Cases of Clinically Proven Hantavirus Infection with a Pulmonary Syndrome among Pregnant Women in Tashkent, Uzbekistan

Andrey V. An*

1st Perinatal Centre, Tashkent, Republic of Uzbekistan

*Corresponding author: Andrey V. An, 1st Perinatal Centre, 35/48, Chilonzor-1, 700115, Tashkent, Republic of Uzbekistan. Fax/Tel: 998-71-2508599/ 998-71-2775486. E-mail: dongnamuz@mail.ru andrey.an.vl@gmail.com

Abstract: 

Background: For nearly a decade, a disease likely to have been misdiagnosed was observed in pregnant women in Tashkent, Uzbekistan. It caused the rapid decline and death of patients, with about 45% mortality rate. The disease was suspected to be caused by a virus of the HVP (Hantavirus) family, and clinical studies were conducted to ascertain.
Methods: As no system for registration of such cases had been maintained, researchers developed a questionnaire with indicators chiefly based on relevant literature. All the women admitted exhibiting the symptoms listed were covered by the study.
Results: Among the 16 cases identified from September to December 2008, ten survived; 80% belonged to the indigenous ethnic group; 80% were housewives. Most (90%) were between 16 and 34 weeks’ pregnancy, 24.5 weeks on average. Almost all of them experienced labored breathing and abnormally high body temperature. About 75% of the women lived in the vicinity of rodents’ habitats, and about half of them could have been in direct contact with the aerosolized rodent excreta.
Conclusions: Researchers believe that those women exposed to the excreta were cases of HPS. In practice, the surgical removal of the fetus proved to be the most efficient treatment. However, the medical community has a growing concern about patients with HPV being misdiagnosed and the related difficulties in diagnosing and treating them.

Keywords: 
HPV; diagnosing; treating; pregnancy.
References: 
  1. Andersen HF, Lynch JP, Johnson TR. Adult respiratory distress syndrome in obstetrics and gynecology. Obstet Gynecol 1980; 55:291–5.
  2. Duchin JS, Koster FT, Peters CJ, et al. Hantavirus pulmonary syndrome: a clinical description of 17 patients with a newly recognized disease. N Engl J Med 1994; 330:949–55.
  3. Howard MJ, Doyle TJ, Koster FT, Zaki SR, Khan AS, Petersen EA, Peters CJ, Bryan RT. Hantavirus Pulmonary Syndrome in Pregnancy. Clinical Infectious Diseases 1999; 29:1538–44.
  4. Lee HW, Lee PW, Johnson KM. Isolation of the etiologic agent of Korean hemorrhagic fever. J Infect Dis 1978; 137:298–308.
  5. Mertz GJ, Hjelle BL, Bryan RT. Hantavirus infection. Adv Intern Med 1997; 42:369–421.
  6. Nichol ST, Spiropoulou CF, Morzunov S, et al. Genetic identification of a hantavirus associated with an outbreak of acute respiratory illness. Science 1993; 262:914–7.
  7. Khan AS, Khabbaz RF, Armstrong LR, et al. Hantavirus pulmonary syndrome: the first 100 US cases. J Infect Dis 1996; 173:1297–303.
  8. Hollingsworth HM, Irwin RS. Acute respiratory failure in pregnancy. Clin Chest Med 1992; 13:723–40.
  9. Mabie WC, Barton JR, Sibai BM. Adult respiratory distress syndrome in pregnancy. Am J Obstet Gynecol 1992; 167:950–7.
  10.  Smith JL, Thomas F, Orme JF, Clemmer TP. Adult respiratory distress syndrome during pregnancy and immediately postpartum. West J Med 1990; 153:508–10.
  11.  Gilson GJ, Maciulla JA, Nevils BG, Izquierdo LE, Chatterjee MS, Curet LB. Hantavirus pulmonary syndrome complicating pregnancy. Am J Obstet Gynecol 1994; 171:550–4.
  12.  Peterson HC, Richardson L. Hantavirus pulmonary syndrome: Kansas, 1993 [news]. Kans Med 1994; 95:74–5.
  13.  Pini NC, Resa A, Laime GJ, et al. Hantavirus infection in children in Argentina. Emerg Infect Dis 1998; 4:85–7.
  14.  Toro J, Vega JD, Khan AS, et al. An outbreak of Hantavirus Pulmonary Syndrome, Chile, 1997. Emerg Infect Dis 1998; 4:1–8.
  15.  Kim WD, Park YK, Lee HW, Moon GJ. A case of fetal death after maternal infection of Korean hemorrhagic fever. Korean J Infect Dis 1978; 10: 36–40.
  16.  Lee HW. Hemorrhagic fever with renal syndrome in Korea. Rev Infect Dis 1989; 11(Suppl 4):S864–76.
  17.  Liu YF, Yan PS, Wang BY, et al. Intrauterine infection of epidemic hemorrhagic fever (EHF) via placenta. Chin Med J (Engl) 1987; 100:756–8.
  18.  An A.V. Interview regarding the Long-Term Outcomes of the HPV cases researched in Tashkent, Uzbekistan in 2008 (2009).

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Int J Biomed. 2012; 2(4):267-270. © 2012 International Medical Research and Development Corporation. All rights reserved.