Hantaviruses in the United States

C. J. Peters, MD; Ali S. Khan, MD; Sherif R. zaki, MD, PhD
Arch Intern Med. 1996;156(7):705-707. doi:10.1001/archinte.1996.00440070019003.
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HANTAVIRUSES CAUSE chronic infections of rodents and occasionally infect other species as well. Several of the Old World viruses are well known as causes of hemorrhagic fever with renal syndrome (HFRS) in Eurasia. Although HFRS has rarely been described in the United States,1 it is assumed to be underreported. In 1993, an outbreak of febrile disease resembling adult respiratory distress syndrome occurred in the southwestern United States and was found to be caused by a new hantavirus, Sin Nombre virus.2

The unique pulmonary syndrome (hantavirus pulmonary syndrome [HPS]) differed from the renal disease so prominent in HFRS. Immunohistologic studies provide evidence of compartmentalization of a selective immune response in the lung in combination with large amounts of viral antigens in the pulmonary microvasculature.3 Detailed mechanisms of pathogenesis are not understood, although there are some similarities to HFRS.4 Selective inflammatory cell recruitment to the lung may occur


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