INTRODUCTION

Hantavirus cardiopulmonary syndrome (HCPS) is a viral zoonosis that may result in cardiogenic shock and respiratory failure with significant associated mortality. Hantavirus infection has been identified throughout much of North, Central, and South America. In the United States 453 cases of HCPS have been reported through September 2006 with a case fatality rate of 35%. The majority of these cases have been from the southwest. The incidence is even greater in South America, particularly in Argentina, Brazil, Chile, and Paraguay. In Chile 495 cases have been reported through 2006, with a case fatality rate of 37%.

VIROLOGY

HCPS is caused by an infection with a hantavirus. There have been approximately 20 New World hantaviruses identified since their discovery in 1993. The New World hantaviruses differ from the Old World hantaviruses that cause hemorrhagic fever with renal syndrome (HFRS) and are found primarily in Asia and Europe. The most common hantavirus causing HCPS in Canada and the United States is sin nombre virus (SNV). Other hantaviruses that cause significant disease in Central and South America include Andes virus (ANDV) in Chile and Argentina, Choclo virus in Panama, and Laguna Negra virus in Paraguay. The hantaviruses are small single-stranded negative-sense RNA viruses that belong to the family Bunyaviridae, a family known to include other viruses that cause significant zoonotic illnesses.