title: Hantavirus fever without pulmonary syndrome in Panama.
abstract: In Panama, hantavirus pulmonary syndrome (HPS) is caused by Choclo virus, a species phylogenetically related to Andes and Maporal viruses. Up to 60% of the population has been positive for specific serum antibody in community-based surveys, but mortality is very uncommon. In four western Panama clinics, we tested individuals presenting with a severe febrile prodrome for acute hantavirus (HV) infection by immunoglobulin M enzyme-linked immunosorbent assay and reverse transcription polymerase chain reaction as well as clinically similar infections, such as dengue and leptospirosis. From 2006 to 2009, at least 21% of 117 patients diagnosed with HV infection had HV Fever (HF) with no evidence of pulmonary edema (no respiratory distress or radiographic lung infiltrates), and 44% of patients had very mild HPS (radiographic pulmonary edema but no respiratory insufficiency). HV infection caused by Choclo virus in Panama presents often as HF, which contrasts with HV in the Americas but is consistent with the high seroprevalence in endemic regions.
authors.affiliation: Epidemiology and Microbiology, Gorgas Memorial Institute for Health Research, Panama City, Panama. barmien@gorgas.gob.pa
authors.forename: Blas
authors.initials: B
authors.lastname: Armien
authors.forename: Juan M
authors.initials: JM
authors.lastname: Pascale
authors.forename: Carlos
authors.initials: C
authors.lastname: Muñoz
authors.forename: Jamileth
authors.initials: J
authors.lastname: Mariñas
authors.forename: Heydy
authors.initials: H
authors.lastname: Núñez
authors.forename: Milagro
authors.initials: M
authors.lastname: Herrera
authors.forename: José
authors.initials: J
authors.lastname: Trujillo
authors.forename: Deyanira
authors.initials: D
authors.lastname: Sánchez
authors.forename: Yaxelis
authors.initials: Y
authors.lastname: Mendoza
authors.forename: Brian
authors.initials: B
authors.lastname: Hjelle
authors.forename: Frederick
authors.initials: F
authors.lastname: Koster
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006476:Orthohantavirus / Q000235:genetics / Q000302:isolation & purification*; D018804:Hantavirus Pulmonary Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D006480:Hemorrhagic Fever with Renal Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D010176:Panama / Q000453:epidemiology; D012367:RNA, Viral / Q000302:isolation & purification; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D012367:RNA, Viral