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Contact Tracing Investigation after First Case of Andes Virus in the United States ? Delaware, February 2018

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  • Contact Tracing Investigation after First Case of Andes Virus in the United States ? Delaware, February 2018

    Source: https://www.cdc.gov/mmwr/volumes/67/...cid=mm6741a7_w
    Notes from the Field: Contact Tracing Investigation after First Case of Andes Virus in the United States ? Delaware, February 2018

    Weekly / October 19, 2018 / 67(41);1162?1163



    Aaron Kofman, MD1,2; Paula Eggers3; Anne Kjemtrup, DVM, PhD4; Rebecca Hall, MPH5; Shelley M. Brown2; Maria Morales-Betoulle, PhD2; James Graziano, MA2; Sara E. Zufan, MPH2; Shannon L.M. Whitmer, PhD2; Deborah L. Cannon, MS2; Cheng-Feng Chiang, PhD2; Mary J. Choi, MD2; Pierre E. Rollin, MD2; Martin S. Cetron, MD5; Hayley D. Yaglom, MPH6; Monique Duwell, MD7; David T. Kuhar, MD8; Melissa Kretschmer, MA9; Barbara Knust, DVM2; John D. Klena, PhD2; Francisco Alvarado-Ramy, MD5; Trevor Shoemaker, MPH2; Jonathan S. Towner, PhD2; Stuart T. Nichol, PhD2 (View author affiliations)
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    In January 2018, a woman admitted to a Delaware hospital tested positive for New World hantavirus immunoglobulin M (IgM) and immunoglobulin G (IgG) by enzyme-linked immunosorbent assay (ELISA). Subsequent testing by CDC?s Viral Special Pathogens Branch detected New World hantavirus by nested reverse transcription?polymerase chain reaction (RT-PCR) and Andes virus by nucleic acid sequencing. This case represents the first confirmed importation of Andes virus infection into the United States; two imported cases have also been reported in Switzerland (1). Before her illness, the patient had traveled to the Andes region of Argentina and Chile from December 20, 2017, to January 3, 2018. She stayed in cabins and youth hostels in reportedly poor condition. No rodent exposures were reported. After returning to the United States on January 10, she developed fever, malaise, and myalgias on January 14. On January 17, while ill, she traveled on two commercial domestic flights. She was hospitalized during January 20?25 in Delaware and discharged to her home after clinical recovery.
    Andes virus, a species of New World hantavirus, is transmitted to humans primarily through contact with long-tailed rice rats (Oligoryzomys longicaudatus), which are endemic to much of Argentina and Chile. Clinical symptoms are similar to those of other New World hantaviruses, and the case fatality rate is approximately 36% (2). Unlike all other hantavirus species, Andes virus can be transmitted from person to person; however, transmission is typically limited to close contacts of ill persons (2?4). Because of this risk, a contact tracing investigation was initiated by CDC as well as state and county health departments...
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