title: Hantavirus pulmonary syndrome: the first 100 US cases.
abstract: In the spring of 1993, hantavirus pulmonary syndrome (HPS) "emerged" in the southwestern United States, where a multiagency investigation led to the rapid description of this new clinical entity and its etiology. Analysis of the first 100 US cases identified showed that the disease was distributed in 21 states, had gone unrecognized since at least 1959, and had a distinct spring-early summer seasonality. Of the infected persons, 54% were male; 63% were Caucasian, 35% were Native American, and 2% were African American. The average age of case-patients was 34.9 years, and 8 were children or adolescents aged < or = 16 years. The overall case-fatality rate was 52%. There was a 91% concordance among serologic, immunohistochemical, and molecular results. HPS in the United States is caused by at least three newly described pathogenic hantaviruses, each of which has a distinct rodent host, and cases of HPS have been recently recognized in Canada and South America. National surveillance of this sporadic disease remains essential for further defining the epidemiology and clinical spectrum.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Khan
authors.forename: R F
authors.initials: RF
authors.lastname: Khabbaz
authors.forename: L R
authors.initials: LR
authors.lastname: Armstrong
authors.forename: R C
authors.initials: RC
authors.lastname: Holman
authors.forename: S P
authors.initials: SP
authors.lastname: Bauer
authors.forename: J
authors.initials: J
authors.lastname: Graber
authors.forename: T
authors.initials: T
authors.lastname: Strine
authors.forename: G
authors.initials: G
authors.lastname: Miller
authors.forename: S
authors.initials: S
authors.lastname: Reef
authors.forename: J
authors.initials: J
authors.lastname: Tappero
authors.forename: P E
authors.initials: PE
authors.lastname: Rollin
authors.forename: S T
authors.initials: ST
authors.lastname: Nichol
authors.forename: S R
authors.initials: SR
authors.lastname: Zaki
authors.forename: R T
authors.initials: RT
authors.lastname: Bryan
authors.forename: L E
authors.initials: LE
authors.lastname: Chapman
authors.forename: C J
authors.initials: CJ
authors.lastname: Peters
authors.forename: T G
authors.initials: TG
authors.lastname: Ksiazek
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000818:Animals; D002648:Child; D005006:Ethnicity; D005260:Female; D018804:Hantavirus Pulmonary Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010542:Peromyscus; D012621:Seasons; D017678:Sex Distribution; D016205:Sigmodontinae; D014481:United States / Q000453:epidemiology