Thursday, March 16, 2017

Reaction and Post from International Society for Infectious Diseases

The material below is the ProMED Mail update posted by the International Society for Infectious Diseases in response to notice of the local hantavirus events. I have added a demarcation sentence in the middle to more clearly separate my notice from their response. The comment they made is very important. If you read one part of this post, please look at that site. The links to recent ProMED posts are in a window on the left. Scroll to 03/15 for the my hantavirus post.

https://www.promedmail.org

ProMED is the world's largest disease reporting system, reaching 75,000 subscribers in 185 countries. With all those recipients, it issues an average of only 13 posts like this day. My post, below, can be best read in their site because then their network of links to similar ProMED posts is available at the bottom of the page. If you look at those other hantavirus warnings, you will see that in a situation such as that happening in King County right now, the "standard" responsible thing to do is to notify the public that a heightened risk for hantavirus exists, and that they should take due precautions.

The King Co. Health Department has failed to make any such notification, and continues to have no plan to do so. That is why I am using hantasite.com and other social and news media to issue these hantavirus cautionary warnings.

– Mark@hantasite.com

The following is from the Wikipedia article about ProMED.
"Program for Monitoring Emerging Diseases (also known as ProMED-mail, abbreviated ProMED) is among the largest publicly available emerging diseases and outbreak reporting systems in the world. The central purpose of ProMED is to promote communication amongst the international infectious disease community, including scientists, physicians, veterinarians, epidemiologists, public health professionals, and others interested in infectious diseases on a global scale."



Published Date: 2017-03-15 12:03:36
Subject: PRO/AH/EDR> Hantavirus update - Americas (21): USA (WA) automobile air system susp
Archive Number: 20170315.4901561

HANTAVIRUS UPDATE- AMERICAS (21): USA (WASHINGTON) AUTOMOBILE AIR SYSTEM SUSPECTED

*********************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Tue 14 Mar 2017
From: Mark C Waterbury [edited]

Hantavirus, Seattle Washington area, 2 cases, one fatality. My wife was the other case.
----------------------------------------------------------------------
My wife collapsed into hantavirus pulmonary syndrome this last Thanksgiving night [24 Nov 2016]. She spent 6 days on the ventilator, 10 in ICU, and barely lived.

We have confirmed Sin Nombre virus infection, through 2 sets of IgG and IgM tests from the CDC. We are convinced that she was infected through her automobile cabin air system, which had repeated infestations with deer mice.

I am a scientist and she is an RN, and we have studied our potential exposure sources in some detail. I've set up a website at http://www.hantasite.com to explore the physical chemistry and epidemiology of hantavirus exposure. I've posted 40 or 50 images of auto rodent infestations. This is potentially a way that many people may be contracting hantavirus, without it being diagnosed.

I've contacted the brother of the hantavirus [infection] victim, and they think their cars may be the source in their case too. I don't know their reasoning for that yet.

Mark C Waterbury, PhD (materials scientist)
Perception Development Co
<waterbury.mark@gmail.com>


(The above was from my notification of these events to them, the following was their reaction. I have added only this passage and the bold face title below. mcw)

ISID ProMED's Comment
[The possibility of transmission of Sin Nombre virus to people through automobile air systems is intriguing. These forced air systems could certainly generate aerosolized particulate mouse excreta that could contain the virus, making the automobile an effective transmission chamber, particularly in colder weather when the blower for the heating system is on and the windows are closed.

Interested readers are encouraged to read Dr Waterbury's website (URL listed above). It has additional information about his wife's case, and at the end of the site there are galleries of photos of rodent nests in automobile air systems. It also has nice images of the deer mice reservoir host.

Sin Nombre hantavirus is endemic in the western USA, including Washington state. Deer mice commonly move into dwellings, and apparently into automobiles, with the onset of cold weather. Cleaning out deer mouse nests from automobile air systems should be done with the same precautions as for cleaning out unoccupied cabins. Materials should be wetted down with a bleach solution, materials handled in an open air space, with gloves and a mask worn.

Deer mice, _Peromyscus maniculatus_, are the reservoir hosts of the virus and shed it in feces, urine, and saliva. Sin Nombre virus infections can be serious, with a relatively high case fatality rate associated with hantavirus cardiopulmonary syndrome. Prompt medical attention is essential.

An image of the deer mouse, _P. maniculatus_, can be seen at http://www.nsf.gov/news/mmg/media/images/mouse_f.jpg.

Dr Waterbury is thanked for sharing this case and situation with ProMED.

A map showing the location of Washington state in the northwest of the lower 48 USA states can be accessed at http://healthmap.org/promed/p/3248. - Mod.TY]

– Mark@hantasite.com

2 comments:

halvin said...

Dr. Waterbury, thanks so much for this blog. I just discovered it this morning so I haven't yet had the opportunity to peruse it entirely.

We're in a rural and forested area of Thurston county and having mice finding their way inside even though I've frantically been attempting to seal all the entry points I think they're using. If these mice are carrying Hantavirus, we're going to contract it, no doubt, as for the past few weeks, we've been finding droppings all over the place ...counters, floors, carpets, furniture, shoes, etc., etc. I've been putting poison bait stations outside and setting snap traps inside. The snap traps are getting one or two each night.

I'm contemplating calling an exterminator to help but in our case, the damage will have already been done if these mice are infected as we've been exposed to their excrement and urine on a wide scale for quite a few weeks now. Even though I've been very careful as to how I dispose of their carcasses, there's just been too much exposure to what they've left behind in the house. I'm crossing my fingers that these mice are not infected but am nervous now that I know that this threat is now on the increase.

I'll be sure to now give the vehicles a very close check too (haven't yet nor observed any droppings in the interior but will have to check the air filters).

We're glad your wife is recovering and wish her the best. Thanks again.

Mark Waterbury said...

Halvin, despite the mouse problem you describe, there are still pretty low odds that you have contacted hantavirus. The virus decomposes pretty rapidly, so much of that is already gone. You should "dispatch" the rest by spraying it with a good commercial disinfectant or a 1/10 solution of bleach in water.

Air out the house before you do that. Wear a dust mask, P100 type (pink disks) preferable.

Give the disinfectant time to work. You want to spray enough to pretty much wet down the mouse excreta, even that worked down in to the carpet. Wet down every place you think there is mouse debris, then close the windows and doors and get out. Leaving it sealed up with disinfectant circulating in the air should be very effective at destroying the pre-existing hantavirus.

Then you can get to work with the traps and blocking any and all holes and cracks, steel wool works great because you can conform it to spaces and they can't eat it.

Thank you, I wish you the best in keeping yourself and family safe.