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Public Health Significance of an Emerging Infectious Disease

Dennis J. White, MS, PhD; Robert G. Means, MS; Guthrie S. Birkhead, MD, MPH; Edward M. Bosler, PhD; Leo J. Grady, PhD; Nando Chatterjee, PhD; Jack Woodall, PhD; Brian Hjelle, MD; Pierre E. Rollin, MD; Thomas G. Ksiazek, DVM, PhD; Dale L. Morse, MD, MS

Arch Intern Med. 1996;156(7):722-726.

Abstract
Background
A case of hantavirus pulmonary syndrome with possible exposure in New York and/or Rhode Island was confirmed in February 1994.

Objective
To conduct four studies to determine the historical and geographic distribution of human and small-mammal infection with hantaviruses in New York State.

Methods
Enzyme-linked immunosorbent assays were performed on serum samples obtained from 130 humans during a 1978 babesiosis survey, 907 small mammals collected in New York State since 1984,12 rodents collected in 1994 near the residences of the patients with hantavirus pulmonary syndrome, and 76 New York patients with acute respiratory distress syndrome—like illness (as suspected cases of hantavirus pulmonary syndrome).

Results
None of the human serum samples from the 1978 serosurvey showed evidence of hantavirus exposure by enzyme-linked immunosorbent assay. Statewide historical serum samples from white-footed mice showed evidence of Sin Nombre virus infection in 12.0% (97/809) and Seoul-like virus infection in 9.6% (78/ 809). Site-specific seropositivity rates were as high as 48.5% with Sin Nombre virus during 1 year (1984). Two of 12 mice captured near the residences of a human patient were positive for Sin Nombre virus by enzyme-linked immunosorbent assay, yet were negative for viral RNA by polymerase chain reaction. None of the patients with suspected hantavirus pulmonary syndrome was serologically reactive for Sin Nombre virus.

Conclusions
We provide serologic evidence of small-mammal infection with hantaviruses in New York State as long ago as 1984. Human cases of hantavirus pulmonary syndrome are rare in New York, and data indicate that transmission to humans is probably infrequent. A unique set of host, agent, and environmental factors may be necessary to cause hantavirus pulmonary syndrome in humans.

(Arch Intern Med. 1996;156:722-726)

Author Affiliations
From the New York State Department of Health, Bureau of Communicable Disease Control (Drs White, Birkhead, Bosler, and Morse and Mr Means), State University of New York School of Public Health (Drs White, Birkhead, Grady, and Morse), and Wadsworth Center for Laboratories and Research (Drs Grady, Chatterjee, and Woodall), Albany, NY; Department of Pathology, University of New Mexico School of Medicine, Albuquerque (Dr Hjelle); and Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Ga (Drs Rollin and Ksiazek).

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