Person-to-Person Household and Nosocomial Transmission of Andes Hantavirus, Southern Chile, 2011

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Abstract

Four persons became ill after exposure to a patient infected with the virus; 2 cases involved hospital transmission.

Abstract

Andes hantavirus (ANDV) causes hantavirus cardiopulmonary syndrome in Chile and is the only hantavirus for which person-to-person transmission has been proven. We describe an outbreak of 5 human cases of ANDV infection in which symptoms developed in 2 household contacts and 2 health care workers after exposure to the index case-patient. Results of an epidemiologic investigation and sequence analysis of the virus isolates support person-to-person transmission of ANDV for the 4 secondary case-patients, including nosocomial transmission for the 2 health care workers. Health care personnel who have direct contact with ANDV case-patients or their body fluids should take precautions to prevent transmission of the virus. In addition, because the incubation period of ANDV after environmental exposure is longer than that for person-to-person exposure, all persons exposed to a confirmed ANDV case-patient or with possible environmental exposure to the virus should be monitored for 42 days for clinical symptoms.

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Most cited references 28

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Hantaviruses: a global disease problem.

C Schmaljohn, B Hjelle (1997)

Hantaviruses are carried by numerous rodent species throughout the world. In 1993, a previously unknown group of hantaviruses emerged in the United States as the cause of an acute respiratory disease now termed hantavirus pulmonary syndrome (HPS). Before than, hantaviruses were known as the etiologic agents of hemorrhagic fever with renal syndrome, a disease that occurs almost entirely in the Eastern Hemisphere. Since the discovery of the HPS-causing hantaviruses, intense investigation of the ecology and epidemiology of hantaviruses has led to the discovery of many other novel hantaviruses. Their ubiquity and potential for causing severe human illness make these viruses an important public health concern; we reviewed the distribution, ecology, disease potential, and genetic spectrum.

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A phylogenetic mixture model for detecting pattern-heterogeneity in gene sequence or character-state data.

Mark Marty Pagel, Andrew Meade (2004)

We describe a general likelihood-based 'mixture model' for inferring phylogenetic trees from gene-sequence or other character-state data. The model accommodates cases in which different sites in the alignment evolve in qualitatively distinct ways, but does not require prior knowledge of these patterns or partitioning of the data. We call this qualitative variability in the pattern of evolution across sites "pattern-heterogeneity" to distinguish it from both a homogenous process of evolution and from one characterized principally by differences in rates of evolution. We present studies to show that the model correctly retrieves the signals of pattern-heterogeneity from simulated gene-sequence data, and we apply the method to protein-coding genes and to a ribosomal 12S data set. The mixture model outperforms conventional partitioning in both these data sets. We implement the mixture model such that it can simultaneously detect rate- and pattern-heterogeneity. The model simplifies to a homogeneous model or a rate-variability model as special cases, and therefore always performs at least as well as these two approaches, and often considerably improves upon them. We make the model available within a Bayesian Markov-chain Monte Carlo framework for phylogenetic inference, as an easy-to-use computer program.

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Hantavirus pulmonary syndrome outbreak in Argentina: molecular evidence for person-to-person transmission of Andes virus.

P.J. Padula, A. Edelstein, S.D.L. Miguel … (1998)

An increase of Hantavirus Pulmonary Syndrome (HPS) cases around a southwestern Argentina town and in persons living 1400 km away but in contact with those cases was detected during the spring of 1996. In order to evaluate person-to-person transmission we compared the homology of PCR-amplified viral sequences of 26 Argentine and Chilean cases. Sixteen of them were epidemiologically linked cases and had the same sequence (Epilink/96) in the S segment 3' noncoding region and in the M segment partial G1 and G2 region (a total of 1075 nucleotides). Contrarily, two geographical and contemporary but nonepidemiologically related cases differed from Epilink/96 in the compared regions. No significant differences, such as glycosylation or hydrophilic pattern, were found between Epilink/96 and the other sequences. Nucleotide and deduced amino acid sequence homologies between samples from southern Argentina and Chile ranged from 90.9 to 100% and 96.4 to 100%, respectively. Phylogenetic analysis revealed that all the analyzed southwestern viruses belong to the Andes lineage. Although human infection principally occurs via inhalation of contaminated rodent excreta, our results with Andes virus show the first direct genetic evidence of person-to-person transmission of a hantavirus.

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Author and article information

Journal

Journal ID (nlm-ta): Emerg Infect Dis

Journal ID (iso-abbrev): Emerging Infect. Dis

Journal ID (publisher-id): EID

Title: Emerging Infectious Diseases

Publisher: Centers for Disease Control and Prevention

ISSN (Print): 1080-6040

ISSN (Electronic): 1080-6059

Publication date (Print): October 2014

Volume: 20

Issue: 10

Pages: 1629-1636

Affiliations

[1]Pontificia Universidad Católica de Chile, Santiago, Chile (C. Martinez-Valdebenito, R.E. Palma, M. Ferrés);

[2]Universidad Austral de Chile, Valdivia, Chile (M. Calvo);

[3]Clínica Alemana–Universidad del Desarrollo, Santiago, Chile (C. Vial, C. Marco, P.A. Vial, F. Valdivieso);

[4]Secretaría Regional Ministerial, Valdivia, Chile (R. Mansilla);

[5]University of New Mexico, Albuquerque, New Mexico, USA (G. Mertz)

Author notes

Address for correspondence: Marcela Ferrés, Escuela de Medicina, Pontificia Universidad Católica de Chile, Marcoleta 391, Santiago, 8320000, Chile; email: mferres@ 123456med.puc.cl

Article

Publisher ID: 14-0353

DOI: 10.3201/eid2010.140353

PMC ID: 4193174

PubMed ID: 25272023

SO-VID: acd07698-154f-4317-8c9e-49fddbd0aaa8

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Person-to-Person Household and Nosocomial Transmission of Andes Hantavirus, Southern Chile, 2011

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IEEE: COVID-19 related research

Most cited references 28

Hantaviruses: a global disease problem.

A phylogenetic mixture model for detecting pattern-heterogeneity in gene sequence or character-state data.

Hantavirus pulmonary syndrome outbreak in Argentina: molecular evidence for person-to-person transmission of Andes virus.

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