Andes Hantavirus as possible cause of disease in travellers to South America.
BACKGROUND
Hantaviruses in Europe and Asia cause haemorrhagic fever with renal syndrome and epidemic nephritis (mortality rate <1-15%). New strains of Hantaviruses cause Hantavirus pulmonary syndrome (HPS) from Canada to South America. Andes virus mortality rate is about 30% in Chile.


METHODS
Clinical charts of 54 patients were reviewed.


RESULTS
Inhalation of aerosolized urine, faeces or saliva of rodents is the principal cause of infection. The incubation period is between 8 and 43 days. The main prodromal symptoms are: myalgias, fever, fatigue, gastrointestinal disorders, dyspnoea, petechiae and coughing. After the 4th day pulmonary oedema, hypotension and renal failure appear. Haemorrhagic disorders may occur. The first laboratory tests presenting alterations are: haemoconcentration, leukocytosis, low platelet count <150 micro/L, and presence of immunoblasts. The treatment is supportive: mechanical ventilation, vasopressor drugs, haemofiltration or haemodialysis, and extracorporeal membrane oxygenation. There is no specific treatment for HPS. Preventive measures must be empathised.


CONCLUSIONS
The principal risk factors for tourists are: accommodation in abandoned or closed up facilities; failure to use indicated pathways when walking in forests; camping outside recommended areas; drinking water from natural sources and fishing in risk areas. The risk of infection for foreign tourists in Chile is low.
Castillo
Constanza
C
Department of Internal Medicine, Faculty of Medicine, Universidad de la Frontera, Manuel Montt 112, Temuco, Chile. eureka@telsur.cl
Nicklas
Claudia
C
Mardones
Jovita
J
Ossa
Gonzalo
G
D000818:Animals; D002677:Chile / Q000453:epidemiology; D004197:Disease Reservoirs / Q000662:veterinary; D006476:Orthohantavirus / Q000472:pathogenicity; D018778:Hantavirus Infections / Q000453:epidemiology* / Q000635:transmission; D018804:Hantavirus Pulmonary Syndrome / Q000453:epidemiology* / Q000635:transmission; D006480:Hemorrhagic Fever with Renal Syndrome / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D012189:Retrospective Studies; D012307:Risk Factors; D012376:Rodent Diseases / Q000453:epidemiology / Q000635:transmission; D012377:Rodentia; D014195:Travel; D015047:Zoonoses