VHF Hanta Virus

Question 1

Actual exam question

What is the classification of Hanta virus

Answer 1

Bunyaviridae - Family

-ssRNA segmented genome
enveloped

Question 2

Hanta virus is often classified as New World or Old World

What are the different sub-types of virus?

Answer 2

New World
Sin Nombre - North America
Andes - South America

Old World
Hantaan - Korea/ Asia
Seoul - Korea/ Asia
Dobrava - Balkans
Puumala - Europe

Ensure that you write: Hanta virus - Sin Nombre.
Hantaan virus refers to the specific species in Korea

Question 3

What is clinical difference between Hanta virus New World and Old World?

Answer 3

New world - Hantavirus pulmonary syndrome

Old world - Haemorrhagic fever with renal syndrome

Question 4

What is the reservoirs of Hanta virus?

Answer 4

Rodents - mice/ rats/ moles/ shrews

Bats can also host

Question 5

How is Hanta virus transmitted?

Answer 5

Inhalation of aerosolised excreta/ urine

Non evidence of person-person, except via blood transmission

Question 6

What is incubation period of Hantavirus?

Answer 6

2 days to 8 weeks

Usual is 2-4 weeks

Question 7

What are typical symptoms of early Hanta virus infection?

Answer 7

Fever
Headache
GI symptoms

Bleeding/ renal failure in HFRS

Pulmonary failure in HPS

Question 8

Is Hantavirus present in the UK?

Answer 8

Yes - although only 6 cases of AKI due to Hanta

32% of rat owners were seropositive for Hanta virus antibodies

Question 9

What is case fatality rate of Hantavirus?

Answer 9

40% if HFRS/ HPS develops

Question 10

How to test for Hantavirus?

Answer 10

Blood - serology/ PCR

Urine - PCR

Question 11

What is treatment for Hantavirus infection?

Answer 11

Supportive - e.g ECMO

No specific drugs

Ribavirin shown some benefit in one Chinese trial. But other studies contradict this

Favipiravir - some efficacy in animal models if given early

Question 12

What vaccines are available for Hanta?

Answer 12

China - various inactivated vaccines

Korea - Hantavax - inactivated vaccine. But requires booster
25% protection 1 dose
50% protection 2 doses
75% protection 3 doses
Often used in South Korea for military

Question 13

How was Hanta virus discovered?

Answer 13

1953 during Korean war - UN soldier based in zone between North/ South border

Hanta virus discovered - named after the Hantaan river near North/ South border

Question 14

How was Hanta virus with pulmonary syndrome discovered in USA?

Answer 14

1993 4 Corners outbreak

4 corners -
Arizona/ New Mexico/ Colorado/ Utah

first human case of hanta virus.
50% mortality - 13 people died

all native American people - deer mice near fields/ homes