Serologic Evidence for Human Hantavirus Infection in Peru

Abstract

While human illness associated with hantavirus infection has been documented in many countries of South America, evidence for hantavirus transmission in Peru has been limited to the isolation of Rio Mamore virus from a pigmy mouse rat (Oligoryzomys microtis) in the Amazon city of Iquitos. To address the possibility of human hantavirus exposure in the region, we screened febrile patients reporting to health clinics in Iquitos from 2007 to 2010 for serological evidence of recent hantavirus infection. In addition, we conducted a serological survey for hantavirus-reactive IgG among healthy participants residing in Iquitos and rural areas surrounding the city. Through the febrile surveillance study, we identified 15 participants (0.3%; 15/5174) with IgM reactive to hantavirus (Andes virus) antigen, all with relatively mild, self-limited illness. From the cross-sectional serosurvey we found that 1.7% (36/2063) of residents of the Iquitos area had serum IgG reactive to one or more hantaviruses, with a higher prevalence in the urban population (2.2%, compared to 1.1% in rural areas). These results suggest that human infection with hantavirus has occurred in Peru.

Diversity and Distribution of Hantaviruses in South America

“…For example, all RIOMV-4 viruses detected here were recovered from rodents in Rondônia, Brazil, where HPS cases have been reported, yet no etiological agent has been identified (45). Similarly in Peru, serological reactivity to ANDV has revealed past evidence of hantavirus exposure in febrile patients, and fatal HPS has recently been reported, yet no associated hantavirus has been identified (6).…”

“…To assess the spatial dynamics of all South American hantaviruses (SAmC) and ANDV clade viruses only (AVC) in the context of rodent host distribution, phylogeographic models incorporating host distribution were compared to models that assigned location states according to other metrics (k-means clustering or South American biome type). According to AICM-based model selection, k-means clustering of the SAmC data into 6 groups (k-means [6]) fit the data better than the model where location states were assigned by host distribution (see Fig. S2a and b in the supplemental material).…”

Epidemiology of acute febrile illness in Latin America

“…Patients with confirmed acute hantavirus infection are mistakenly assumed to have DENV infection or leptospirosis, due to their similar clinical features and the endemicity of the latter two diseases in the region [24]. Epidemiological studies have shown noticeable differences in seroprevalence of antibodies against hantaviruses in humans ranging from 1% to 13.5%, according to geographical and ethnic differences [43,44]. Exposure to rural areas and history of peridomestic activities are some of the risk factors most reported [45].…”

Recent Evidence of Hantavirus Circulation in the American Tropic

“…Fifteen out of 5,174 patients, who had suffered a relatively mild disease, were found to be IgM reactive to ANDV antigen. In the same study, a cross-sectional analysis of healthy residents of Iquitos revealed a seroprevalence of 1.7% (33/2063) [53]. …”