Non-HPS Hantavirus infection is a febrile illness with non-specific viral symptoms including fever, chills, myalgia, headache, and gastrointestinal symptoms. Typical clinical laboratory findings include hemoconcentration, left shift in the white blood cell count, neutrophilic leukocytosis, thrombocytopenia, and circulating immunoblasts.
Hantavirus Pulmonary Syndrome (HPS) is an acute febrile illness (i.e., temperature greater than 101.0°F [greater than 38.3°C]) with a prodrome consisting of fever, chills, myalgia, headache, and gastrointestinal symptoms, and one or more of the following clinical features:
Confirmed: A clinically compatible case of HPS or Non-HPS Hantavirus infection with laboratory evidence.
Laboratory testing should be performed or confirmed at a reference laboratory. Because the clinical illness is nonspecific and ARDS is common, a screening case definition can be used to determine which patients to test. In general, a predisposing medical condition (e.g., chronic pulmonary disease, malignancy, trauma, burn, and surgery) is a more likely cause of ARDS than HPS, and patients who have these underlying conditions and ARDS need not be tested for hantavirus.
Criteria to distinguish a new case of this disease or condition from reports or notifications which should not be enumerated as a new case for surveillance.
Not applicable
S = This criterion alone is Sufficient to classify a case.
N = All “N” criteria in the same column are Necessary to classify a case. A number following an “N” indicates that this criterion is only required for a specific disease/condition subtype (see below).
A = This criterion must be absent (i.e., NOT present) for the case to meet the classification criteria.
O = At least one of these “O” (Optional) criteria in each category (e.g., clinical evidence and laboratory evidence) in the same column—in conjunction with all “N” criteria in the same column—is required to classify a case. (These optional criteria are alternatives, which means that a single column will have either no O criteria or multiple O criteria; no column should have only one O.) A number following an “O” indicates that this criterion is only required for a specific disease/condition subtype.
| Criterion | Hantavirus Pulmonary Syndrome Confirmed | Non-HPS Hantavirus Infection Confirmed* |
|---|---|---|
| Clinical Evidence | ||
| fever (>101°F or >38.3°C) | N | O |
| bilateral diffuse interstitial edema | O | A |
| clinical diagnosis of ARDS | O | A |
| radiographic evidence of noncardiogenic pulmonary edema | O | A |
| unexplained respiratory illness resulting in death | O | A |
| acute onset of illness | N | N |
| healthcare record contains a diagnosis of HPS | O | |
| death certificate lists HPS as a cause of death or a significant condition contributing to death | O | |
| Laboratory Findings | ||
| detection of hantavirus-specific IgM | O | O |
| detection of rising titers of hantavirus-specific IgG | O | O |
| detection of hantavirus-specific RNA in clinical specimens | O | O |
| detection of hantavirus-specific antigen by IHC | O | O |
| acute thrombocytopenia (75% decrease over 2–3 days, not immune mediated) | O | O |
| autopsy examination demonstrating noncardiogenic pulmonary edema without an identifiable cause | O | A |
* Non-HPS Hantavirus Infection is NOT reportable in the state of Alabama.
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