High Seroprevalence of Hantavirus Infection on the Azuero Peninsula of Panama

Abstract

The first outbreak of hantavirus pulmonary syndrome (HPS) in Central America was documented on the Azuero peninsula of Panama in late 1999 and 2000. Reverse transcriptase-polymerase chain reaction evidence implicated only Choclo virus in symptomatic HPS with a mortality rate of 20%, although two rodent-borne hantaviruses (Choclo virus and Calabazo virus) were identified in the peridomestic habitat. Neighborhood serosurveys around case households found seroprevalence rates as high as 30%, the highest in the Americas except for western Paraguay. We report here population-based serosurveys for 1,346 adults and children in four communities, three on the Azuero peninsula and one in adjacent central Panama. Overall seroprevalence ranged from 33.2% in a population engaged in farming and fishing on Isla de Cañas, to 16.3% and 21.2% in two mainland agricultural communities, to 3.1% in central Panama, with a modest male predominance of 1.2:1. Nine percent of children 4-10 years old were seropositive, and seroprevalence increased with age in all communities, with highest levels of 52% in those 41-50 years old cohort on Isla de Cañas. Univariate analysis identified correlations between seroprevalence and multiple agricultural and animal husbandry activities. However, stepwise logistic regression models identified only raising animals (cows, pigs, goats, poultry) and fishing as significant independent variables. Human infection with hantavirus on the Azuero peninsula, either with Choclo virus or combined with Calabazo virus, is frequent but rarely results in hospitalization due to respiratory illnesses resembling HPS.

Hantavirus infection: a global zoonotic challenge

“…Most cases occur during the late spring and early summer months, in contrast to hantavirus infections in Asia. The seroprevalence of hantavirus has been reported in healthy populations (Ferrer et al, 2003;Armien et al, 2004). In North America, SNV is the most prevalent hantavirus that causes HCPS (Knust and Rollin, 2013), whereas in South America, ANDV is the most significant pathogenic hantavirus, with ongoing discovery of new strains (Jonsson et al, 2010;Firth et al, 2012).…”

Hantavirus Fever without Pulmonary Syndrome in Panama

“…4,5 Three other HVs are found in Panama, including two in the HPS-endemic region (Calabazo virus in Zygodontomys brevicauda cherriei and an unnamed virus in Sigmodon hirsutus) and one outside of the HPS-endemic region (a relative of Rio Segundo virus in Reithrodontomys species). 4,6 A high prevalence of HV antibodies in serum, ranging from 12% to 45%, was noted in neighborhoods of HPS patients 3 and community-wide surveys 7,8 among individuals who had no history of hospitalization for respiratory insufficiency. A comparably high seroprevalence found in northern Argentina and Paraguay 9 and in Brazil [10][11][12] contrasts with low seroprevalence in Andes virus-endemic regions.…”

Serologic Investigation of Hantavirus Infection in Patients with Previous Thrombocytopenia, and Elevated Urea and Creatinine Levels in an Epidemic Region of Turkey

“…However, other reports claim that Hantavirus infection rates are more closely related to changes in virus infectivity, loss of forests, increased cultivated areas, and individual risk factors than increased numbers of rodents (36,43). Yet, it is also known that rodent populations fluctuate significantly with the ecological cycle, and that climate influences this cycle (7).…”

“…Hantavirus infection is known to affect forest workers, campers, soldiers, hunters and people living in cottages (7,36). Farmers are also at risk because of increased contact with rodents and their surroundings (4,30,37,38).…”