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A Fatal Hantavirus Pulmonary Syndrome Misdiagnosed as Dengue: An Investigation into the First Reported Case in Rio de Janeiro State, Brazil

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  • 1 Laboratório de Hantaviroses e Rickettsioses, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Rio de Janeiro, Brasil;
  • | 2 Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Rio de Janeiro, Brasil;
  • | 3 Secretaria Municipal de Saúde, Setor de Vigilância Epidemiológica Rio Claro, Rio de Janeiro, Brasil;
  • | 4 Secretaria de Saúde do Estado do Rio de Janeiro, Setor de Vigilância Epidemiológica, Rio de Janeiro, Rio de Janeiro, Brasil

We report the results of an investigation into a fatal case of hantavirus pulmonary syndrome (HPS) in Rio de Janeiro State, Brazil, where the disease had not been reported previous to 2015. Following the notification of an HPS case, serum samples were collected from the household members and work contacts of the HPS patient and tested for antibody to hantaviruses. Seroprevalence of 22% (10/45) was indicated for hantavirus out of 45 human samples tested. Blood and tissue samples were collected from 72 rodents during fieldwork to evaluate the prevalence of hantavirus infection, by using enzyme-linked immunosorbent assay IgG, and to characterize the rodent hantavirus reservoir(s), by reverse transcription polymerase chain reaction and sequencing. Antibody prevalence was 6.9%. The circulation of a single genotype, the Juquitiba hantavirus, carried by two rodent species, black-footed pigmy rice rat (Oligoryzomys nigripes) and cursor grass mouse (Akodon cursor), was shown by analysis of the nucleotide sequences of the S segment. Juquitiba hantavirus circulates in rodents of various species, but mainly in the black-footed pigmy rice rat. HPS is a newly recognized clinical entity in Rio de Janeiro State and should be considered in patients with febrile illness and acute respiratory distress.

Author Notes

Address correspondence to Renata Carvalho de Oliveira, Laboratório de Hantaviroses e Rickettsioses, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Pavilhão Hélio e Peggy Pereira, sala B116, Avenida Brasil 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil. E-mail: reoliveira@ioc.fiocruz.br

Financial support: This work was supported by Conselho Nacional para o Desenvolvimento Cientifico e Tecnológico (CNPq)—PAPES VI/FIOCRUZ (grant number: 407664/2012-2).

Authors' addresses: Renata Carvalho de Oliveira, Alexandro Guterres, Jorlan Fernandes, Liana Strecht Pereira, and Elba Regina Sampaio de Lemos, Laboratório de Hantaviroses e Rickettsioses, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Rio de Janeiro, Brazil, E-mails: reoliveira@ioc.fiocruz.br, guterres@ioc.fiocruz.br, jorlan@ioc.fiocruz.br, liastrecht@gmail.com, and elemos@ioc.fiocruz.br. Bernardo Rodrigues Teixeira, Cibele Rodrigues Bonvicino, and Paulo Sérgio D`Andrea, Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz Rio (FIOCRUZ), Rio de Janeiro, Brazil, E-mails: brt@ioc.fiocruz.br, cibelerb@inca.gov.br, and dandrea@ioc.fiocruz.br. João Marcos Penna Júnior, Reynaldo de Jesus Oliveira Júnior, and João Bosco Júnior, Secretaria Municipal de Saúde, Setor de Vigilância Epidemiológica, Rio Claro, Rio de Janeiro, Brazil, E-mails: marquinhopenna@yahoo.com.br, enf.reynaldo@gmail.com, and drjoaoboscojr@gmail.com. Patrícia Soares Meneguete and Cristina M. Giordano Dias, Secretaria de Saúde do Estado do Rio de Janeiro, Setor de Vigilância Epidemiológica, Rio de Janeiro, Rio de Janeiro, Brazil, E-mails: patricia.meneguete@saude.rj.gov.br and cristina.giordano@saude.rj.gov.br.

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