Introduction

Hantavirus cardiopulmonary syndrome (HCPS) is a viral zoonosis that may result in cardiogenic shock and respiratory failure with significant associated mortality. Hantavirus infection has been identified throughout much of North, Central, and South America. In the United States 586 cases of HCPS have been reported through December 2012 with a case-fatality rate of 35%. Half of these cases have been in the Four Corners area in the southwest. The incidence is even greater in South America, particularly in Argentina, Brazil, Chile, and Paraguay. In Chile alone, 795 cases have been reported through December 2012, with a case-fatality rate of 35%.

Virology

HCPS is caused by an infection with a hantavirus. There have been over 20 New World hantaviruses identified since their discovery in 1993. The New World hantaviruses differ from the Old World hantaviruses that cause hemorrhagic fever with renal syndrome (HFRS) and are found primarily in Asia and Europe. The most common hantavirus causing HCPS in Canada and the United States is Sin Nombre virus (SNV). Other hantaviruses that cause significant disease in Central and South America include Andes virus (ANDV) in Chile and Argentina, Choclo virus in Panama, and Laguna Negra virus in Paraguay. The hantaviruses are small single-stranded negative-sense RNA viruses that belong to the family Bunyaviridae, a family known to include other viruses that cause significant zoonotic illnesses.