Original Article

Hantavirus Pulmonary Syndrome in Texas: 1993–2006

Authors: Megan N. Rivers BS, James L. Alexander DVM, MPVM, Rodney E. Rohde MS, J Rush Pierce Jr MD, MPH

Abstract

Background:Hantavirus pulmonary syndrome (HPS) is a rare cardiopulmonary disease that was first described after a 1993 epidemic in the southwestern United States. This study reviewed all cases reported in Texas to date.Methods:We reviewed case report forms submitted to the Texas Department of State Health Services and medical records (when available) to determine demographic and clinical features of Texas HPS cases.Conclusions:Middle-aged adults were more commonly affected. Respiratory symptoms were often accompanied by fever, gastrointestinal symptoms, and headache. Hypoxemia was observed in all cases. Common laboratory features included thrombocytopenia (92% of patients), elevated creatinine (61% of patients), increased polymorphonuclear leukocyte band forms (52% of patients), and hematocrit more than 55% (32% of patients). Most cases were associated with seeing rodents or rodent excreta at home. HPS was frequently misdiagnosed on initial presentation. Mortality was over 46%, higher for infection with the Sin Nombre virus (50%) than with the Bayou virus (0%). In Texas, the distribution of HPS is mainly along the coast and in west Texas.

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