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Diagnosis and treatment of new world hantavirus infections

Mertz, Gregory Ja; Hjelle, Brianc; Crowley, Markb; Iwamoto, Garya; Tomicic, Vinkoe; Vial, Pablo Ad

Current Opinion in Infectious Diseases: October 2006 - Volume 19 - Issue 5 - p 437–442
doi: 10.1097/01.qco.0000244048.38758.1f
Tropical and travel-associated diseases
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Purpose of review The purpose of this review is to summarize the current knowledge regarding the diagnosis and treatment of indigenous new world hantavirus infections.

Recent findings Recent studies have defined the incubation period of new world hantavirus infections, provided additional evidence for person-to-person transmission of Andes virus, described a rapid method for the presumptive diagnosis of infection in the cardiopulmonary phase through a review of the peripheral smear, and suggested that intravenous ribavirin is probably not effective for the treatment of new world hantavirus infections when started in the cardiopulmonary phase.

Summary Presumptive diagnosis may be made by a review of the peripheral blood smear after the onset of the cardiopulmonary phase. Critical care management includes the avoidance of fluid overload, pressors to maintain cardiac output, and the use of extracorporeal membrane oxygenation in the most severe cases, but treatment with intravenous ribavirin is probably not effective.

aDepartments of Internal Medicine, USA

bPediatrics, USA

cPathology, University of New Mexico, Albuquerque, New Mexico, USA

dDepartments of Pediatrics, Chile

eAdult Intensive Care, Clinica Alemana School of Medicine, Universidad del Desarrollo, Santiago, Chile

Correspondence to Gregory J. Mertz, MD, Department of Internal Medicine, MSC10 5550, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA Tel: +1 505 272 5666; e-mail: gmertz@salud.unm.edu

© 2006 Lippincott Williams & Wilkins, Inc.