1. HANTAVIRUS An Increasing Public Health Concern in Urban Areas. Walters Y Mbimba PhD Student in Public Health. Walden University PUBH 8165 Environmental Health Instructor: Dr. Howard Rubin Spring 2011 Presented to The United States Environmental Protection Agency (EPA)

2. Learning Outcomes Origin of Hantavirus History of Hantavirus. Transmission Prevention and Control Bioterrorism Reference. Center for Disease Control and Protection (2011).Retrieved from www.cdc.gov.

3. What is Hanta virus? Cause of Hantavirus pulmonary Syndrome (HPS). A newly identified disease but not an emerging disease. Existed as early as 1959 First diagnosed in 1978. 1993 outbreak at four corners in southwest region (New Mexico, Arizona, Colorado and Utah) Healthy young adults developed respiratory disease. 50% mortality. References Knust, B (2010).A Cup of Health. A CDC weekly feature of the MMWR. Retrieved from www.cdc.gov/ncidod/diseases/hanta/hps/.www.cdc.gov/ncidod/diseases/hanta/hps/ Center for Disease Control and Protection (2011).Retrieved from www.cdc.gov.www.cdc.gov United States Environmental Protection Agency (EPA), (2011). Retrieved from www.epa.gov.

4. Anatomy Family of Bunyavirus Single Stranded negatively sensed. Enveloped RNA Virus Replicates in cytoplasm of cells. References Knust, B (2010).A Cup of Health. A CDC weekly feature of the MMWR. Retrieved from www.cdc.gov/ncidod/diseases/hanta/hps/.www.cdc.gov/ncidod/diseases/hanta/hps/ Center for Disease Control and Protection (2011).Retrieved from www.cdc.gov.

5. Distribution Common in areas with heavy rodent population. South Western Region of US (Historical). Only about 20-40 cases yearly in the US recently. References Knust, B (2010).A Cup of Health. A CDC weekly feature of the MMWR. Retrieved from www.cdc.gov/ncidod/diseases/hanta/hps/.www.cdc.gov/ncidod/diseases/hanta/hps/ Center for Disease Control and Protection (2011).Retrieved from www.cdc.gov.

6. Descriptive Statistics of HPS from 1993 to 2009 SEX/ETHNICITYPERCENTAGE (%). Males 63 Females 37. Whites 78 American Indians 18 African American 2 Asians 1 Mean Age – 37years Range - 6-83 years References Knust, B (2010).A Cup of Health. A CDC weekly feature of the MMWR. Retrieved from www.cdc.gov/ncidod/diseases/hanta/hps/.www.cdc.gov/ncidod/diseases/hanta/hps/ Center for Disease Control and Protection (2011).Retrieved from www.cdc.gov.

7. Transmission By Rodents. White footed mouse and deer mouse. When in contact with rodent feces, urine or saliva Rodents found in buildings References Knust, B (2010).A Cup of Health. A CDC weekly feature of the MMWR. Retrieved from www.cdc.gov/ncidod/diseases/hanta/hps/.www.cdc.gov/ncidod/diseases/hanta/hps/ Center for Disease Control and Protection (2011).Retrieved from www.cdc.gov.www.cdc.gov United States Environmental Protection Agency (EPA), (2011). Retrieved from www.epa.gov.

8. Symptoms of Hantavirus Pulmonary Syndrome (HPS). Vomiting Fever Myaglia Chills headache, Nausea muscle pain. Abdominal pain Back Pain References Knust, B (2010).A Cup of Health. A CDC weekly feature of the MMWR. Retrieved from www.cdc.gov/ncidod/diseases/hanta/hps/.www.cdc.gov/ncidod/diseases/hanta/hps/ Center for Disease Control and Protection (2011).Retrieved from www.cdc.gov. Respiratory Distress Cough. Shortness of breath. Flu-like,

9. Treatment of HPS Rare but deadly disease. Go to Emergency Room immediately HPS is suspected. Intensive care unit No specific treatment. Careful Monitoring. Fluid/Electrolyte therapy Blood pressure monitoring. References Knust, B (2010).A Cup of Health. A CDC weekly feature of the MMWR. Retrieved from www.cdc.gov/ncidod/diseases/hanta/hps/.www.cdc.gov/ncidod/diseases/hanta/hps/ Center for Disease Control and Protection (2011).Retrieved from www.cdc.gov.

10. Management and Prevention of (HPS). Consult your health provider Keep high hygienic conditions Control of rodents Integrated Pest management Practices (IPM). References Knust, B (2010).A Cup of Health. A CDC weekly feature of the MMWR. Retrieved from www.cdc.gov/ncidod/diseases/hanta/hps/.www.cdc.gov/ncidod/diseases/hanta/hps/ Center for Disease Control and Protection (2011).Retrieved from www.cdc.gov.www.cdc.gov United States Environmental Protection Agency (EPA), (2011). Retrieved from www.epa.gov.

11. Public Health Significance of Hantavirus Little knowledge about risk factors of HPS. Laboratory animal workers are at risk. Man to man transmission is not possible. Clinicians-Physicians, nurses and laboratory Technicians at risk. Major biosafety concern for OSHA. Bioterrorism References Knust, B (2010).A Cup of Health. A CDC weekly feature of the MMWR. Retrieved from www.cdc.gov/ncidod/diseases/hanta/hps/.www.cdc.gov/ncidod/diseases/hanta/hps/ Center for Disease Control and Protection (2011). All About Hantavirus. Retrieved from www.cdc.gov

12. Conclusion HPS is rare but fatal. HPS can be engineered and produce in mass quantities Recognize HPS as a public Health issue especially Bioterrorism Health Education Prompt Response if infection is suspected. Report suspicious Activities

13. References Knust, B (2010).A Cup of Health. A CDC weekly feature of the MMWR. Retrieved from www.cdc.gov/ncidod/diseases/hanta/hps/ Center for Disease Control and Protection (2011). All About Hantavirus. Retrieved from www.cdc.gov. United States Environmental Protection Agency (EPA), (2011). Retrieved from www.epa.gov.

14. Sources For Further Reading The World Health Organization (2011).Retrieved at www.who.orgwww.who.org Urban Integrated Pest Management (1992): A Guide for commercial Applicators.EPA,Pesticide and Toxic Substances Washington State Department of Notifiable Conditions (2011). Retrieved from www.doh.wa.gov