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Rodent-Borne Diseases

Rodent-Borne Diseases. Presented by Minoo Madon and Stephanie Heintz Greater LA County Vector Control District. Wild Rodent-Borne Diseases. Hantavirus Pulmonary Syndrome. Hantavirus Pulmonary Syndrome (HPS).

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Rodent-Borne Diseases

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  1. Rodent-Borne Diseases Presented by Minoo Madon and Stephanie Heintz Greater LA County Vector Control District

  2. Wild Rodent-Borne Diseases

  3. Hantavirus Pulmonary Syndrome

  4. Hantavirus Pulmonary Syndrome (HPS) • Unexplained illness occurred in May 1993 in the "Four Corners," area of the Southwest shared by New Mexico, Arizona, Colorado, and Utah • Previously healthy young adults suddenly developed acute respiratory symptoms; about half died (mortality rate in CA ~ 40%) • “Bumper crop" of rodents due to heavy rains during the spring of 1993 produced an extra-plentiful supply of food for rodents

  5. New World Hantaviruses New York Peromyscus leucopus Sin Nombre Peromyscus maniculatus Prospect Hill Microtus pennsylvanicus Muleshoe Sigmodon hispidus Bloodland Lake Microtus ochrogaster Isla Vista Microtus californicus Bayou Oryzomys palustris Black Creek Canal Sigmodon hispidus El Moro Canyon Reithrodontomys megalotis Rio Segundo Reithrodontomys mexicanus Calabazo Zygodontomys brevicauda Juquitiba Unknown Host Laguna Negra Calomys laucha Caño Delgadito Sigmodon alstoni Choclo Oligoryzomys fulvescens Maciel Necromys benefactus Rio Mamore Oligoryzomys microtis Hu39694 Unknown Host Orán Oligoryzomys longicaudatus Lechiguanas Oligoryzomys flavescens Bermejo Oligoryzomys chacoensis Pergamino Akodon azarae Andes Oligoryzomys longicaudatus

  6. Hantavirus Pulmonary Syndrome Canada (36)3 Countries with reported cases of HPS (no of cases) Number of cases by date 1PAHO 01 2January 02 3May 02 4August 02 5 September 02 6 October 02 7 November 02 United States (335)7 Countries with no reported cases of HPS Panama (31) 6 Brazil (168)2 Bolivia (20)4 Paraguay (74)1 Uruguay (23) 1 Chile (273)5 Argentina (404)4

  7. HPS Cases by State of Residence U.S.-July 6, 2005 Source: CDC

  8. Location of HPS Cases by Virus Type as of July 6, 2005 Source: CDC

  9. HPS, U.S. Descriptive Demographic Statistics, July 6, 2005 Source: CDC

  10. Transmission • Deer mice predominantly infected in CA (along with cotton rats and rice rats in the southeastern states and the white-footed mouse in the northeast US) • Rodents shed the virus in their urine, droppings, and saliva • The virus is mainly transmitted to people when they breath in contaminated air (aerosolized) with the virus

  11. Peromyscus maniculatus Deer mouse Sigmodon hispidus Cotton rat

  12. Other Modes of Transmission • Rodent with the virus bites someone, but this type of transmission is rare • Touch something that has been contaminated with rodent urine, droppings, or saliva, and then touch their nose or mouth • Eat food contaminated by urine, droppings, or saliva from an infected rodent

  13. Risk of Acquiring HPS • Anyone who comes into contact with rodents that carry hantavirus • Rodent infestations in and around the home • Cleaning rodent-contaminated areas • Housecleaning Activities • Work-related Exposure • Campers and Hikers

  14. Symptoms • Incubation time is not positively known • Symptoms may develop between 1 and 5 weeks after exposure Four to 10 days after the initial phase of illness, the late symptoms of HPS appear

  15. Hantavirus Pulmonary SyndromePhysical Examination • Tachypnea • Tachycardia • Hypotension • Crackles or rales on lung examination Source: CDC

  16. Radiographic Progression of HPS in the Lungs May 27, 1993 May 30, 1993 May 31, 1993 Source: CDC

  17. HPS Management • Early aggressive intensive care • Early use of inotropic agents (Dobutamine) • Early ventilation • Careful monitoring • Oxygenation • Fluid balance • Blood pressure Source: CDC

  18. Laboratory-Confirmed Diagnosis • Serology • IgM • IgG • Immunohistochemistry • Reverse transcription and polymerase chain reaction (RT-PCR)

  19. Treatment • Treatment is based on symptoms. No specific treatment, cure, or vaccine for hantavirus infection • Infected individuals are recognized early and receive medical care in an intensive care unit, they may do better • Intubated and given oxygen therapy to help them through the period of severe respiratory distress

  20. HPS Prevention Control Mice Inside Control Mice Outside Use Safety Precautions

  21. Plague

  22. Plague • Bacterium called Yersinia pestis, is transmitted from rodent to rodent by infected fleas • Hungry infected fleas that have lost their normal hosts seek other sources of blood, thus increasing the increased risk to humans and other animals frequenting the area • The last rat-borne epidemic in the United States occurred in Los Angeles in 1924-25 • The California ground squirrel and its fleas are the most common source of infection • Wild rodents such as deer mice and voles are reservoir hosts • Domestic cats (and sometimes dogs) are readily infected by fleas or from eating infected wild rodents • Infected canines harbor milder infection and do not infect fleas • Felids become very ill and can be involved in pneumonic transmission

  23. Risk Group • In the U.S. persons exposed to rodent fleas, wild rodents, or other susceptible animals in enzootic areas of western states • Most cases occur in southwestern states of NM, AZ, CO, and in CA • Highest rates in Native Americans, especially Navajos • Other risk groups: • Hunters • Veterinarians and pet owners handling infected cats • Campers or hikers entering areas with outbreaks of animal plague

  24. Three Phases of Plague(not progressive stages)

  25. Treatment • Plague is a reportable disease • Patient should be isolated and local and state health departments should be notified • Drug therapy should begin as soon as possible after the laboratory specimens are taken • Recommended broad-spectrum antibiotics • Penicillin is not effective against Yersenia pestis

  26. Prevention • Environmental Management • Controlling rodent populations in both urban and rural areas • Public Health Education • Reducing food and shelter for rodents in and around homes, work places, and recreation areas • Surveillance for plague activity in rodent populations • Flea control during wild animal plague outbreaks • Vaccine • Not recommended for the general population. It is only for those who work in high risk situations

  27. Plague A “bubo” on the lymph node Septicemic plague

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