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The first outbreak of hantavirus pulmonary syndrome (HPS) in Central America was documented on the Azuero peninsula of Panama in late 1999 and 2000. Reverse transcriptase–polymerase chain reaction evidence implicated only Choclo virus in symptomatic HPS with a mortality rate of 20%, although two rodent-borne hantaviruses (Choclo virus and Calabazo virus) were identified in the peridomestic habitat. Neighborhood serosurveys around case households found seroprevalence rates as high as 30%, the highest in the Americas except for western Paraguay. We report here population-based serosurveys for 1,346 adults and children in four communities, three on the Azuero peninsula and one in adjacent central Panama. Overall seroprevalence ranged from 33.2% in a population engaged in farming and fishing on Isla de Cañas, to 16.3% and 21.2% in two mainland agricultural communities, to 3.1% in central Panama, with a modest male predominance of 1.2:1. Nine percent of children 4–10 years old were seropositive, and seroprevalence increased with age in all communities, with highest levels of 52% in those 41–50 years old cohort on Isla de Cañas. Univariate analysis identified correlations between seroprevalence and multiple agricultural and animal husbandry activities. However, stepwise logistic regression models identified only raising animals (cows, pigs, goats, poultry) and fishing as significant independent variables. Human infection with hantavirus on the Azuero peninsula, either with Choclo virus or combined with Calabazo virus, is frequent but rarely results in hospitalization due to respiratory illnesses resembling HPS.
Received July 15, 2003. Accepted for publication October 26, 2003.
Acknowledgments: We are grateful for the support of the Ministry of Health and the Social Security System, the serosurvey team of the Gorgas Memorial Institute, and the communities participating in the surveys. Thomas Ksiazek provided a gift of Sin Nombre antigen for use in the enzyme-linked immunoassay. The Statistics Clinic of the University of New Mexico provided statistical advice. Karl Johnson provided valuable suggestions and support.
Financial support: This study was supported by an Opportunity Pool award and supplement from the International Centers for Infectious Diseases Research program of the National Institutes of Health (AI-45452), and funds from the Gorgas Memorial Institute, Hantavirus Research Project No. 04-90-0075-8, Ministry of Health, Panama.
Authors’ addresses: Blas Armien, Instituto Commemorativo Gorgas, Avenida Justo Arosemena, Apartado 6991, Zona 5, Panama, E-mail: barmien{at}gorgas.gob.pa. Juan Miguel Pascale, Vicente Bayard, Carlos Munoz, Anibal Armien, Evelia Quiroz, Zoila Castillo, and Yamizel Zaldivar, Gorgas Memorial Institute of Health Studies, Panama City, Panama. Itza Mosca, Gladis Guerrero, and Fernando Gracia, Ministry of Health, Panama City, Panama. Brian Hjelle, University of New Mexico Health Sciences Center, Albuquerque, NM 87131. Frederick Koster, Lovelace Respiratory Research Institute, 2425 Ridgecrest Drive, Albuquerque, NM 87108, Telephone: 505-348-9367, Fax: 505-348-8567, E-mail: fkoster{at}lrri.org.
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