Hantaviruses are a group of viruses that cause lung disease (hantavirus pulmonary syndrome) or blood vessels and kidneys (hemorrhagic fever with renal syndrome). This virus is carried and spread by rats and other rodents.
The spread of hantavirus infection to humans generally occurs through direct contact with the feces, urine, and saliva of infected mice. Hantavirus disease is rare, but quite dangerous. Death rate due to hantavirus pulmonary syndrome about 40%, and at hemorrhagic fever with renal syndrome around 5–15%.
Causes of Hantavirus Infection
Hantaviruses are a group of viruses that can infect humans and cause hantavirus disease. Hantavirus disease can cause a collection of symptoms or syndromes according to the part of the body it attacks.
Hantavirus is spread by rats or rodents. Until now, transmission of hantavirus infection between humans is very rare. Some factors that can increase a person's risk of being infected with hantavirus are:
- Touching faeces, saliva, or urine, from hantavirus-infected mice
- Inhaling airborne particles that contain hantavirus
- Eating food that has been contaminated with hantavirus
- Wounded by the bite of a hantavirus-infected rat
- Touching your eyes, nose, or mouth without washing your hands first after coming into contact with an object contaminated with hantavirus
Because it is carried and spread by mice infected with this virus, there are several conditions that can increase a person's risk of being infected with hantavirus, including:
- Stay and clean the house or area where there are a lot of mice
- Having a job that often comes in contact with rats or their secretions, such as the construction industry or pest control
- Have a hobby of camping, hiking, hunting, or doing other activities that have a high potential for contact with rats
Symptoms of Hantavirus Infection
Hantavirus disease does not immediately cause symptoms. New symptoms appear about 1-8 weeks after a person is exposed to and infected with this virus. Symptoms that arise depend on the organ that is attacked.
Hantavirus infection can cause hantavirus pulmonary syndrome (HPS) and hemorrhagic fever with renal syndrome (HFRS).
Hantavirus pulmonary syndrome (HPS)
In the early stages, HPS will cause symptoms such as:
- Fever
- Cheerful and not feeling well
- Headache
- Nausea and vomiting
- Stomach pain and diarrhea
- Muscle ache
- Unexplained fatigue
If left for a few weeks, people with HPS will experience the following symptoms:
- Fever
- Cough
- Shortness of breath or difficulty breathing
- Chest pain, like being tied tightly
In advanced stages, people with HPS will experience swelling of the lungs or pulmonary edema which can cause shock and be fatal.
Hemorrhagic fever with renal syndrome (HFRS)
Some of the early symptoms that can appear when a person has HFRS are fever, severe headache, back and abdominal pain, fatigue, blurred vision, redness of the face, and the appearance of a rash on the skin.
In advanced stages, HFRS will cause circulatory failure, low blood pressure, bleeding and plasma leakage, and acute kidney failure.
When to go to the doctor
Immediately see a doctor if you experience the symptoms mentioned above, especially if you have recently been in contact with or come into contact with rat body fluids. Examination and treatment need to be done immediately to prevent complications.
Get regular checkups if you are at risk of exposure to the hantavirus, for example from working in a pest control office or living in an area with a large number of rats.
Diagnosis of Hantavirus Infection
To diagnose a hantavirus infection, the doctor will ask the patient's symptoms and complaints, as well as his medical history. Next, the doctor will perform a thorough physical examination.
To confirm the diagnosis, the doctor will perform the following investigations:
- Blood tests, to determine the number and levels of blood cells, protein levels, electrolyte levels, as well as knowing liver and kidney function
- Urine test, to assess kidney function and see whether there is blood in the urine
- X-ray or CT scan of the chest in cases of HPS, to detect lung disorders, such as pulmonary edema
- Serology test, to detect hantavirus antigen in blood
- PCR test (polymerase chain reaction), to detect hantavirus in blood
Hantavirus Treatment
Treatment of hantavirus infection aims to relieve symptoms and prevent complications. There is no truly effective treatment for hantavirus infection. Treatment is generally carried out in the intensive care unit of a hospital. Some of the types of treatment that will be given are:
- Supplemental oxygen delivery via a breathing apparatus, including a ventilator
- Giving fluids through an IV, to restore fluid and electrolyte balance
- Administration of antiviral drugs, such as ribavirin, to treat viral infections in early-stage HFRS
- Administration of drugs to treat shock, including normalizing blood pressure
In patients with severe HPS, an ECMO can be inserted.extracorporeal membrane oxygenation). The goal is to replace damaged lung function, so that all body tissues still get adequate oxygen intake.
In patients with severe HFRS, doctors will recommend dialysis methods to replace damaged kidney function.
The earlier treatment is started, the better the patient's chances of recovery. The duration of recovery for HPS patients generally takes 2–3 weeks, while the recovery duration for HFRS patients varies more, ranging from 6 weeks to 6 months.
Complications of Hantavirus Infection
If left untreated, a hantavirus infection can lead to various complications, such as:
- Heart failure
- Kidney failure
- Severe pulmonary edema
- Shock
- Death
Hantavirus Prevention
Until now, there is no vaccine to prevent hantavirus infection. Therefore, the best way to prevent it is to avoid factors that make you more likely to be infected with this virus. Ways of prevention that can be done include:
- Make it a habit to diligently wash your hands with soap and water.
- Eliminate the circulation of rats around the house and workplace and close the access for rats to enter the house. If necessary, install a mousetrap.
- Keep food ingredients and tools used to process food clean.
- Clean your home and work area with disinfectant regularly, including cleaning places that allow mice to nest, such as trash cans, warehouses, and spaces that are cluttered or rarely used.
- Avoid contact with mice and their body fluids, namely saliva, urine, and feces.
- Use personal protective equipment (PPE) and follow applicable standard operating procedures (SOPs) if you have a job where you are in frequent contact with rats