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HANTAVIRUS - INDIA: (MAHARASHTRA)
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A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Wed 3 Feb 2010
Source: Mumbai Mirror [edited]
<http://www.mumbaimirror.com/article/2/2010020320100203021832496a72b62ab/Woman-survives-rare-respiratory-disease.html>
A woman with a rare respiratory disease baffled doctors at a Chembur
hospital [Mumbai], as they had not come across the disease in their
careers. Brought in a critical condition with [a] hantavirus
[infection], she was discharged after treatment on Tuesday [2 Feb
2010], but government health departments have been alerted about the
case.
The woman, a 21-year-old resident of Govandi, was admitted to Joy
Hospital on 21 Jan [2010]. She suffered from severe abdominal pain,
vomiting, headache, rapid shallow breathing, and constipation. She had
earlier consulted a general practitioner, but as her symptoms were
similar to the flu, the disease could not be diagnosed. She then
approached a specialist, who said she needed hospitalisation.
At the hospital, investigations found her haemoglobin level was low
and she was given a blood transfusion. Only when doctors made a
special request to a private laboratory to test her blood samples for
hantavirus did they find the cause. After 7 days in the ICU and 3 days
in a ward, she was discharged on Tuesday [2 Feb 2010].
"I have never come across the disease in my 8 years of practice. This
is a very rare virus and not common in our country. Once we ruled out
any other disease, we made a special request to a laboratory to
conduct the test. After the sample tested positive, I spoke to senior
doctors, all of whom agreed that they had not come across the disease
in their careers," said Dr Vikrant Shah, senior physician and
intensivist.
Experts say 70 percent of patients infected by the virus do not
survive if it is not diagnosed in time. The woman said, "I thought it
was just fever. Doctors have told me that maintaining hygiene is the
best precaution against the disease."
"Since a rare viral disease was found in the city, we immediately
informed the BMC's [Brihanmumbai Municipal Corporation] M/west ward
health officer," said Dr Roy Patankar, director, Joy Hospital.
Experts said there was no need to worry as the disease cannot be
spread by humans. "Our laboratory is not equipped to do this test.
Generally, the virus is not found in our population," Dr Abhay
Chowdhary, director, Haffkine Institute of Research and Training.
"It is not found in the city and is a very rare virus. Though I have
headed the department of microbiology here for the last 11 years, I
have not seen a hantavirus positive patient," said Dr Priti Mehta, KEM
[King Edward Memorial] Hospital.
[Byline: Santosh Andhale]
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Communicated by:
ProMED-mail
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[It would be of interest to know which hantavirus was the etiological
agent in this case. In 2005, 2 fatal cases of hantavirus infection in
India were reported by Dr Jan Clement (see ProMED-mail archive no.
20051105.3240), with an excellent review of hantaviruses in India. The
Clement report provided serological evidence of Puumala or a related
hantavirus infection. Other possible hantaviruses responsible for the
above case include Seoul virus, which is widely distributed in rats
(_Rattus norvegicus._) around the world, and Thailand virus (host
_Bandicota indica_), which can cause mild hemorrhagic fever with renal
syndrome and occurs in Southeast and South Asia.
The CDC has an excellent PowerPoint presentation on hantaviruses available at
<http://www.cdc.gov/ncidod/diseases/hanta/hps/noframes/hpsslideset/hpsslides1-12.htm>.
A map showing the location of Mumbai in Maharashtra state can be accessed at
<http://www.lib.utexas.edu/maps/middle_east_and_asia/india_pol01.jpg>.
A HealthMap/ProMED-mail interactive map of India can be accessed at
<http://healthmap.org/r/014d>. - Mod.TY]