EPIDEMIOLOGY AND TRANSMISSION OF HANTAVIRAL CARDIOPULMONARY SYNDROME

汉病毒心肺综合征的流行病学和传播

• 批准号: 6352634
• 负责人: Brian L. Hjelle
• 金额: $ 10.05万
• 依托单位: UNIVERSITY OF NEW MEXICO
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-01 至 2001-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6352634
• 关键词: Hantavirus; South America; cardiopulmonary disease; clinical chemistry; clinical research; communicable disease transmission; cooperative study; disease outbreaks; emerging infectious disease; epizootiology; human subject; questionnaires; virus antigen

Hantavirus cardiopulmonary syndrome (HCPS) is an often-fatal acute viral infection that was first recognized in 1993. The viruses that cause HCPS are transmitted to man from wild rodents. More than 200 cases with 45% of them fatal have been reported in North America. In South America, HCPS is proving to be more common and just as lethal as its North American counterpart. The rodents that carry HCPS viruses in South America are different but related to those that carry HCPS viruses in North America. As of August 1998, Chile and Argentina combined have experienced about as many cases (228) as the US and Canada, and with a case-fatality rate of 50%. The viruses active in South America are quite similar to those in North America, but not the same. Both the North American and South American diseases have the potential to cause epidemics, because rodent populations can increase drastically in response to climatological and ecological changes. Up until recently, however, we could take some comfort in knowing that hantaviruses are transmitted solely from rodent to man, and that person-to-person transmission was unheard of. Thus, epidemics could be controlled if the public was given sufficient and helpful advice about how to avoid contact with wild rodents. In late 1996, an outbreak occurred in southern Argentina involving very clear examples of person-to-person transmission of HCPS. Especially affected were hospital workers who treated patients with HCPS. This result was completely unexpected and led to heightened concern about increased epidemic potential of HCPS in both North and South America. It is disturbing that we know virtually nothing about the mechanism of interpersonal transmission of the Argentine/Chilean virus, Andes virus. Safety practices in Argentina were not noticeably different from those in the US or elsewhere. In addition, extraordinary examples of "clustering" of cases in Argentina and Chile have emerged since that suggest that the Argentine outbreak of 1996 was not unique. In this application, we will conduct both epidemiology and laboratory studies to try to define exactly how Andes virus is transmitted in southern Chile. Specifically we will study populations for hantavirus antibodies and use questionnaires to establish what kinds of rodent or interpersonal exposures might result in Andes virus transmission. We will study the blood, urine and lung secretions of patients with HCPS to determine whether Andes virus is present in high quantities in bodily fluids. We will also determine what viruses other than Andes virus might be associated with HCPS in Chile. With the information learned from this proposal, we hope to be able to offer very specific advice about ways to reduce the risk of contracting the viruses that cause HCPS.

汉坦病毒心肺综合征（HCP）是一种通常是致命的急性病毒感染，于1993年首次被识别。引起HCP的病毒是从野生啮齿动物传播到人的。北美报告了200多个案例，其中45％的致命案件已有报道。在南美，HCP被证明更为普遍，与北美同行一样致命。南美携带HCP病毒的啮齿动物不同，但与北美携带HCP病毒的啮齿动物有关。截至1998年8月，智利和阿根廷的合并经历了大约与美国和加拿大一样多的案件（228），并且案件策略率为50％。在南美活跃的病毒与北美的病毒非常相似，但不一样。北美和南美疾病都有可能引起流行病的潜力，因为啮齿动物种群可以响应气候和生态变化而大大增加。然而，直到最近，我们才能知道汉坦病毒仅从啮齿动物到人传播，并且这种人对人的传播是闻所未闻的。因此，如果向公众提供有关如何避免与野生啮齿动物接触的足够和有用的建议，则可以控制流行病。 1996年底，阿根廷南部发生了一次爆发，​​其中涉及非常明确的HCP传播例子。特别受影响的是治疗HCP患者的医院工作人员。这一结果是完全出乎意料的，引起了人们对北美HCP的流行潜力增加的关注。令人不安的是，我们几乎不知道阿根廷/智利病毒的人际传播机制，安第斯山脉病毒。阿根廷的安全实践与美国或其他地方的安全实践并没有明显不同。此外，由于这表明1996年的阿根廷爆发并非独特，因此出现了阿根廷和智利案件“聚类”的特殊例子。在此应用中，我们将同时进行流行病学和实验室研究，以确切定义安第斯山脉病毒在智利南部如何传播。具体而言，我们将研究汉坦病毒抗体的种群，并使用问卷来确定哪些类型的啮齿动物或人际暴露可能导致安第斯山脉病毒的传播。我们将研究HCP患者的血液，尿液和肺部分泌物，以确定体液中是否存在高量的Andes病毒。我们还将确定除安第斯山脉病毒以外的其他病毒可能与智利中的HCP有关。通过从该提案中学到的信息，我们希望能够提供有关减少引起HCP病毒风险的方法的非常具体的建议。