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Skip Navigation LinksHome > January 2009 - Volume 102 - Issue 1 > Hantavirus Pulmonary Syndrome in Texas: 1993–2006
Southern Medical Journal:
doi: 10.1097/SMJ.0b013e318187d06f
Original Article

Hantavirus Pulmonary Syndrome in Texas: 1993–2006

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

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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.

Key Points

* Patients with hantavirus pulmonary syndrome (HPS) are most likely middle-aged adults who present with both respiratory and gastrointestinal symptoms.

* A vast majority of patients report seeing evidence of rodents in or about their homes.

* Thirty-two percent of patients were initially sent home to return later with severe illness.

* Forty-six percent of Texas HPS patients died.

* HPS occurred more commonly in the high plains region than in other areas of Texas.

© 2009 Southern Medical Association

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