Saturday, February 25, 2017

Automobile Air System Infestation as Hantavirus Source

Mouse Infestation of Auto Cabin Air Filter

One of the future HantaSite articles will begin an analysis of risks from automobile air systems. Mouse infestations of these systems are extremely common. Toyota vehicles appear to be especially attractive to rodents.

The following is a quote from an otherwise excellent Canadian government hantavirus information website, (in the links list at right).

"Consult your health care provider as soon as possible if you have had contact with rodents and are feeling ill. The sooner you get treatment, the better your chances for recovery"

If you report to an emergency ward with flu-like symptoms, you may be asked about contact with rodents. If you answer yes you might be tested for hantavirus. But no one in Emergency or ICU will ever ask you if you were in an automobile.

The result is that the standard questioning for patients presenting with "unidentified community acquired pneumonia," a catch-all classification for incoming patients, systematically excludes any who may have acquired hantavirus by driving an infested vehicle. In general, no hantavirus test, no hantavirus diagnosis. This possible omission may only slightly affect patient care, but it can adversely impact our understanding of the epidemiology of hantavirus.

The following is a brief outline of the upcoming article.

Automobile Cabin Air Systems as a Transmission Mode
            Incidence of mouse infestation in automobile cabin air intakes
            Rapid capture, drying, and aerosolization of SNV laden mouse urine            
            Physics of electret filters, minimum efficiency particle size
            Denaturing of SNVvirions – time factors

This Youtube video shows a mouse infestation in an auto air filter system. If you google "mice cabin air filter" or anything like that you will see many, many such photographs and complaints about uncontrollable automobile mouse incursions.

The man performing this cleanup is making a critical mistake. He is wearing gloves, but NOT wearing a respirator mask. The primary risk to him is through inhaling the dust he is raising from the mouse nesting materials.

Cleaning processes like this should be done only while wearing a P100 particle mask. These masks are much more effective than the typical "surgical masks" that are more common. They are not very expensive and are a good investment for many purposes.

The following comment from a Toyota Tacoma discussion site describes a common experience.

"anyone else had this problem??? i got in my truck the other day and out of the blue there was a hint of dead animal smell, thinking that i was from outside i continued to drive, a couple miles later i turned the heat on, BAD IDEA!! i almost puked...

"when i got to work i checked my engine air filter, nothing in there... i didnt realise i had a cabin air filter til later on in the day. removed the glove box, super easy thankfully, pulled 2 tabs, there was the filter."

i started sliding it out, i wasnt moving, finally after some prying, came out a ton of chewed paper, leaves and sticks, and then 2 dead baby mice, very tiny, they were still soft, so they werent dead long. so i got a new filter, vaccumed everything and sprayed an ac duct spray for mildew etc. the next day, smells still there... i figured id take it apart again, sure enough i had missed another baby... took that out. sprayed again."

This guy didn't realize he had a cabin air filter. How would he know unless he actually read the owner's manual? These filters are relatively new and are usually incredibly well-concealed behind the glove box. Close to half of car owners are not aware that they breath through filters that are supposed to be changed about once per year.

Friday, February 24, 2017

Some Future HantaSite Articles

These are some of the articles I'm writing about hantavirus, particularly the Sin Nombe variant. Expect an article or so a week over the next few months until the site is "populated" and then I hope to make updates and corrections. Format is the working title along with a few bullet points about each article.

HantaSite Motivation and Introduction
            Why am I creating HantaSite, and who am I to do it?
Both skills and limits
            What needs did I see?

What are Hantavirus, Sin Nombre Virus (SNV), and Hantavirus Pulmonary Syndrome (HPS)?
            Hantavirus life cycle, worldwide and domestic incidence
Structure and properties of the virion form (the assembled, portable virus “seeds”)
            SNV (previously Four Corners virus) and HPS        

How does one become ill with SNV?
            What has to happen for infection from mouse to human?
            Inhalation of aerosols of SNV virions
            Numerous factors, many with large probability factors

Hantavirus in Mice – A good year for mice is a bad year for Sin Nombre
            What does SNV look like among the deer mouse population in which it is endemic?
            How is SNV spread among mice, and what causes a mouse to shed SNV virions?
            Correlations between mice, mouse population swings, and SNV incidence?

Hantavirus Housekeeping
            Links to online resources for safe mouse removal and cleanup operations
            Safe housekeeping in cabins, tents, etc.
            Bleach or disinfectants to neutralize virus and wet or damp procedures
            No sweeping!?

SNV Clusters
            Hanta site-related factors
            Mouse ecology
Urban/rural interface zone      

Automobile Cabin Air Systems as a Transmission Mode
            Incidence of mouse infestation in automobile cabin air intakes
            Rapid capture, drying, and aerosolization of SNV laden mouse urine           
            Physics of electret filters, minimum efficiency particle size
            Denaturing of SNVvirions – time factors

Intensive Care Cacophony – The Data Must Go On
            Is lack of sleep in ICU an inevitable thing?
            Does ICU sleep deprivation contribute to “ICU-itis?”
            What can be done to reduce sleep interruptions for tests?

Hantavirus Survivor’s Story –  Jolissa Doerksen 
            Cleaning a cabin as an infection mode

            Experiences and recovery battle

Why Me? Why does SNV strike in an Apparently Rare Way
            We don't have mice swinging from our chandeliers. We don't even have chandeliers.
            SNV is ubiquitous in the U.S.
            Roughly 10% of most common rodents, deer mice or equiv.
            Time, Space, and Aerosolization

The Yosemite Park Hantavirus Outbreak
        Aerosolization of mouse detritus by double walled tent aspiration
        The forces exerted by wind loading on the outside of a double wall tent
        No such forces on the inner wall – Result is a bellows-like configuration
        That bellows configuration is almost ideal for aerosolizing debris that is
        near small leaks in the inner tent layer
       Airflow with breathing-like action between tent interior and trapped airspace
       Concentration and protection from UV of hantavirus in protected airspace

Thursday, February 23, 2017

Hantavirus Survivors Interviews

Jolissa Doerksen, a hantavirus survivor in Edmonton, Alberta, CA will be on the radio today on an Edmonton, Alberta, Canada station called 630 CHED.

She will share a little bit about her story and recovery in the cardiovascular ICU at U. of Alberta Hospital. 

Jolissa will be on the radio at 11:30am (MST) Today, February 23, 2017.

She will also be a special guest speaker for Heart Pledge Day to raise funds for more ECMO (external oxygenation) life support machines at University of Alberta Hospital CVICU  (Cardio-Vascular ICU). 

Another hantavirus survivor who contracted the hemorrhagic fever form in Belgium, has written a book about her experiences as a victim of hantavirus and of sepsis, the bodies' system-wide destructive response to attack.  A description of her book can be found in the Faces of Sepsis section at at:

An English version of Idelette's book on sepsis,  is now available. It is a bit difficult to order from the U.S., but it is possible. Sepsis and Afterwards has been recommended by the U.K. Sepsis Trust and Global Sepsis Alliance.

– Mark

Thursday, February 16, 2017

HantaSite is Under Construction

This hantavirus site is currently under construction. I will be posting articles in the next few weeks that will provide information and insights on Sin Nombre hantavirus (SNV), which has a mortality rate of 40% and that is endemic to most of North America.

At this time the Hantavirus Links section is the first active and potentially useful portion. Locating information about hantavirus using google, etc. isn't terribly difficult, but it can be time consuming – at a tremendously difficult time. These links are intended to provide a quick hopping off point to reliable, respected websites containing accessible hantavirus information.

– Mark