title: Outbreak of hantavirus infection in the Four Corners region of the United States in the wake of the 1997-1998 El Nino-southern oscillation.
abstract: Hantavirus cardiopulmonary syndrome (HCPS), a rodent-borne zoonosis, has been endemic in the Americas for at least several decades. It is hypothesized that the 1991-1992 El Niño-southern oscillation (ENSO) caused increased precipitation that allowed an increase in rodent population densities, thereby increasing the possibility of transmission to humans. The result was a 1993-1994 outbreak of the disease in the Four Corners states of the southwestern United States. A second strong ENSO occurred in 1997-1998, after a period of considerable public education about the risks of hantavirus infection that began during the 1993-1994 outbreak. The caseload of HCPS increased 5-fold above baseline in the Four Corners states in 1998-1999. Regions that had received increased rainfall in 1998 were especially affected. A large majority of the 1998-1999 case patients reported indoor exposure to deer mice. Hantavirus outbreaks can occur in response to abiotic events, even in the face of extensive public education and awareness.
authors.affiliation: Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA. bhjelle@salud.unm.edu.
authors.forename: B
authors.initials: B
authors.lastname: Hjelle
authors.forename: G E
authors.initials: GE
authors.lastname: Glass
mesh_terms: D000818:Animals; D001130:Arizona / Q000453:epidemiology; D003120:Colorado / Q000453:epidemiology; D004196:Disease Outbreaks; D018778:Hantavirus Infections / Q000453:epidemiology* / Q000503:physiopathology / Q000635:transmission; D006801:Humans; D015994:Incidence; D009516:New Mexico / Q000453:epidemiology; D010542:Peromyscus; D011156:Population Density; D011891:Rain; D014589:Utah / Q000453:epidemiology; D014887:Weather