Hantavirus

We’ve all heard about the strange end of actor Gene Hackman and his wife: The 95-year-old Hackman, his 65-year-old wife, and a dog were discovered dead in their home. She was found on the bathroom floor with a spilled bottle of pills, while he was in another room. A deceased dog was also found in a crate in the home, while two others were found alive outdoors.

Originally, I believed that she overdosed her husband, who had late-stage Alzheimer’s disease, and then took sleeping pills in a murder-suicide. That was not the case, however. It turns out that she died a week before Hackman of a rare illness called Hantavirus Pulmonary Syndrome (HPS). He died some days later of heart disease and dehydration.

WHAT IS HANTAVIRUS?

Members of the hantavirus family (hantaviridae) are mostly found in their natural reservoir: rodents. Rats and mice are likely to be constant companions of survival groups in disaster settings, so it’s important to know about them.

Hantaviruses are species-specific, which means that each type of rodent has its own version of the virus. While infected rodents remain outwardly healthy, they can transmit the disease to humans and cause life-threatening damage.

TRANSMISSION OF HANTAVIRUS TO HUMANS

Humans contract hantaviruses in several ways:

• Getting bitten or scratched by an infected animal.
• Being in contact with droppings or urine.
• Eating or drinking contaminated food or water.

Survival retreats with large stores of food are always high-risk for rodent infestations and the spread of infection.

Your next question should be: Can I get sick if I take care of someone with hantavirus? No, there haven’t been any cases of human-to-human transmission in the United States.  Although Gene Hackman’s wife had hantavirus, he did not.

HANTAVIRUS PULMONARY SYNDROME (HPS)

The initial symptoms of Hantavirus Pulmonary Syndrome are flu-like: Expect to see sudden onset of fever, cough, headache, and muscle pain. Three to five days later, the infected person may feel shortness of breath and chest pain. Respiratory failure follows rapidly due to an immune reaction gone haywire. In the Hackman case, the wife must have thought she had a cold, then collapsed. If so, what was in the medicine bottle? It was just thyroid pills.

Hantavirus pulmonary syndrome (HPS) made its first identifiable appearance in 1993. Every year in the Western US, a few cases are reported; the death rate is 30-60 percent. Survivors of the first few days recover in a few weeks, but may have long-term ill effects.

HEMORRHAGIC FEVER WITH RENAL SYNDROME (HFRS)

Hantavirus hemorrhagic disease was first described in an ancient Chinese medical text about 300-400 BC, one of a long line of disease-causing organisms originating in China.  It makes appearances throughout history in the Old World. During WWI, hantavirus disease was called “trench nephritis.” Nephritis simply means kidney inflammation. Cases were reported again during WWII, Korea, etc. Finally, in 1978, the virus was discovered and eventually given the name hantavirus.

100,000 cases of HFRS are reported annually, much more than its rarer cousin in the Americas. The death rate, however, is only about 1 percent or so, depending on the subtype.

CAN YOU TREAT HANTAVIRUS INFECTION?

It’s already been proven that a person made ill by hantavirus isn’t contagious to other humans. There is, sadly, no cure. In normal times, treatment depends on the particular variant and includes oxygen therapy, antiviral meds, and dialysis.

Unfortunately, there is no proven effective treatment off the grid. The medic should treat the symptoms like fever, ensure good hydration, and generally support the patient until they recover. Survivors may take weeks or months to fully return to normal, with chronic fatigue and decreased exercise tolerance commonly seen long-term. Symptoms include:

• Coughing
• Trouble breathing.
• Rapid heartbeat.
• Chest tightness.

PREVENTION OF HANTAVIRUS INFECTION

There isn’t a hantavirus vaccine, but diligent rodent-proofing can help reduce the risk of infection.  There are steps you can take to help reduce your risk:

• Avoid exposure to mice, rats, and their droppings.
• Wear gloves and a mask that covers your nose and mouth if you can’t avoid exposure to droppings.
• Use disinfectant on areas contaminated with mouse or rat droppings.
• Don’t use a broom to clean out droppings, as it causes viral dust enter into the air.
• Seal holes around the retreat that might allow mice and rats to enter.
• Set rodent traps in and around your home.
• Avoid leaving human or pet food outside.
• Assure good ventilation in the retreat.

More information on rodent-proofing a home can be found by clicking this link.

Joe Alton MD