Hantavirus Pulmonary Syndrome (HPS)

What is hantavirus pulmonary syndrome (HPS)?

HPS disease is a rare but extremely serious illness of the lungs caused by a family of viruses known as hantavirus.  In 1993, the first United States cases were diagnosed in the southwestern part of the country.  Isolated cases of HPS are now being diagnosed in other parts of the country and several different types of hantavirus have been identified.  

Who can get HPS?  Where is the virus found?

Persons who have exposure to wild rodents or rodent-infested areas are at highest risk of getting HPS.  Hantavirus is carried by infected rodents, primarily deer mice in the southwest US, cotton and rice rats in the south, and the white-footed mouse in the northeastern coastal area.  The virus, which is found in the animal's urine, saliva and droppings, gets in the air as mist or dust when droppings or nests are stirred up.

How is the virus spread?

The main way that HPS is spread to humans is by breathing air contaminated with rodent urine, droppings or saliva. It can also be transmitted by handling rodents or by touching your nose or mouth after handling contaminated materials. A rodent's bite can also spread the virus. There is no evidence that cats, dogs, farm animals, or insects transmit the disease to humans. You cannot get HPS from another person.

What are the symptoms of HPS disease?

The initial symptoms are fever (101-104F),fatigue, and muscle aches. Other common symptoms that may occur are headache, dizziness, chills, nausea, vomiting, diarrhea, and abdominal pain. Later symptoms of HPS are coughing and shortness of breath caused by fluid build-up in the lungs.  These breathing problems start 4-10 days after the first symptoms and can progress to respiratory failure and sometimes death.   In some cases of HPS, the kidneys and other organs will stop working.

How soon after exposure do symptoms appear?

The symptoms can start as soon as one week or as long as six weeks after exposure, but they usually start about two weeks after exposure.  

What is the treatment for HPS disease?

At the present time, there is no specific treatment for HPS. Early intensive hospital care can save lives.  

How can hantavirus infection be prevented?

• Keep your home clean to discourage rodents: wash dishes promptly, clean counters and floors, put pet food and water away at night, store food and garbage in containers with tight lids.
• Prevent mice from entering your house by sealing all openings with caulking or steel wool. Remember rodents can squeeze through holes as small as a dime.
• Follow these precautions before cleaning up a dead rodent or an area where mice have been: 
• Wear rubber or plastic gloves.
• Don't stir up and breathe dust.
• If you are going into a building, garage or basement that has been closed, open it to air out for at least one hour before spending time inside.
• Wet down dusty areas that may be contaminated with rodent droppings or urine before cleaning them up. You can use a commercial disinfectant such as Lysol spray or prepare a solution of 1 1/2 cups bleach to 1 gallon of water. Use a spray bottle to mist the area and gently but thoroughly wet it. A hard spray will just stir up more dust. 
• Wipe up any debris; do not use a broom or vacuum cleaner because they create dust in the air. 
• Dead rodents should be sprayed with disinfectant and then placed in a plastic bag containing enough disinfectant to thoroughly wet the carcasses. 
• When cleanup is complete, seal the bag and place into a second plastic bag before disposing by burying, burning or placement in an appropriate waste disposal system.. 
• Before removing gloves, wash gloved hands in disinfectant and then in soap and water. 
• Thoroughly wash hands with soap and water after removing gloves.
• Control rodents outside your house:
• Clear brush and grass away from the foundation.
• Place woodpiles and garbage cans on platforms at least 12 inches off the ground and keep them at least 100 feet from the house.
• Haul away junk that can provide homes for rodents.
• When camping or sleeping outdoors, avoid disturbing or sleeping near rodent droppings or burrows.
• Avoid sleeping on bare ground. Use a mat or elevated cot if available.
• Store foods in rodent proof containers and promptly discard, bury or burn all garbage.

Where can I obtain more information on hantavirus pulmonary syndrome?

Additional information on the hantaviruses and on hantavirus pulmonary syndrome is available at: http://www.cdc.gov/ncidod/diseases/hanta/hps/index.htm.

If you need information on cleaning rodent-infested areas and rodent-proofing buildings, refer to Hantavirus Pulmonary Syndrome - United States: Updated Recommendations for Risk Reduction, available at http://www.cdc.gov/mmwr/PDF/rr/rr5109.pdf.