Hantavirus pulmonary syndrome, Southern Chile, 1995-2012

Abstract

Hantavirus is endemic to the Region de Los Lagos in southern Chile; its incidence is 8.5 times higher in the communes of the Andean area than in the rest of the region. We analyzed the epidemiologic aspects of the 103 cases diagnosed by serology and the clinical aspects of 80 hospitalized patients during 1995-2012. Cases in this region clearly predominated during winter, whereas in the rest of the country, they occur mostly during summer. Mild, moderate, and severe disease was observed, and the case-fatality rate was 32%. Shock caused death in 75% of those cases; high respiratory frequency and elevated creatinine plasma level were independent factors associated with death. Early clinical suspicion, especially in rural areas, should prompt urgent transfer to a hospital with an intensive care unit and might help decrease the high case-fatality rate.

Keywords: Andes virus; Chile; hantavirus; hantavirus pulmonary syndrome; vector-borne infections; viruses.

Figure 1

The 13 communes in the provinces of Llanquihue and Palena, southern Chile. (Two communes share the name of the province to which they belong.) Asterisk indicates Andean communes. Inset: South America, with study area in box.

Figure 2

Number of hantavirus pulmonary syndrome cases in provinces of Llanquihue and Palena, southern Chile, 1995–2012.

Figure 3

Seasonal incidence of hantavirus pulmonary syndrome, provinces of Llanquihue and Palena, Chile (n = 103), and entire country (n = 785), 1995–2012.