Microbe snapshots: Hantavirus (Sin Nombre)

Sin Nombre virus (SNV) is the main hantavirus species found in North America. Zoonotic SNV infection in humans occurs via inhalation of virions from aerosolized excreta of the deer mouse ( Peromyscus maniculatus ), the predominant reservoir of SNV in the Americas. Most cases occur in the Southwestern USA and Western Canadian provinces. Infection with SNV commonly results in hantavirus pulmonary syndrome (HPS) – a severe respiratory illness progressing through three phases, with a high risk of cardiopulmonary deterioration and case fatality rates of 35-55%. The mainstay of diagnosis is hantavirus-specific serology (IgM + IgG) with molecular detection of SNV considered adjunctive. Given the lack of effective anti-viral therapies for HPS, timely clinical recognition, early access to intensive care, and consideration of venoarterial extracorporeal membrane oxygenation are critical determinants to help improve survival.