Hantavirus Reported in Mumbai, India

In early August, the city of Mumbai, India, reported its first case of Hantavirus [1]. On June 27th, a 39 year old man from Kurla, a suburb of Mumbai, came down with a fever [2]. Although he initially consulted a doctor, his condition worsened and within a week, he was admitted to a Sapna Hospital in Ghatkopar [2]. After developing further respiratory complications, the man was moved to the intensive care unit (ICU) and placed on a ‘non-invasive life-support system’ [2]. However, with appropriate treatment – he was discharged after ten days [2].

 

All About Hantavirus

Hantavirus, which belongs to the Bunyaviridae family, can often be found in rural areas such as fields, forests, and farms — places where the virus’ rodent hosts may live [3]. Infected rodents shed the virus in their urine, droppings, and saliva; transmission of the disease to humans occurs when aerosolized particles are inhaled or if an individual comes in contact with rodents or their urine and droppings [4,5]. Transmission can also happen directly, in which the virus can enter through broken skin or mucous membranes such as the eyes, nose, and mouth [5]. Therefore, individuals working with rodents have a higher risk of contracting the disease [5]. However, person-to-person transmission has not been documented [4].

Hantavirus can progress into Hantavirus Pulmonary System (HPS) or Hemorrhagic Fever with Renal Syndrome (HFRS) [4,5]. Early symptoms of HPS include fever, fatigue, headaches, chills, nausea, and muscle aches; whereas, later symptoms of HPS include shortness of breath and coughing [4]. Early symptoms for HFRS include intense headaches, back and abdominal pain, fever, chills, nausea, and blurred vision [5]. Later symptoms of HFRS include low blood pressure, vascular leakage, acute kidney failure, and acute shock – all leading to fluid overload in the body [5]. Because there are various types of hantaviruses that can cause HFRS, severity of the disease depends on the specific virus strain causing the infection – for example, severe infections are often caused by the Hantaan and Dobrava viruses, while Seoul, Saaremma, and Puumala viruses tend to manifest more moderately [5].

Treatment of Hantavirus is supportive and based on symptoms [2,5]. This type of care includes careful management of the infected patient’s fluid and electrolyte levels, maintenance of oxygen saturation and blood pressure levels, as well as any treatment for secondary infections [5].

Because there is no vaccine or specific treatment for Hantavirus, prevention is ideal. The best way to prevent Hantavirus infection is through rodent control [4]. Various methods of prevention include: setting up traps, sealing up any holes in your home or garage, as well as cleaning up easy-to-get food [7]. Additionally, care should be taken when cleaning up areas where rodents may have been. All dust should be sprayed with water before being cleaned up, to prevent it becoming aerosolized.  

 

Hantavirus in India

There are conflicting reports regarding whether or not the report from Mumbai is the Hantavirus case in the India [2]. While the Brihanmumbai Municipal Corporation (BMC) claims that this report is the first of its kind in Mumbai and in India, the Hindustan Times reports that there were Hantavirus cases in India in 2006 and 2010 [2]. Previous research has proven serological evidence of Hantavirus in India [X]. Though the virus has been speculated to be in the country for decades, the first documented presence of Hantavirus in volunteer blood donors was only made in 2005 [8,9].

 

Sources

[1] http://outbreaknewstoday.com/mumbai-reports-1st-hantavirus-case-indian-media-41450/

[2] http://www.hindustantimes.com/mumbai/mumbai-reports-1st-case-of-rare-hantavirus-this-year/article1-1376536.aspx

[3] http://www.cdc.gov/hantavirus/technical/

[4] http://www.nlm.nih.gov/medlineplus/hantavirusinfections.html

[5] http://www.cdc.gov/hantavirus/hfrs/index.html

[7] http://www.cdc.gov/hantavirus/hps/prevention.html

[8] http://www.natureasia.com/en/nindia/article/10.1038/nindia.2008.104

[9] http://trstmh.oxfordjournals.org/content/102/1/70

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