Hantavirus infection among children hospitalized for febrile illness suspected to be dengue in Barbados

Abstract

Emerging picture of hantavirus infection in the South America is characterized by greater proportion of childhood infection and wider spectrum of disease from mild asymptomatic to lethal cardiopulmonary disease. Barbados is endemic for dengue and leptospirosis, both of which share clinical features with hantavirus infection and in many cases neither of these diagnosis could be confirmed. We investigate whether some of the children hospitalized with suspected dengue could indeed have been hantavirus infections. In this prospective study children hospitalized with suspected dengue were tested for hantavirus infection using ELISA for the IgM antibodies. Thirty-eight children tested positive for hantavirus infection. They presented with fever, headache and mild respiratory and gastrointestinal symptoms and signs. None of them had features suggestive of hantavirus cardiopulmonary syndrome. Blood count values ranged from low to normal to high for their age. There were no deaths. Hantavirus infection is prevalent in this Caribbean country. It predominantly presents with milder disease and is responsible for some of the nonspecific febrile illnesses in children.

Serum LPS Associated with Hantavirus and Dengue Disease Severity in Barbados

“…Hantavirus transmission in Barbados has been detected since 2001 among febrile persons under investigation for acute DENV infection and in wild rats [25,26]. Hantavirus infections have remained endemic in Barbados since then however the identity of the circulating strain(s) has proven elusive.…”

Epidemiology of acute febrile illness in Latin America

“…Hantavirus are emerging viruses transmitted by inhalation of rodent secretions, and responsible for Hantavirus Pulmonary Syndrome in Latin America [42]. Patients with confirmed acute hantavirus infection are mistakenly assumed to have DENV infection or leptospirosis, due to their similar clinical features and the endemicity of the latter two diseases in the region [24]. Epidemiological studies have shown noticeable differences in seroprevalence of antibodies against hantaviruses in humans ranging from 1% to 13.5%, according to geographical and ethnic differences [43,44].…”

“…Exposure to rural areas and history of peridomestic activities are some of the risk factors most reported [45]. Studies investigating recent hantavirus infection in febrile patients found a prevalence that ranges from 0.3% to 14% [10,24,44,46].…”

Infecciones por hantavirus

“…Por lo tanto, es aconsejable utilizar una aproximación síndromatica, en la cual la evaluación de la presencia de una infección por hantavirus se hace al mismo tiempo, de la causada por otros agentes que causan cuadros clínicos similares. Los hantavirus han sido asociados a 3 síndromes infecciosos: a) el síndrome febril de origen viral con síntomas respiratorios; b) el síndrome pulmonar: c) el síndrome febril hemorrágico con compromiso renal (32). (30).…”