Hantavirus pulmonary syndrome in children: case report and case series from an endemic area of Brazil

Abstract

Hantavirus Cardiopulmonary Syndrome (HCPS) is an important emergent zoonosis associated with wild rodents in Brazil, where this viral infection in children is generally rare. We present HCPS in a child from the Pantanal Biome and a review of all reported pediatric cases in Mato Grosso State, an endemic area for HCPS in Brazil. The investigation used the Information System for Notifiable Diseases database (SINAN). A 12-year-old boy was hospitalized with fever and respiratory failure and hantavirus IgM and IgG antibodies were detected by ELISA in serum samples. During the period of 1999 to 2016, 32 HCPS pediatric cases confirmed by serology were reported to SINAN with a mortality rate of 34.4%. The possibility of hantavirus infection in children with acute febrile illness associated with respiratory failure should be considered mainly in recognized endemic areas as Mato Grosso State, contradicting a hypothesis that children are more protected from lung involvement.

Emergent Pneumonia in Children

“…The median between onset of symptoms and death is 5 days in the Reyes series (49). In a study of 32 infected Brazilian children showed similar clinical manifestations to adults identifying the two phases, prodromal, with non-specific symptoms and the cardiopulmonary syndrome phase, where cough (46.9%) and dyspnea (59.4%) appears; 59.4% of these children were hospitalized and the CFR was 34.4%, like was described by Reyes (51). In countries such as Barbados where hantavirus infection is milder, the infection in children can occur as a non-specific febrile syndrome mistaken for arbovirus infections such as dengue (52).…”

“…The laboratory findings include thrombocytopenia in 94.7%, hemoconcentration in 63.1%, left shift leukocytosis in 47.3%, and atypical lymphocytes in 26.3% (51).…”

Factors in time to malaria treatment in the Brazilian Amazon: a survival analysis

“…Historically in LA, mining, gold panning and forestry were high-exposure occupations [28,29] due to their environmental impact, poor living conditions, remoteness and low access to health services. It is also important to highlight the relationship between malaria and gold mining/panning as a major source of disease in the areas where it is done, because the nature of the activity itself favors contact with and proliferation of mosquitoes [30][31][32].…”

Doenças infecciosas: inovações e aprendizados para área médica

“…Somando-se aos achados supracitados, o estudo de Santos et al (2019), no qual há o relato de 10 pacientes com SCPH que evoluíram para o óbito poucas horas ou dias após a admissão e que foram submetidos à necropsia entre os anos de 2000 e 2014, reforça o predomínio do sexo masculino com atividades relacionadas à área rural e contato prévio com roedores. Terças-Trettel et al (2019) analisaram dados secundários de casos de SCPH em crianças do MT, confirmados entre os anos 1999 e 2018, sendo 32 deles em menores de 14 anos. 84,4% dos casos de exposição das crianças ocorreram em casa durante a vida cotidiana, as condições de risco mais relatadas foram o contato com casos humanos em suas famílias (56,2%), presença ou participação na limpeza da casa (50%) e contato direto com roedores (40,6%).…”

“…A fase prodrômica, com duração de 3 a 4 dias, clinicamente apresenta sintomas pouco específicos como vômito, tontura, tosse não produtiva e náuseas (RUPASINGHE et al, 2021). Terças-Trettel et al (2019) relataram que a sintomatologia mais comumente descrita abrangia febre (75%), dispneia (59,4), tosse (46,9%), cefaleia (43,7%) e dor abdominal (43,7%). Em consonância, Santos et al (2019) concluíram que febre (80%), dispneia (90%) e mialgia (70%) estiveram presentes na análise dos pacientes em estudo.…”