Hantavirus pulmonary syndrome
A 26-year-old Canadian woman from the Prairie region was admitted to the intensive care unit due to acute respiratory distress. She was previously in good health and had no significant medical history other than two normal pregnancies and deliveries; she had no allergies, no family history of asthma, and no history of trauma. About a week prior to her admission, she began feeling unwell, reporting a headache and a low-grade fever. The day before her admission, she began having a dry cough, followed by progressive shortness of breath. Upon rigorous questioning, her husband stated that the only unusual activity his wife had engaged in about two weeks before the onset of symptoms was cleaning their old garage, which she had completely cleared out before vacuuming it. She had commented at the time on the abundance of mouse droppings in the garage. An astute clinician sent blood samples to the National Microbiology Laboratory for hantavirus diagnostic testing. Despite intensive mechanical ventilation and conscientious fluid administration, the woman eventually developed considerable pulmonary edema, went into shock, and died 24 hours after admission. Her Sin Nombre virus infection was established by serological and molecular tests, thereby confirming that she had contracted hantavirus pulmonary syndrome.Sin Nombre virus
The Sin Nombre virus belongs to the hantavirus genus (family Bunyaviridae)Footnote 7 Footnote 8. The Bunyaviridae family encompasses a large group of diverse RNA viruses with a tripartite genome composed of S, M, and L segments. This family currently includes five genera: Orthobunyavirus, Nairovirus, Phlebovirus, Tospovirus, and Hantavirus, all of which contain agriculturally and medically important viruses. The hantavirus genus was established in 1983, and currently, the International Committee on Taxonomy of Viruses recognizes more than 20 unique species within the hantavirus genusFootnote 7 Footnote 8. About half of these species are associated with human diseases such as hemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome. Spillover events are very rare, and each hantavirus species is usually associated with a single rodent reservoir; coevolution with rodent hosts has likely been occurring for thousands, if not millions, of yearsFootnote 8 Footnote 9.