Hantavirus Pulmonary Syndrome
Steven Q. Simpson, MD*, Leslie Spikes, MD, Saurin Patel, MD,
Ibrahim Faruqi, MD, MPH
KEYWORDS
Hantavirus Pneumonia Viral pneumonia
Acute respiratory failure Hemorrhagic fever
Hantavirus pulmonary syndrome (HPS), a disease now known to have been present
for centuries, if not millennia, in the Americas was discovered only 16 years ago in
the southwestern United States.1 Two young long-distance runners who lived together
in the New Mexican desert fell victim in early May, 1993, to what seemed to be a rapidly
progressive pulmonary infection, and both of them died within days. The unusual
circumstance of two highly fit individuals succumbing in this manner, especially in
the spring, led health officials to investigate the cause and initiate surveillance for
other, similar cases. It soon became evident that they were in the midst of an outbreak
of a seriously deadly infectious agent and that the syndrome was one that had not
been previously described by the medical community.
The causative agent for the illness was soon (<6 weeks after the index cases were
identified) determined to be an unidentified North American member of the Hantavirus
genus. The clinical syndrome caused by this agent, ultimately named Sin Nombre virus
(SNV), came to be called the hantavirus pulmonary syndrome. This designation distinguished
it from previously described hantaviral illnesses, which were characterized as
hemorrhagic fever with renal syndrome (HFRS). Early in the course of events it became
evident that cardiac function, and respiratory function, are markedly impaired by
infection with this virus. For that reason, some authors have adopted the moniker
Hantavirus cardiopulmonary syndrome. Although that name certainly has logic, the
Centers for Disease Control and Prevention (CDC) continue to refer to the illness as
HPS, as does this article.
HANTAVIRUSES
The hantaviruses are an enveloped genus of the family Bunyaviridae. Virions are spherical
and encapsulated by a bilayered phospholipid membrane. The composition of each
virion is greater than 50% protein, 20% to 30% lipid, and 2% to 7% carbohydrate,
____________________________________________________________________
Division of Pulmonary and Critical Care Medicine, University of Kansas, 3901 Rainbow
Boulevard, Mail Stop 3007, Kansas City, KS 66160-7381, USA
* Corresponding author.
E-mail address: ssimpson3@kumc.edu (S.Q. Simpson).
Infect Dis Clin N Am 24 (2010) 159–173
doi:10.1016/j.idc.2009.10.011 id.theclinics.com
0891-5520/10/$ – see front matter ª 2010 Elsevier Inc. All rights reserved
Steven Q. Simpson, MD*, Leslie Spikes, MD, Saurin Patel, MD,
Ibrahim Faruqi, MD, MPH
KEYWORDS
Hantavirus Pneumonia Viral pneumonia
Acute respiratory failure Hemorrhagic fever
Hantavirus pulmonary syndrome (HPS), a disease now known to have been present
for centuries, if not millennia, in the Americas was discovered only 16 years ago in
the southwestern United States.1 Two young long-distance runners who lived together
in the New Mexican desert fell victim in early May, 1993, to what seemed to be a rapidly
progressive pulmonary infection, and both of them died within days. The unusual
circumstance of two highly fit individuals succumbing in this manner, especially in
the spring, led health officials to investigate the cause and initiate surveillance for
other, similar cases. It soon became evident that they were in the midst of an outbreak
of a seriously deadly infectious agent and that the syndrome was one that had not
been previously described by the medical community.
The causative agent for the illness was soon (<6 weeks after the index cases were
identified) determined to be an unidentified North American member of the Hantavirus
genus. The clinical syndrome caused by this agent, ultimately named Sin Nombre virus
(SNV), came to be called the hantavirus pulmonary syndrome. This designation distinguished
it from previously described hantaviral illnesses, which were characterized as
hemorrhagic fever with renal syndrome (HFRS). Early in the course of events it became
evident that cardiac function, and respiratory function, are markedly impaired by
infection with this virus. For that reason, some authors have adopted the moniker
Hantavirus cardiopulmonary syndrome. Although that name certainly has logic, the
Centers for Disease Control and Prevention (CDC) continue to refer to the illness as
HPS, as does this article.
HANTAVIRUSES
The hantaviruses are an enveloped genus of the family Bunyaviridae. Virions are spherical
and encapsulated by a bilayered phospholipid membrane. The composition of each
virion is greater than 50% protein, 20% to 30% lipid, and 2% to 7% carbohydrate,
____________________________________________________________________
Division of Pulmonary and Critical Care Medicine, University of Kansas, 3901 Rainbow
Boulevard, Mail Stop 3007, Kansas City, KS 66160-7381, USA
* Corresponding author.
E-mail address: ssimpson3@kumc.edu (S.Q. Simpson).
Infect Dis Clin N Am 24 (2010) 159–173
doi:10.1016/j.idc.2009.10.011 id.theclinics.com
0891-5520/10/$ – see front matter ª 2010 Elsevier Inc. All rights reserved
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