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What do we want know about Hantavirus Pulmonary
Syndrome (HPS)?
Susan RedwoodPUBH 6165
Walden University
A global public health problem
Stakeholders
Community members
Immunocompromised patients including those with HIV/AIDS, cancers and other blood borne diseases
Government at all levels (local, state, national)
Healthcare facilities (Clinics, hospitals, nursing home, group home etc)
Education institutions (primary schools, colleges, universities, libraries)
Community centers
CDC, EPA, FDA, WHO
Stakeholders contd.
Landlords and people who live in poor and overcrowded environment
Local businesses (restaurants, shopping malls, place of employment)
Homeless shelters
Mass media (Internet, TV, Radio, Twitter, Face book, Cell phones)
Doctors office
Churches
Should you be afraid of a mouse in your house?
What is Hantavirus Pulmonary Syndrome?
A severe and sometimes fatal respiratory disease in humans caused by infection with a hantavirus.
Lipid-enveloped, spherical viruses approximately 80-110 in diameter
From Bunyaviridae family with 3 RNA segment (small, medium, large which encode Viral nucleocapsid (N) Glycoproteins (G1and G2) RNA polymerase (Pol)
(Skehan,n.d.)
Molecular Structure
(Infection landscape, 2012)
History
First discovered in Asia during the Korean War
Virus was not isolated until 1976
Classified under its own genus "hantavirus”
First American outbreak occurred in May of 1993 among healthy members of the Navajo Nation in New Mexico who died within a short period of time
(Hantavirus info, 1998)
Etiology
Deer mouse White-tailed mouse Cotton rat Rice rat
How is the virus transmitted
Cases reported by race
Caucasians 78%
American Indians 18%
African Americans 2%
Asian 1%
(CDC, 2014)
Diagnosis
Physical examination difficult to diagnose in early stage because symptoms mimic influenza
Serological testing immunofluorescent antibody test (IFA), enzyme-linked immunosorbent assays (ELISA), immunoblotting and virus neutralization
Obtain tissue samples for antigens with immunohistochemistry
Chest X-Ray
Pulse oximetry to measure oxygen saturation
(Cfsph, 2009)
Early Signs and Symptoms
Fatigue
Fever
Muscle aches
Headache
Dizziness
Chills
Nausea
Vomiting
Diarrhea
Abdominal pain
(Health crafter, 2013)
Late Signs and Symptoms
Cough Shortness of breath with or without chest
tightness Fluid filled lungs
http://www.cdc.gov/hantavirus/technical/hps/clinical-manifestation.html
Complications
Acute Respiratory Distress Syndrome (ARDS)
Kidney failure
Hypoxia
Hypotension
Death
http://media.victoriaadvocate.com/img/photos/2013/09/28/hanta_virus_ew_092913_04_221015.jpg
Treatment
Confirmed diagnoses admission to hospital
Intravenous fluids
Medication administration
Oxygen
Ventilator support for respiratory complication
Prevention
No vaccine available at present
Avoid contact with rodents in home, worksite, camp, barn, shed
Seal gaps and holes
Set up rodent traps
Keep all area clean and free of food
Use gloves and mask for contact with rodents
Avoid the use of vacuum for rodent debris
Decontaminate surface areas with detergent and bleach solution
Challenges
Prognosis is fair to poor: Misdiagnosis Recovery rate 62% Mortality rate 38% Prolonged hospitalization Poverty Lack of or inadequate access to medical care
http://www.cdc.gov/hantavirus/surveillance/annual-cases.html
Future Research
Combine ecology and change in other host-virus ecosystems via modeling and hypothesis-driven research
Concentrate on risk of exposure, multidirectional transmission, and human disease (Johnson, Figueiredo, &Vapalahti, 2010)
(CDC, 2012)
The future of vaccination
(Medcity News, 2012)
References
Centers for Disease Control and Prevention. (2012). Hantavirus. Retrieved from http://www.cdc.gov/hantavirus/technical/hanta/ecology.html
Centers for Disease Control and Prevention. (2013). CDC, Hantavirus Pulmonary Syndrome. Retrieved from http://www.cdc.gov/hantavirus/hps/index.html
Centers for Disease Control and Prevention. (2014). Reported cases of HPS. Retrieved from http://www.cdc.gov/hantavirus/surveillance/index.html
Center for Food Security and Public Health. (2009). Hantavirus. Retrieved from http://www.cfsph.iastate.edu/Factsheets/pdfs/hantavirus.pdf
Hantavirusinfo. (1998). Basic facts about HPS and the hantivirus. Retrieved from http://www.hantavirus.net/info1.html
Healthcrafter. (2013). Step to avoid hantivirus outbreak. Retrieved from http://healthcrafter.net/steps-to-avoid-hantavirus-outbreak/3069
Hepojoki,J., Strandin,T., Lankinen,H., & Vaheri,A. (2012). Hantavirus structure—molecular interactions behind the scene. Journal of General Virology, 93(8), 1631-44.
Infection Landscape. (2012). Hantaviruses. Retrieved from http://www.infectionlandscapes.org/2012/09/hantaviruses.html
References
Johnson,C., Figueiredo, L., & Vapalahti, A. (2010). A global perspective on hantavirus ecology, epidemiology and disease. Clinical Microbiology Reviews, 23(2), 412-441.
Mayo Clinic. (2014). Hantavirus pulmonary syndrome cause- disease and conditions. Retrieved from http://www.mayoclinic.org/diseases-conditions/hantavirus-pulmonary-syndrome/basics/causes/con-20030129
Medcity News. (2012). Cross-kingdom vaccine may protect against fungal and bacterial infection. Retrieved from http://medcitynews.com/2012/05/cross-kingdom-vaccine-may-protect-against-fungal-and-bacterial-infections/
Skehan, E. (n.d). Hantavirus Pulmonary Syndrome (HPS). Retrieved from http://www.austincc.edu/microbio/2421c/hps.htm
Worthy, S. (2009). Earth end: New beginning. Retrieved from http://www.earthend-newbeginning.com/page/32/