title: Ten years of a hantavirus disease emergency in the Federal District, Brazil.
abstract: BACKGROUND
  Hantavirus diseases are emerging human diseases caused by Hantavirus spp. of the Bunnyaviridae family. Hantavirus pulmonary syndrome (HPS) has been detected in the Federal District (DF) of Brazil since 2004. Among the 27 Brazilian Federal Units, DF has the highest fatality rate. More than 10 years have already passed since then, with confirmation of cases caused by the Araraquara and Paranoa species. The reservoir is Necromys lasiurus.
  
  
  METHODS
  Local surveillance data of the confirmed cases were analyzed, including age, sex, month and year of occurrence, clinical symptoms, syndromes and outcomes, and probable transmission place (PTP). The cases were mainly confirmed by IgM detection with a capture enzyme immunoassay. The cases were classified as autochthonous if PTPs were in the DF area.
  
  
  RESULTS
  From 2004 to 2013, in the DF, 126 cases of hantavirus were confirmed, and the cumulative incidence was 5.0 per 100,000 inhabitants. The occurrence of cases was predominantly from April to August. At least 75% of the cases were autochthonous. Acute respiratory failure was reported in 47.5% of cases, and the fatality rate was 40%.
  
  
  CONCLUSIONS
  In the DF, the cumulative incidence of HPS was one of the highest worldwide. A seasonal pattern of hantavirus disease in the dry season is clear. There was a high frequency of severe clinical signals and symptoms as well as a high fatality rate. For the near future, visitors and inhabitants of DF rural areas, particularly male adults, should receive continuous education about hantavirus transmission and prevention.
authors.affiliation: Programa de Pós-Graduação em Medicina Tropical, Universidade de Brasília, Brasília, Distrito Federal, Brazil.
authors.forename: Roberto de Melo
authors.initials: Rde M
authors.lastname: Dusi
authors.affiliation: Subsecretaria de Vigilância em Saúde, Secretaria de Estado da Saúde do Distrito Federal, Brasília, Distrito Federal, Brazil.
authors.forename: Angelika
authors.initials: A
authors.lastname: Bredt
authors.affiliation: Centro de Gerenciamento de Informações para Emergências em Vigilância Sanitária, Agência Nacional de Vigilância Sanitária, Brasília, Distrito Federal, Brazil.
authors.forename: Daniel Roberto Coradi de
authors.initials: DR
authors.lastname: Freitas
authors.affiliation: Subsecretaria de Vigilância em Saúde, Secretaria de Estado da Saúde do Distrito Federal, Brasília, Distrito Federal, Brazil.
authors.forename: Maria Isabel Rao
authors.initials: MI
authors.lastname: Bofill
authors.affiliation: Secretaria Executiva de Vigilância em Saúde, Secretaria Estadual de Saúde de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: José Alexandre Menezes da
authors.initials: JA
authors.lastname: Silva
authors.affiliation: Programa de Pós-Graduação em Medicina Tropical, Universidade de Brasília, Brasília, Distrito Federal, Brazil.
authors.forename: Stefan Vilges de
authors.initials: SV
authors.lastname: Oliveira
authors.affiliation: Programa de Pós-Graduação em Medicina Tropical, Universidade de Brasília, Brasília, Distrito Federal, Brazil.
authors.forename: Pedro Luiz
authors.initials: PL
authors.lastname: Tauil
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000818:Animals; D003411:Arvicolinae / Q000821:virology*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D004199:Disease Vectors; D005260:Female; D018778:Hantavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D012621:Seasons; D055815:Young Adult