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Update: Hantavirus-Associated Illness -- North Dakota, 1993
On August 27, 1993, a previously healthy 14-year-old North
Dakota boy died suddenly after a brief unexplained febrile
respiratory illness. Subsequent examination at CDC of specimens
from this patient demonstrated the presence of serum immunoglobulin
M antibody to hantavirus antigens, a positive polymerase chain
reaction assay for hantavirus genetic sequences in multiple
tissues, and a positive immunohistochemical stain for hantavirus
antigen in lung tissue, confirming the diagnosis of acute
hantavirus infection. The patient had no history of recent travel
outside the west north central region. An ongoing investigation of
this illness is being conducted by the state health department, the
Indian Health Service, and CDC.
Reported by: WB Kingree, MD, D Deegan, Fort Totten; RW Petty, MD,
Devil's Lake; L Johnson, MD, Grand Forks; SL McDonough, MD, LA
Shireley, MPH, State Epidemiologist, North Dakota State Dept of
Health and Consolidated Laboratories. TK Welty, MD, Indian Health
Service, Rapid City, South Dakota. Div of Viral and Rickettsial
Diseases, National Center for Infectious Diseases, CDC. Editorial Note
Editorial Note: The recognition of a case of hantavirus-associated
respiratory illness in North Dakota, in addition to previously
confirmed cases that have occurred outside of the four-corners
region of the Southwest (1-4), reinforces the need for clinicians
throughout the United States to maintain a high index of suspicion
for this condition and to inform local or state health authorities
of suspected cases. As of September 15, 36 cases, including the one
reported here, have been confirmed in the United States. Interim
recommendations to reduce the risk of exposure to potentially
infected rodents in the southwestern United States have been
published (5); these recommendations generally are applicable to
rural settings in other parts of the country.
References
CDC. Update: outbreak of hantavirus infection -- southwestern
United States, 1993. MMWR 1993;42:495-6.
CDC. Update: hantavirus infection -- United States, 1993. MMWR
1993;42:517-9.
CDC. Update: hantavirus disease -- southwestern United States,
1993. MMWR 1993;42:570-2.
CDC. Update: hantavirus disease -- United States, 1993. MMWR
1993;42:612-4.
CDC. Hantavirus infection -- southwestern United States: interim
recommendations for risk reduction. MMWR 1993;42(no. RR-11).
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