Infection With Sin Nombre Hantavirus: Clinical Presentation and Outcome in Children and Adolescents

Abstract

Methods. We analyzed clinical and laboratory data on 13 patients who were <16 years old with SNV infection from 1993 through March 2000 identified from a database at the University of New Mexico.Results. The patients ranged from 10 to 16 years of age, with a median of 14. Fifty-four percent were female. Fifty-four percent were Native American. The most common prodromal symptoms were fever, headache, and cough or dyspnea (100%); nausea or vomiting (90%); and myalgia (80%). The most common physical findings at admission were tachypnea (67%) and fever (56%); hypotension was seen in 33% of patients. On admission, all patients manifested thrombocytopenia (median platelet count: 67 000/mm 3 ) and elevated lactate dehydrogenase (median level: 1243 IU/L), and >85% of patients had elevated levels of serum aspartate aminotransferase, alanine aminotransferase, and hypoalbuminemia. Leukocytosis and hemoconcentration were seen in less than one third of patients at admission. HCPS developed in 12 of the 13 patients (92%), and 4 of those 12 died (33% casefatality ratio). The majority of HCPS patients (8 of 12 [67%]) were critically ill and required mechanical ventilation. Extracorporeal membrane oxygenation was used in 2 patients, 1 of whom survived. An elevated prothrombin time (>14 seconds) at admission was predictive of mortality.Conclusions. Infection with SNV in children and adolescents causes HCPS with a clinical course and mortality rate similar to that described in adults. We believe that early recognition of HCPS in children and adolescents and appropriate referral to tertiary care centers that are experienced with HCPS are important in reducing mortality. Pediatrics 2001;108(2). URL: http://www. pediatrics.org/cgi/content/full/108/2/e27; hantavirus, children, adolescents, extracorporeal membrane oxygenation.

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

“…Over half of all cases in this series were in the age group less than ten years with median age of 5 years (age range 7 months to 181 months). In the report from USA the age range for the infected children was from 10 to 16 years [33]. As noted earlier serological evidence of hantavirus transmission in this country was documented as early as the late nineties [27].…”

“…There are only a small number of studies reporting hantavirus infection in children [9,32,33]. Over half of all cases in this series were in the age group less than ten years with median age of 5 years (age range 7 months to 181 months).…”

Development and evaluation of serological assays for detection of human hantavirus infections caused by Sin Nombre virus

“…Sin Nombre virus (SNV) is the major causative agent of HCPS in the US with the deer mouse (Peromyscus maniculatus) representing its primary rodent reservoir (Childs et al, 1994). In addition to the US, P. maniculatus-borne SNV and clinical cases caused by this virus have also been detected in Canada (Ramos et al, 2001;Drebot et al, 2001).…”

Immunoinformatics Predication and Modelling of a Cocktail of B- and T-cells Epitopes from Envelope Glycoprotein and Nucleocapsid Proteins of Sin Nombre Virus

“…One of these diseases is HCPS especially caused by SNV. Despite SNV is not transmitted from person-to-person; SNV is highly pathogenic (case fatality rate 30 to 50%) [44] regardless of age, [45] health status, [46] or access to advanced medical care, and was responsible for the 2012 Yosemite National Park outbreak [21,47]. The absence of effective vaccines, post exposure prophylactics, or therapeutics to prevent HCPS caused by SNV participated in the worry experienced by about 270,000 Yosemite visitors who got notice of possible exposure [46].…”