As a nurse, have you ever seen Hantavirus Pulmonary Syndrome?

allnurses Guide · Sep 15, 2018

It takes about 2 weeks to show up, and acts like flu symptoms. Careful history taking is needed. It can be fatal, a woman died this spring in Farmiington NM.

The CDC has more information.

I know of one case where a young man was comatose for several months, and it mutated in his spine leaving him a paraplegic.

cleback · Sep 16, 2018

Following.

I was told it is rapidly progressing and essentially as soon as the diagnosis is confirmed, patient is intubated. Not so sure about the last part...

MunoRN, RN · Sep 16, 2018

Clinically it's essentially the same as influenza. Similar symptoms, similar treatments, which is mainly just supportive care. Like influenza, it has a fairly set duration as well, so basically you treat symptoms until the virus runs it's course.

Nsco2018 · Sep 16, 2018

Clinically it's essentially the same as influenza. Similar symptoms, similar treatments, which is mainly just supportive care. Like influenza, it has a fairly set duration as well, so basically you treat symptoms until the virus runs it's course.

So it can be treated with antivirals? I know that seems like common sense since it is a virus but I read Somewhere there is no known antiviral to treat it

MunoRN, RN · Sep 16, 2018

So it can be treated with antivirals? I know that seems like common sense since it is a virus but I read Somewhere there is no known antiviral to treat it

There is no antiviral approved for use in the case of hantavirus, although there may be effect against hantavirus when using with influenza-approved antivirals. It's unlikely though that they would be any more effective in treating hantavirus than they would be in treating influenza, and they aren't all that effective in treating influenza.

cleback · Sep 16, 2018

Following.
I was told it is rapidly progressing and essentially as soon as the diagnosis is confirmed, patient is intubated. Not so sure about the last part...

Sorry, going to quote myself but I found this on the CDC website under treatment:

"In intensive care, patients are intubated and given oxygen therapy to help them through the period of severe respiratory distress. The earlier the patient is brought in to intensive care, the better. If a patient is experiencing full respiratory distress, it is less likely the treatment will be effective."

So maybe what I was told was correct?

meanmaryjean, DNP, RN · Sep 16, 2018

We had a case in IN during the original outbreak where it was identified. He arrived in 'almost dead' condition and lingered a few days as I recall. It was during a really bad summer drought- there was very real concern about it becoming airborne over a wide area.

BSN16 · Sep 16, 2018

My boyfriend's aunt died from this. Ended up having to go on ecmo for it, clotted off and died. Took a very long time to diagnose, not sure exactly how it was diagnosed.

Home Health Columnist / Guide · Sep 16, 2018

Lung Association has good information:

Hantavirus Pulmonary Syndrome (HPS) Symptoms, Causes and Risk ...

Key Facts:

People exposed to rodent secretions (such as urine or saliva) or with a history of recent travel to rural areas (potential rodent exposure) are at risk for developing HPS.
Symptoms include abrupt onset of fever, chills, weakness, nausea, vomiting and abdominal pain followed by difficulty breathing.
HPS can be rapidly fatal if not identified and treated promptly.
There isn't a vaccine for HPS, and treatment Treatment of HPS is Supportive care: oxygen therapy, fluid replacement and use of medications to support blood pressure. Due to the risk of rapid respiratory deterioration, patients suspected to have HPS should be transported immediately to a hospital with intensive care monitoring, support with mechanical ventilation (respirator) and kidney dialysis.

broughden · Sep 16, 2018

There are a few clinical trials either recently completed or currently underway testing both possible vaccines and/or antivirals.

USAMRID is currently testing a hanta DNA vaccine. The problem is the sheer number of different hantaviruses currently known (20+) and whether one antigen will provide protection against them all. The hope is that it will provide at least enough protection to keep symptoms to a minimum. They are testing for the hemorrhagic fever with renal syndrome (HFRS) versus pulmonary syndrome (HCPS).

Green Cross (a Korean pharma company) tried to produce one but it didnt work based on titer tests.

Both the US and Chile tested Ribavirin intravenously against and while it showed a 7 fold reduction in mortality when used against HFRS, there was no benefit shown in using it against HCPS.

Chile also tested Methylprednisolone but there was no significant difference in mortality in the study. (41% mortality rate for confirmed HCPS cases)

According to current animal trials Favipiravir (T-705) is highly effective in preventing viral replication. But no human trials yet.

Im curious if Gamma-Globulin given in suspected cases of exposure to hantavirus could be effective as it is against Hep A. To my knowledge this has not yet been tested.

And just so everyone is aware, there have been confirmed cases of human to human transmission of the ANDV (Andes) version of the hantavirus responsible for HCPS so make sure you wear proper protection.