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Hantavirus Pulmonary Syndrome (HPS)
1996 Case Definition
Clinical description
Hantavirus pulmonary syndrome (HPS), commonly referred
to as hantavirus disease, is a febrile illness characterized by bilateral
interstitial pulmonary infiltrates and respiratory compromise usually
requiring supplemental oxygen and clinically resembling acute respiratory
disease syndrome (ARDS). The typical prodrome consists of fever, chills,
myalgia, headache, and gastrointestinal symptoms. Typical clinical laboratory
findings include hemoconcentration, left shift in the white blood cell
count, neutrophilic leukocytosis, thrombocytopenia, and circulating immunoblasts.
Clinical case definition
An illness characterized by one or more of the following
clinical features:
- A febrile illness (i.e., temperature greater than
101.0 F [greater than 38.3 C]) characterized by bilateral diffuse
interstitial edema that may radiographically resemble ARDS, with
respiratory compromise requiring supplemental oxygen, developing
within 72 hours of hospitalization, and occurring in a previously
healthy person
- An unexplained respiratory illness resulting in
death, with an autopsy examination demonstrating noncardiogenic
pulmonary edema without an identifiable cause
Laboratory criteria for diagnosis
- Detection of hantavirus-specific immunoglobulin
M or rising titers of hantavirus-specific immunoglobulin G, or
- Detection of hantavirus-specific ribonucleic acid
sequence by polymerase chain reaction in clinical specimens, or
- Detection of hantavirus antigen by immunohistochemistry
Case classification
- Confirmed: a clinically
compatible case that is laboratory confirmed
Comment
Laboratory testing should be performed or confirmed at
a reference laboratory. Because the clinical illness is nonspecific and
ARDS is common, a screening case definition can be used to determine
which patients to test. In general, a predisposing medical condition
(e.g., chronic pulmonary disease, malignancy, trauma, burn, and surgery)
is a more likely cause of ARDS than HPS, and patients who have these
underlying conditions and ARDS need not be tested for hantavirus.
See also:
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