Detection of Hantavirus during the COVID-19 Pandemic, Arizona, USA, 2020

Abstract

We identified 2 fatal cases of persons infected with hantavirus in Arizona, USA, 2020; 1 person was co-infected with SARS-CoV-2. Delayed identification of the cause of death led to a public health investigation that lasted ≈9 months after their deaths, which complicated the identification of a vector or exposure.

Keywords: 2020. Emerg Infect Dis. 2023 Aug [date cited]. https://doi.org/10.3201/eid2908.221808; Adame G; American Indians or Alaska Natives; Arizona; COVID-19; Close R; Dale AP; Ruberto I; SARS-CoV-2; Snyder S-J et al. Detection of hantavirus during the COVID-19 pandemic; USA; United States; coinfection; hantavirus pulmonary syndrome; hantavirus
Suggested citation for this article: Hecht G; respiratory infections; viruses; zoonoses.

Figure 1

Timeline of illness course, laboratory testing, and public health investigations for 2 patients who died of hantavirus infection, Arizona, USA. Asterisk (*) indicates reported information that applies to both cases. IDPB, Infectious Diseases Pathology Branch, CDC (National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology); IHC, immunohistochemical testing; CDC, Centers for Disease Control and Prevention; NP, nasopharyngeal; rRT-PCR, real time reverse transcription PCR; TGen, Translational Genomics Research Institute; VSPB, Viral Special Pathogens Branch, CDC (National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology).

Figure 2

Phylogenetic tree for Orthohantavirus short (S) segment of samples from 2 patients who died of hantavirus infection, Arizona, USA. We inferred the phylogenetic history of full-length Sin Nombre virus S segment using maximum-likelihood estimation. Non–Sin Nombre virus species, Black Creek Canal virus, and Bayou virus are included as outgroups. Bold indicates isolates from this study; squares indicate those from patient 1 and circles those from patient 2. Numbers at nodes indicate bootstrap support >70% after 1,000 iterations. Phylogenetic trees were made using a nucleotide alignment of Orthohantavirus S segments. GenBank accession numbers are provided. Scale bar indicates nucleotide substitutions per site. Additional phylogenetic trees for Orthohantavirus medium and large segments of Sin Nombre virus are in the Appendix.