MMWR Morb Mortal Wkly Rep. 2009 Dec 25;58(50):1409-12.
Hantavirus pulmonary syndrome (HPS) is a reportable infectious disease with a high case-fatality rate, transmitted to humans by exposure to rodents. Each year, 20--40 cases of HPS occur in the United States; cases in persons aged <17 years make up fewer than 7% of those cases, and cases in children aged <10 years are exceptionally rare. CDC received reports of five pediatric cases of HPS occurring during May 16--November 25, 2009, among children aged 6--14 years from Arizona, California, Colorado, and Washington. Three of the children were aged <10 years, and all five had exposure to rodents. This report summarizes the five cases, including the clinical findings and likely means of transmission of a hantavirus. Thrombocytopenia, elevated white blood cell (WBC) count, and pulmonary infiltrates were observed in all five children; elevated hematocrit was observed in three. One child died, and three of the four children who recovered required mechanical ventilation during hospitalization. Clinicians should consider HPS in the differential diagnosis for children with unexplained acute respiratory distress, especially if recent rodent exposure is noted. Public health agencies should promote preventive measures, including rodent control in housing and play areas, and children should be advised to avoid contact with rodents and areas of infestation.
汉坦病毒肺综合征（HPS）是一种病死率很高的须报告传染病，通过接触啮齿动物传播给人类。在美国，每年有20至40例HPS病例；17岁以下人群中的病例占这些病例的比例不到7%，10岁以下儿童的病例极为罕见。美国疾病控制与预防中心（CDC）收到报告，2009年5月16日至11月25日期间，亚利桑那州、加利福尼亚州、科罗拉多州和华盛顿州6至14岁的儿童中出现了5例小儿HPS病例。其中3名儿童年龄小于10岁，所有5名儿童均接触过啮齿动物。本报告总结了这5例病例，包括临床发现以及汉坦病毒可能的传播途径。所有5名儿童均出现血小板减少、白细胞（WBC）计数升高和肺部浸润；3名儿童出现血细胞比容升高。1名儿童死亡，4名康复儿童中有3名在住院期间需要机械通气。临床医生在对不明原因急性呼吸窘迫的儿童进行鉴别诊断时应考虑HPS，尤其是在注意到近期有啮齿动物接触史的情况下。公共卫生机构应推广预防措施，包括在居住和游乐区域控制啮齿动物，并且应建议儿童避免接触啮齿动物和有鼠患的区域。
