Lázaro Maria E, Cantoni Gustavo E, Calanni Liliana M, Resa Amanda J, Herrero Eduardo R, Iacono Marisa A, Enria Delia A, González Cappa Stella M
Hospital Zonal Bariloche, Bariloche, Argentina.
Emerg Infect Dis. 2007 Jan;13(1):104-10. doi: 10.3201/eid1301.060404.
Person-to-person transmission of a hantavirus was first confirmed during a 1996 outbreak of hantavirus pulmonary syndrome in southern Argentina, where Andes virus is endemic. To identify other episodes of secondary transmission, we reviewed reports of 51 cases of hantavirus infection from this region (November 1993-June 2005). Nine clusters involving 20 cases (39.2%) were found. Two patients, who had symptoms 3 weeks after they shared risks for rodent exposure, were considered a cluster. The other 8 clusters each began with an index case, which was almost always fatal, followed 19-40 days later by the illness of at least 1 person who had close and prolonged contact with the index case-patient. Person-to-person transmission was considered the probable source of these 8 clusters. The probability of initiating secondary cases was 41% for patients who died versus 4% for those who survived (p = 0.005). Interpersonal transmission of Andes virus infection should be considered even when rodent exposure cannot be definitively excluded.
1996年在阿根廷南部发生汉坦病毒肺综合征疫情期间,首次证实了汉坦病毒的人际传播,安第斯病毒在该地区为地方流行病毒。为了确定其他二代传播病例,我们查阅了该地区(1993年11月至2005年6月)51例汉坦病毒感染病例的报告。发现了9个聚集性病例,涉及20例(39.2%)。两名在共同接触啮齿动物风险3周后出现症状的患者被视为一个聚集性病例。其他8个聚集性病例均以首例病例开始,首例病例几乎均死亡,19 - 40天后,至少有1名与首例病例患者有密切和长期接触的人发病。人际传播被认为是这8个聚集性病例的可能传播源。死亡患者引发二代病例的概率为41%,而存活患者为4%(p = 0.005)。即使不能明确排除啮齿动物接触,也应考虑安第斯病毒感染的人际传播。