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Hantavirus infections among overnight visitors to Yosemite National Park, California, USA, 2012

Jonathan J Núñez et al. Emerg Infect Dis. 2014 Mar.

Abstract

In summer 2012, an outbreak of hantavirus infections occurred among overnight visitors to Yosemite National Park in California, USA. An investigation encompassing clinical, epidemiologic, laboratory, and environmental factors identified 10 cases among residents of 3 states. Eight case-patients experienced hantavirus pulmonary syndrome, of whom 5 required intensive care with ventilatory support and 3 died. Staying overnight in a signature tent cabin (9 case-patients) was significantly associated with becoming infected with hantavirus (p<0.001). Rodent nests and tunnels were observed in the foam insulation of the cabin walls. Rodent trapping in the implicated area resulted in high trap success rate (51%), and antibodies reactive to Sin Nombre virus were detected in 10 (14%) of 73 captured deer mice. All signature tent cabins were closed and subsequently dismantled. Continuous public awareness and rodent control and exclusion are key measures in minimizing the risk for hantavirus infection in areas inhabited by deer mice.

Keywords: Peromyscus spp.; Sin Nombre virus; hantavirus; hantavirus pulmonary syndrome; respiratory infections; viruses.

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Figures

Figure 1
Figure 1
Dates of stay in Yosemite National Park, incubation periods, and dates of illness onset for 10 case-patients, 2012. Incubation period calculated as days from last date of Yosemite stay to first date of illness.
Figure 2
Figure 2
Regular and signature tent cabins, Yosemite National Park, summer, 2012. A) Outside view of a regular tent cabin. B). Outside view of a signature tent cabin. C) Inner layer of foam insulation under the canvas of a signature tent cabin.
Figure 3
Figure 3
Inside view of regular and signature tent cabins, Yosemite National Park, summer 2012. A) Regular tent cabin showing canvas affixed over a wood frame. B) Signature tent cabin showing drywall between the exterior canvas and the interior living space.
Figure 4
Figure 4
Damage from rodents tunneling in the foam insulation of a signature tent cabin, Yosemite National Park, summer 2012.
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