Hantavirus

• hemorrhagic fever with renal syndrome(old world), pulmonary syndrome(new world)
• Etiology : Hantavirus
  • genus Hantavirus
    • subgroup A(HFRS) : Hantaan virus, Seoul virus - 신증후군출혈열(한국형출혈열)
    • subgroup B(HPS) : Sin Nombre virus - 폐질환
    • subgroup C : no importance
  • reservoir : small rodents
  • no athropod vectors bunyavirus family에서 exceptional
• Occurence
  • during Korean War : fatality 30%
  • harbor cities, by ship rats (항구에서 선박의 쥐)
  • 10,000 case annually (Seoul, Hantaan)
• Transmission
  • striped field mouse(등줄쥐)가 매개체
  • human : contaminated water/food, dried material (aerosol)
    • 설치류 배설물에 의해 오염
    • human-to-human은 rare
    • lab workers, farmers
• Clinical manifestation
  • KHF(HFRS) 신증후군출혈열
    • sudden fever for 3-6 days
    • hemorrhage in axillary, neck, soft palate
    • renal functions insufficient
  • HPS 폐질환
    • high fever 등 → respiratory distress
    • 제때 치료하지 않으면 호흡 곤란으로 사망
• Diagnosis
  • IgM capture ELISA in acute cases 유용
  • hantavirus isolation은 쉽지 않음
• Differential Diagnosis : Tsutsugamushi(scrub typhus, ST)와 감별 진단 중요
  • 공통점 : 초여름-가을, 등줄쥐가 옮김
  • 차이점 (KFT / ST)
    • Duration of fever : 3-6일 / 일시적, sudden
    • Type of edema : erythema on face(얼굴 홍반) / maculopapular on trunk, hand, legs (몸통, 사지에 홍반)
    • Organs complicated : 심각한 경우 renal / pneumonia, myocarditis
• Therapy & Prophylaxis
  • 대증 치료, 백신 무의미, 개인 위생 관리