Hantavirus pulmonary syndrome in Latin America.

PURPOSE OF REVIEW

Since the identification of hantavirus pulmonary syndrome in the United States in 1993, Latin America has been the region of the world where more hantaviruses have been identified, associated with human disease or not. This update shows the advances in the study of hantaviruses in several countries of the region and the problems that are still unresolved.

RECENT FINDINGS

Clinical findings in Chile have shown differences in the classical description of hantavirus pulmonary syndrome in the United States. Hemorrhage was observed in 64% of the cases and alteration in renal function in 48%. The classification of cases in mild, self-limited forms and severe forms has a prognostic value, with statistically significant differences between survivors and nonsurvivors. Epidemiological studies have shown noticeable differences in seroprevalence of antibodies against hantaviruses in humans, ranging from about 1% to more than 40% according to geographical and ethnical differences. Risk factors continue to be related to rural activities and peridomestic sites. Rodent studies have allowed the identification of putative reservoirs of hantaviruses in Uruguay, Brazil and Argentina and detected antibodies in several rodent species not previously reported in Paraguay and Panama. An Andes virus gene-based hantavirus pulmonary syndrome vaccine is currently under study.

SUMMARY

Progress in research on hantaviruses has been continuous but slow. The complex picture of the viruses, the rodent reservoirs and the clinical forms of the disease mean researchers are faced with the great challenge of properly clarifying the genetic and pathogenic relationships between hantaviruses in the Americas.