A hantavirus infection is notifiable in Germany and can take a severe course. Successful therapies depend on the form of the hantavirus infection.
What is hantavirus infection?
Hantavirus infection is an infectious disease that can be caused by different forms of hantavirus.
Hantavirus infection is found to varying degrees around the world; for example, the infection is relatively widespread in Southeast Asia. Cases of hantavirus infection also occur in Europe: a relative frequency can be observed here, for example in the Balkans or in parts of Scandinavia. The hantavirus infection was named after the South Korean river Hantan, where many soldiers contracted the virus during the Korean War in the 1950s.
In Germany, a hantavirus infection has been notifiable since 2001. According to the Robert Koch Institute (a federal institute that is familiar with infectious diseases, among other things), in 2007 hantavirus infection was one of the five most common viral diseases that had to be reported on a national average.
Causes
Hantavirus infection is primarily transmitted to humans by rodents. Although infection can also occur from person to person, this happens comparatively rarely.
Transmission of the hantavirus infection by rodents takes place primarily via the animals’ excretions; The pathogens of the hantavirus infection are then ingested by humans via the air they breathe. Due to this source of transmission, people who frequently come into contact with potential excrements from rodents are particularly at risk:
For example, people who are employed as hunters, foresters or soldiers are at higher risk of hantavirus infection and are therefore relatively often in forests where rodents live.
Symptoms, Ailments & Signs
A hantavirus infection can manifest itself through very unspecific symptoms. As a rule, flu – like symptoms appear at the beginning, such as a sudden high fever with chills, headaches and body aches. The eyes are often extremely sensitive to light, and visual disturbances are also possible. Occasionally there is a cough, sore throat, diarrhea, vomiting and abdominal pain.
Depending on the type of pathogen, the infection can spread to the kidneys or lungs: If the kidneys are involved, blood is often found in the urine, and the amount of urine also decreases significantly. Large amounts of protein can be detected in the urine. Other warning signs are the smallest bleeding (petechiae) in the skin, the mucous membrane and the conjunctiva of the eyes as well as a significant drop in blood pressure.
In severe cases, the progressing infection leads to complete kidney failure. In rare cases, a hantavirus infection can lead to inflammation of the heart muscle ( myocarditis ), inflammation of the thyroid gland ( thyroiditis ), inflammation of the liver ( hepatitis ) or functional disorders of the central nervous system.
Possible signs of lung involvement are severe coughing and increasing shortness of breath, which can develop into life-threatening acute respiratory distress syndrome (ARDS). Hantavirus infections take very different courses, often they go unnoticed due to the minor symptoms or are confused with a harmless cold. Severe forms, especially those with life-threatening involvement of the respiratory tract, are rare in Europe.
Diagnosis & History
In order to be able to diagnose a hantavirus infection, a diagnostician often first collects data on a patient’s professional activity and on his daily environment. This can serve as an initial risk assessment in relation to a hantavirus infection.
Other sources of information for the diagnostician for the diagnosis of a hantavirus infection are the so-called clinical (i.e. the observable or currently present) symptoms of a patient and various laboratory values (such as blood values).
The course of a hantavirus infection can vary greatly depending on the form of the hantavirus and the patient. In severe cases, hantavirus infection can be fatal. The incubation period (i.e. the time between infection and the first noticeable symptoms) of the hantavirus infection can be around 1-5 weeks.
Possible first symptoms of a hantavirus infection are, for example, fever, chills, muscle pain or pain in the lumbar spine. Depending on the form of a hantavirus infection, coughing, vomiting or diarrhea can also occur. Severe cases show up in kidney inflammation or bleeding in the gastrointestinal tract.
Complications
In the worst case, the hantavirus infection can lead to the death of the patient. Without treatment, there is no automatic healing process. The affected person suffers from this infection with fever and pain in different regions of the body. As a result, muscles and joints ache and there is a stabbing headache that can spread to the back.
Abdominal pain, sometimes even diarrhea or vomiting, also occurs. The patient can also suffer from a dry cough and usually also suffers from conjunctivitis. The patient’s everyday life is made more difficult and the person concerned feels tired and exhausted. Active participation in life is usually not possible due to the symptoms of the hantavirus infection. Furthermore, it can quickly lead to infection in other patients.
In the worst case, it can lead to inflammation in the kidneys, which can lead to kidney failure. If left untreated, this can lead to the death of the patient. Treatment takes place with the help of medication and is usually successful if started early. No other complications arise. After treatment, the affected person is usually immune to the hantavirus infection.
When should you go to the doctor?
Hantavirus infection is treated symptomatically. Depending on the type of virus and the immune system of the infected person, there may be no or life-threatening symptoms. In the case of an infection with the hantaviruses occurring in North and South America, there is, among other things, the risk of severe pneumonia with pulmonary edema, which requires medical supervision or treatment.
