Hemorrhagic Fever in California

Rare and exotic infections caused by Ebola, Marbug, and Lassa viruses used to be confined to distant parts of the world, such as Africa Many of these infections have high mortality and create a public health alarm These diseases Cxdiovasculx inslabillty aid signtficant internal hemorrhlrses uiuallv lead to de3lli Diaenosis of whitewater Arroyo~virus is through serology and occasionaliy viral isolation Currently the University of Texas, Galveston is one of the few labs that can identify Whitewater Arroyo virus Hanta V ~ r u r Hanta virus \VZ first recogn~zed In thc Four-Curner region of h e southwest in 1993 and this viral subwoe freauentlv is referred to as Sin Nombre Virus The deer mouse serves as the reservoir for hanta typically result in a "hemorrhagic fever" syndrome, which I 8 human cases wrre reported in 2000 in CA The relates to the clinical presentation of very high fevers and severe author lRUI has ocrsondlv observed deer micr and their internal and external bleeding from c a p i i l ~ l e a k a g e or viral-induced coagulopathy Transmission occurs with inhalation of airborne particles and direct contact with body secretions. These viruses are hardy and can last for days on hard surfaces such as wood, dirt, and stone Time from infection to death or recovery may last days, enabling these patients to travel long distances by jet and possibly infect others Emergency physicians frequently are the first to encounter patients who present with these infections, placing them at high risk This type of msmission can be best exemplified by the first isolation of Lassa Virus in 1969, in which anurse missionary in Lassa, Nigeria contracted a high fever and died of massive hemorrhage days later Of the two nurses caring for her, one died similarly, and the other flew home to New York City and became ill The virus was identified at that time, but only after two virologists investigating the case also contracted the disease, one of whom died Over the past year the number of hemorrhagic fever cases reported in California have increased A well-known. '. fecal material in Eastern Sierra camping areas In one area of the Walker River watershed in Eastern California, 60% of deer mice were found to have had evidence of hanta virus infection ' The inhalation of mouse fomites such as urine, feces, or other particles may initiate infection …