Hantavirus Pulmonary Syndrome , Southern Chile, 1995–2012 - Volume 21, Number 4—April 2015 - Emerging Infectious Disease journal - CDC

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Hantavirus Pulmonary Syndrome , Southern Chile, 1995–2012 - Volume 21, Number 4—April 2015 - Emerging Infectious Disease journal - CDC

Volume 21, Number 4—April 2015

Synopsis

Hantavirus Pulmonary Syndrome , Southern Chile, 1995–2012

On This Page

• Material and Methods
• Results
• Discussion
• Suggested Citation

Figures

• Figure 1
• Figure 2
• Figure 3

Tables

• Table 1
• Table 2
• Table 3
• Table 4

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Raúl Riquelme, María Luisa Rioseco, Lorena Bastidas, Daniela Trincado, Mauricio Riquelme, Hugo Loyola, and Francisca Valdivieso

Author affiliations: Universidad San Sebastian, Hospital de Puerto Montt, Puerto Montt,Chile (R. Riquelme, M.L. Rioseco, M Riquelme); Hospital de Puerto Montt, Puerto Montt (L. Bastidas, D. Trincado); Clínica Alemana Universidad del Desarrollo, Santiago, Chile (H. Loyola, F. Valdivieso)

Suggested citation for this article

Abstract

Hantavirus is endemic to the Region de Los Lagos in southern Chile; its incidence is 8.5 times higher in the communes of the Andean area than in the rest of the region. We analyzed the epidemiologic aspects of the 103 cases diagnosed by serology and the clinical aspects of 80 hospitalized patients during 1995–2012. Cases in this region clearly predominated during winter, whereas in the rest of the country, they occur mostly during summer. Mild, moderate, and severe disease was observed, and the case-fatality rate was 32%. Shock caused death in 75% of those cases; high respiratory frequency and elevated creatinine plasma level were independent factors associated with death. Early clinical suspicion, especially in rural areas, should prompt urgent transfer to a hospital with an intensive care unit and might help decrease the high case-fatality rate.

Since the first cases described in United States in 1993, hantavirus pulmonary syndrome (HPS) has been reported in the United States, Argentina, Bolivia, Brazil, Chile, Ecuador, Paraguay, Panama, Uruguay, and Venezuela (1). Several types of New World hantaviruses (family Bunyaviridae) have been recognized. Their distribution is determined by the density of rodent populations serving as specific reservoirs of each virus type.

In Chile, Andes virus is the only identified hantavirus (2). It was first reported in 1995 during an outbreak in Argentina and is carried by the murid rodent Oligoryzomyslongicaudatus (i.e., long-tailed mouse or “colilargo”) in southern Argentina and central and southern Chile (3).

In Chile, where HPS is subject to immediate mandatory reporting to health authorities, a total of 786 cases occurred during 1995–2012. Regional and seasonal incidences varied from 0.17 to 0.53 cases per 100,000 inhabitants (4). Despite such low incidence, HPS is of public health concern because of its severity and its high case-fatality rate (CFR) (20%–60%).

We examined the clinical and epidemiologic features of HPS during 17 years in the provinces of Llanquihue and Palena, which had the highest incidences of this disease in Chile. This geographic area is served by the Health Service of Reloncaví (HSR) in Puerto Montt city, which has its 420-bed reference center at the Hospital of Puerto Montt in Puerto Montt.

Dr. RaúlRiquelme is associated professor of internal medicine and respiratory diseases in the School of Medicine, San SebastianUniversity, Hospital de Puerto Montt, Chile. His primary research interests are community-acquired pneumonia and hantavirus disease.

Acknowledgment

We thank Roberto Murua for his valuables comments. We also thank Carolina Larrain for assistance in manuscript editing. We greatly appreciate the technical assistance of Marcela Amtmann.

References

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Figures

• Figure 1. The 13 communes in the provinces of Llanquihue and Palena, southern Chile. (Two communes share the name of the province to which they belong.) Asterisk indicates Andean communes. Inset:...
• Figure 2. Number of hantavirus pulmonary syndrome cases in provinces of Llanquihue and Palena, southern Chile, 1995–2012.
• Figure 3. Seasonal incidence of hantavirus pulmonary syndrome, provinces of Llanquihue and Palena, Chile (n = 103), and entire country (n = 785), 1995–2012.

Tables

• Table 1. Incidence of hantavirus pulmonary syndrome, Health Service of Reloncaví, Chile, 1995–2012
• Table 2. Clinical characteristics on admission to Hospital Puerto Montt for 80 patients with confirmed hantavirus disease, Puerto Montt, Chile, 1995–2012
• Table 3. Vital signs and laboratory results for 80 hantavirus pulmonary syndrome patients admitted to Hospital Puerto Montt, Puerto Montt, Chile, 1995–2012
• Table 4. Study variables with significant differences between hantavirus pulmonary syndrome patients who did and did not survive, Hospital Puerto Montt, Puerto Montt, Chile, 1995–2012

Suggested citation for this article:Riquelme R, Rioseco ML, Bastidas L, Trincado D, Riquelme M, Loyola H, et al. Hantavirus pulmonary syndrome, southern Chile, 1995–2012. Emerg Infect Dis [Internet]. 2015 Apr [date cited]. http://dx.doi.org/10.3201/eid2104.141437

DOI: 10.3201/eid2104.141437