It is therefore advisable to consider the possibility of a hantavirus infection during stays on the American continent and to consult a doctor immediately if you suddenly develop lung problems. Asian and European strains of the hantavirus can cause HFRS (hemorrhagic fever with renal syndrome) in severe cases of infection; medical care is also absolutely necessary in these cases.
If symptoms of the first phase appear, such as high fever, chills, headaches and body aches, red eyes, nausea, abdominal and/or back pain, then there is a risk of the onset of a further, potentially life-threatening phase of the infection, ending in kidney failure can.
The doctor must be consulted even if the symptoms of the first phase are mentioned. In addition, an infection with the hantavirus is notifiable, although it is not always recognized by the doctor or those affected if it is mild or due to its flu-like symptoms.
Treatment & Therapy
The successful therapy of a hantavirus infection depends, among other things, on the diagnosed form of a hantavirus infection and the symptoms present. It often makes sense to have a hantavirus infection treated in clinics that, if necessary, have an adequate intensive care unit.
For the pure symptom treatment of a hantavirus infection, among other things, analgesics (medicines to combat pain) or so-called antipyretics (to combat fever) are used. If an affected person is found to have an impairment of the kidneys caused by an infection, it may be necessary to check the fluid balance and, if necessary, balance the fluid balance in the therapy of a hantavirus infection.
If, during the course of a hantavirus infection, there is also a failure of the kidneys, possible treatment steps include so-called hemodialysis ( i.e. blood washing that takes place outside the body with the help of an ‘artificial kidney’).
If the lung function is impaired during the course of the hantavirus infection, a therapeutic step can be ventilation in an intensive care environment. After successful therapy of a hantavirus infection, the affected person usually has immunity to the treated form of the hantavirus infection.
Outlook & Forecast
Statistically, the hantavirus causes death in rare cases in Europe. Viruses from rodents are hardly aggressive here. The situation is different in Asia and South America. There, scientists have not only detected far more dangerous pathogens. Rather, the local climatic conditions also offer good living and distribution conditions. The hygienic conditions allow contact with rats and mice and their excrements.
The infection with the hantavirus usually subsides without residual damage. A medically ordered therapy ensures an improvement in a short time. Only the so-called hantavirus pulmonary syndrome has a mortality rate of 50 percent. Most deaths are caused by organ failure. Anyone who observes the usual hygiene standards in Europe will hardly come into contact with infected rodents.
People at risk work almost exclusively in agriculture. After successfully combating the virus, you remain immune to the pathogen for decades. So far there is no vaccine to prevent hantaviruses.
Overall, it can be said that infection with hantaviruses in Germany usually takes a good course. In view of the less aggressive pathogens, the prospect of a complete cure can be classified as very favorable.
Prevention
Although there is still no approved vaccine against hantavirus infection, appropriate preventive measures can reduce the risk of hantavirus infection. For example, when cleaning locations of mouse or rat droppings (such as barns or attics), dampening the droppings beforehand or wearing a respirator can reduce the risk of hantavirus infection.
Aftercare
In the case of a hantavirus infection, the measures or the direct options for aftercare are severely limited in most cases. The focus here is on early detection and treatment of the disease so that there are no further complications or upsets. The earlier the disease is recognized by a doctor, the better the further course is, as a rule.
Therefore, those affected should consult a doctor at the first symptoms or signs of hantavirus infection. Most of the time, this infection is treated with medication. Those affected must ensure that they are taken regularly with the correct dosage. Side effects and interactions should also be taken into account.
If you have any questions or are unclear, always contact a doctor first. Furthermore, regular control of the internal organs is very important in the case of hantavirus infection, with the kidneys in particular being checked. In some cases, those affected are dependent on dialysis. The care and support of one’s own family or friends is often necessary to alleviate the symptoms properly. This infection may also reduce the life expectancy of the person affected.
You can do that yourself
Hantavirus infection is always treated with medication. The person affected can support the administration of analgesics and anapyretics with a number of measures.
Bed rest is important. Since it is a classic viral disease, the typical measures can be taken. It helps to adjust your diet and stop eating foods that could irritate the gastrointestinal tract. In addition, the body temperature should be measured regularly.
If the fever rises or falls suddenly, consult a doctor. The sufferer should also drink plenty of water and take supplements to compensate for any loss of fluids and nutrients. In severe cases, the patient must go to a hospital.
After intensive care, the body is very weak and should be rested for at least two to three weeks. In addition, a close check by a doctor is indicated, because complications can only be ruled out by regularly checking the blood values and the general state of health of the patient. If signs of a new outbreak of the hantavirus infection become noticeable after the treatment, the doctor responsible must be consulted immediately.
