closed structures that have had rodent habitation.[12]
close contact with hantavirus-infected humans
Person-to-person transmission has been reported only in Argentina and Chile so far and has been documented to occur mainly in family clusters. Sexual partners were found to have a 10-fold increase in risk of infection compared with the rest of household contacts.[22]
Only two cases of nosocomial transmission have been reported so far, both in Chile.[20]
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