Thursday, June 14, 2018

PRO/AH/EDR> Hantavirus - Americas (41): USA (OR)

HANTAVIRUS - AMERICAS (41): USA (OREGON)
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Date: Wed 13 Jun 2018 2:43 PM PDT
Source: The Bulletin [edited]
<https://www.bendbulletin.com/localstate/6309272-151/hantavirus-kills-deschutes-county-resident>


Deschutes County Health Department officials confirmed a local woman
died [Wed 13 Jun 2018] from hantavirus pulmonary syndrome [HPS], a
disease [virus] transmitted through rodent droppings.

The woman, 67, and her husband, lived in Redmond but also maintained a
home in the 3 Rivers community in Culver [Jefferson county].

According to a neighbor, she had come to the Culver home before
Memorial Day to prepare for a family visit.

"They have a loft in their barn that they use for extra sleeping,"
said a neighbor and friend. "She had gone out with a Shop-vac. She
didn't know, as well as most people didn't, that you should wear
protective gear and all that stuff."

Hantavirus exposures usually occur after breathing in the virus when
rodent urine and droppings are stirred up into the air. People can
also become infected when they touch mouse or rat urine, droppings, or
nesting materials that contain the virus, and then touch their eyes,
nose, or mouth. The disease [virus] is not spread from person to
person, and cats and dogs cannot transmit hantavirus infections to
people.

"A lot of times it will happen after an area has been closed up for a
while, a summer home or a barn, something like that. They go in and
they do spring cleaning, and there are mice droppings everywhere,"
said Heather Kaisner, a spokeswoman for the health department.

[The neighbor] said she saw her friend at the 3 Rivers Community
Church on [3 Jun 2018], but the next day [the woman] came down with
what they both thought was the flu. On [7 Jun 2018], she was having
trouble staying awake and her husband called 911.

[The woman] was admitted to the ICU at St Charles Redmond, and on [Sat
9 Jun 2018], was placed on a ventilator. She was airlifted to Oregon
Health and Sciences University in Portland on [Sun 10 Jun 2018], where
she died [Wed 13 Jun 2018].

"She was in good health," [her neighbor] said. "You would have never
in a million years thought she would have been gone in a week."

The case is the 23rd hantavirus infection in Oregon since 1993, and
the 7th in Deschutes county. Officials from the Deschutes and
Jefferson counties health departments are working with Oregon Public
Health officials to investigate the case. They have not completed
their investigation and could not yet confirm how or where [the woman]
had been infected.

The incubation period from infection to the point when symptoms first
appear can range from 1-6 weeks.

"It's pretty rare, but it is a very deadly disease," Kaisner said.

According to the federal Centers for Disease Control and Prevention,
about 35 percent of those infected will die from the disease.

Symptoms include tiredness, dizziness, fever and chills, muscle aches
and headaches, nausea and vomiting, stomach pain, and coughing. More
severe symptoms may include shortness of breath or severe difficulty
breathing. The virus can trigger an inflammatory reaction that causes
hantavirus pulmonary syndrome, a condition characterized by blood
leaking into the lungs, affecting both breathing and circulation.

There is no vaccine to prevent infection and no treatment for the
condition, said Dr Jon Lutz, an infectious disease specialist at
Summit Medical Group Oregon-Bend Memorial Clinic who was not involved
in Farr's care. "You just have to avoid exposure," he said.

Health officials stressed that prevention starts by rodent-proofing
homes and by taking precautions when cleaning up rodent droppings.

"All of us don't think about it. We've got some mouse droppings, let's
clean it up," Kaisner said. "You definitely don't want to take the
vacuum out and have it aerosolize. That's when you breathe it in."

Most of the cases in Oregon have occurred east of the Cascades, and
are linked to deer mice. "The deer mouse is present throughout the
United States. It's not like there's more in Eastern or Western
Oregon," Oregon Public Health Veterinarian Dr Emilio DeBess said.
"Does Eastern Oregon have more hantavirus than Western Oregon? We
don't know have that answer."

[The victim's friend] described her as "the kind of person who always
put everybody else first." She was part of a Bears and Quilt group at
the 3 Rivers Church that sewed teddy bears and donated them to
Jefferson County Emergency Medical Services to hand out to young
patients. "She was always trying to help people out and make things
easier for everybody," Hunt said.

[Byline: Markian Hawryluk]

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[This case illustrates how quickly a hantavirus infection can proceed
from a febrile disease to full-blown HPS. The report above indicates
that the woman was present in several settings where her Sin Nombre
hantavirus might have been acquired. Although this is the 1st case of
Sin Nombre virus infection in Oregon this year (2018), there was a
recent case reported from the neighboring state of Washington (see
ProMED-mail archive Hantavirus - Americas (33): USA (WA), Panama (LS)
http://promedmail.org/post/20180504.5784821). Cases were reported in
Oregon last year (2017). Sporadic cases of hantavirus infections occur
annually across the western USA including occasionally in Oregon. The
hantavirus involved in this, and other cases in the western USA, is
Sin Nombre virus. Fatalities are due to hantavirus cardiopulmonary
syndrome (HPS). HPS can be very serious, and patients developing the
symptoms should seek medical attention at the earliest possible time.

Infected rodents shed the virus in feces, urine, and saliva.
Individuals opening up cabins or storage areas that have been closed
over winter or cleaning areas with signs of rodent presence should
heed the precautions that the CDC recommends in order to avoid
exposure to the virus
(<https://www.cdc.gov/rodents/cleaning/index.html>).

Deer mice, _Peromyscus maniculatus_, are the reservoir hosts of the
virus. An image of the deer mouse, _P. maniculatus_, can be seen at
<http://www.nsf.gov/news/mmg/media/images/mouse_f.jpg> and in the
report at the source URL above (2nd image).

A HealthMap/ProMED-mail map of the USA showing the location of Oregon
can be accessed at <http://healthmap.org/promed/p/239> and a map
showing the location of Deschutes and Jefferson counties in central
Oregon at <http://geology.com/county-map/oregon.shtml> - Mod.TY]

[See Also:
Hantavirus - Americas (39): USA (CA)
http://promedmail.org/post/20180603.5835571
Hantavirus - Americas (33): USA (WA), Panama (LS)
http://promedmail.org/post/20180504.5784821
Hantavirus - Americas (32): USA (CA)
http://promedmail.org/post/20180428.5771405
Hantavirus - Americas (30): USA (NM)
http://promedmail.org/post/20180422.5763028
Hantavirus - Americas (26): USA (NM)
http://promedmail.org/post/20180328.5716118
Hantavirus - Americas (19): USA (CO)
http://promedmail.org/post/20180307.5671608
Hantavirus - Americas (18): USA (NM)
http://promedmail.org/post/20180304.5664080
Hantavirus - Americas (16): USA (AZ) comment
http://promedmail.org/post/20180302.5659946
Hantavirus - Americas (14): USA (AZ), Panama (LS)
http://promedmail.org/post/20180301.5657531
Hantavirus - Americas (11): USA, Canada
http://promedmail.org/post/20180213.5625804
Hantavirus - Americas (09): USA, Canada
http://promedmail.org/post/20180201.5600860
2017
----
Hantavirus - Americas (55): USA (OR)
http://promedmail.org/post/20171027.5408550
Hantavirus update - Americas (09): USA (OR)
http://promedmail.org/post/20160213.4018784]
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