Hantavirus pulmonary syndrome. Pathogenesis of an emerging infectious disease
- PMID: 7887439
- PMCID: PMC1869168
Hantavirus pulmonary syndrome. Pathogenesis of an emerging infectious disease
Abstract
A recent outbreak of a severe pulmonary disease in the southwestern United States was etiologically linked to a previously unrecognized hantavirus. The virus has been isolated from its major reservoir, the deer mouse, Peromyscus maniculatus, and recently named Sin Nombre virus. Clinically, the disease has become known as the hantavirus pulmonary syndrome (HPS). Since May 1993, 44 fatal cases of HPS have been identified through clinicopathological review and immunohistochemical (IHC) testing of tissues from 273 patients who died of an unexplained noncardiogenic pulmonary edema. In 158 cases for which suitable specimens were available, serological testing and/or reverse transcription-polymerase chain reaction (RT-PCR) amplification of extracted RNA was also performed. IHC, serological, and PCR results were concordant for virtually all HPS and non-HPS patients when more than one assay was performed. The prodromal illness of HPS is similar to that of many other viral diseases. Consistent hematological features include thrombocytopenia, hemoconcentration, neutrophilic leukocytosis with a left shift, and reactive lymphocytes. Pulmonary histopathological features were similar in most of the fatal HPS cases (40/44) and consisted of an interstitial pneumonitis with a variable mononuclear cell infiltrate, edema, and focal hyaline membranes. In four cases, however, pulmonary features were significantly different and included diffuse alveolar damage and variable degrees of severe air space disorganization. IHC analysis showed widespread presence of hantaviral antigens in endothelial cells of the microvasculature, particularly in the lung. Hantaviral antigens were also observed within follicular dendritic cells, macrophages, and lymphocytes. Hantaviral inclusions were observed in endothelial cells of lungs by thinsection electron microscopy, and their identity was verified by immunogold labeling. Virus-like particles were seen in pulmonary endothelial cells and macrophages. HPS is a newly recognized, often fatal disease, with a spectrum of microscopic morphological changes, which may be an important cause of severe and fatal illness presenting as adult respiratory distress syndrome.
Similar articles
-
Fatal illness associated with a new hantavirus in Louisiana.J Med Virol. 1995 Jul;46(3):281-6. doi: 10.1002/jmv.1890460320. J Med Virol. 1995. PMID: 7561804
-
Identification of a new North American hantavirus that causes acute pulmonary insufficiency.Am J Trop Med Hyg. 1995 Feb;52(2):117-23. doi: 10.4269/ajtmh.1995.52.117. Am J Trop Med Hyg. 1995. PMID: 7872437
-
Serologic and genetic identification of Peromyscus maniculatus as the primary rodent reservoir for a new hantavirus in the southwestern United States.J Infect Dis. 1994 Jun;169(6):1271-80. doi: 10.1093/infdis/169.6.1271. J Infect Dis. 1994. PMID: 8195603
-
Hantavirus pulmonary syndrome: clinical, diagnostic, and virologic aspects.Semin Respir Infect. 1995 Dec;10(4):259-269. Semin Respir Infect. 1995. PMID: 8668854 Review.
-
The incubation period of hantavirus pulmonary syndrome.Am J Trop Med Hyg. 2000 Jun;62(6):714-7. doi: 10.4269/ajtmh.2000.62.714. Am J Trop Med Hyg. 2000. PMID: 11304061 Review.
Cited by
-
Correlation of CD38 expression with the progression of hemorrhagic fever with renal syndrome.Arch Virol. 2021 Sep;166(9):2399-2406. doi: 10.1007/s00705-021-05136-5. Epub 2021 Jun 10. Arch Virol. 2021. PMID: 34114140
-
Binding of the Andes Virus Nucleocapsid Protein to RhoGDI Induces the Release and Activation of the Permeability Factor RhoA.J Virol. 2021 Aug 10;95(17):e0039621. doi: 10.1128/JVI.00396-21. Epub 2021 Aug 10. J Virol. 2021. PMID: 34133221 Free PMC article.
-
Pathogenesis and host response in Syrian hamsters following intranasal infection with Andes virus.PLoS Pathog. 2011 Dec;7(12):e1002426. doi: 10.1371/journal.ppat.1002426. Epub 2011 Dec 15. PLoS Pathog. 2011. PMID: 22194683 Free PMC article.
-
The Role of the Endothelium in HPS Pathogenesis and Potential Therapeutic Approaches.Adv Virol. 2012;2012:467059. doi: 10.1155/2012/467059. Epub 2012 Jun 28. Adv Virol. 2012. PMID: 22811711 Free PMC article.
-
Andes virus infection of lymphatic endothelial cells causes giant cell and enhanced permeability responses that are rapamycin and vascular endothelial growth factor C sensitive.J Virol. 2012 Aug;86(16):8765-72. doi: 10.1128/JVI.00817-12. Epub 2012 Jun 13. J Virol. 2012. PMID: 22696643 Free PMC article.
References
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical