How at risk is Nepal from the Hanta virus that has swept the world?
Since the initial symptoms of many infectious diseases are very similar to each other, laboratory tests are helpful in distinguishing the infection.
According to the World Health Organization, 3 out of 8 people have died from Hanta virus seen on a cruise ship.
Although Hanta virus is transmitted through the feces, urine or saliva of infected rats, it has been confirmed that the 'Andean' species can be transmitted from person to person.
Nepal is at risk of Hanta virus, but even if it has not been confirmed as an outbreak, regular testing and research are necessary.
Recently, the Hanta virus seen on a cruise ship has swept the world. According to the information published by the World Health Organization a few days ago (on May 8), 3 out of 8 people have died.
That is, about 38 percent of the infected have died. This human-to-human transmission is considered very rare, but currently, dozens of cases on cruise ships have become a matter of concern and interest.
At the time of writing, the main source of infection is unknown. Information on the circumstances under which it spread from person to person is yet to be released.
Hantavirus can be transmitted to humans through contact with the feces, urine, or saliva of infected rats. Even if an infected rat does not show symptoms, it can still cause death if it infects humans.
The mortality rate of the Hantavirus strain seen in the Americas is many times higher than that of the Hantavirus strain seen in Europe and Asia, which is about 50 percent. Recently, a cruise ship has seen a mortality rate of about 38 percent. The World Health Organization has reported that the mortality rate of the Hantavirus strain seen in Europe and Asia is up to 15 percent.
Although Hantavirus is said to be transmitted only through the feces, urine, or saliva of infected rats, the ‘Andean’ strain of Hantavirus can be transmitted from person to person to some extent.
The Hantavirus strain currently circulating on cruise ships has also been confirmed by gene sequencing to be ‘Andean’. Hantavirus is mainly divided into two types based on symptoms, which also vary according to geographical location.
First, Hanta pulmonary syndrome and second, hemorrhagic fever with renal syndrome.
Hanta pulmonary syndrome is mainly seen in the Americas, while hemorrhagic fever with renal syndrome and Hantavirus are seen in Europe and Asia.
Hanta pulmonary syndrome is characterized by symptoms such as fever, chills and dizziness, muscle pain, diarrhea, nausea or vomiting, abdominal pain, and low blood pressure. If it becomes complicated, coughing, difficulty breathing, chest tightness, and pneumonia may occur.
These symptoms may appear within one to six weeks of infection.
Hemorrhagic Fever with Renal Syndrome Hanta virus causes chills, stomach pain, headache, nausea, blurred vision, red eyes, and later complications, bleeding, and there is a risk of kidney failure.
These symptoms appear one to two weeks after infection, and sometimes up to 8 weeks. This Hanta virus is seen in Asia, especially in countries like China, Korea, Japan, and Russia. Research articles have also been published that Hanta virus has been seen in neighboring India. But there is no information that it has taken the form of a major outbreak.
Is there a risk of Hanta virus in Nepal?
Hanta virus is transmitted when it comes into contact with rat feces, urine, or saliva. Rats are seen in significant numbers in all villages and cities in Nepal.
The number of people who come to Teku Hospital for treatment of rat bites is also high. Most people with such problems do not come to the hospital. There is a lot of contact between humans and rats in Nepal too.
Hundreds of scrub typhus cases are reported in Nepal every year. The main source of scrub typhus infection is the mite found in rats. This also clearly shows that the risk of any infection that can be spread by rats in Nepal is high.
Hanta virus is no exception. In 2017, a tourist fell ill and was admitted to the ICU immediately after returning to his country after visiting Nepal. A research article was published stating that the person had been diagnosed with hanta virus. This was published in an American medical journal in 2020.
This also indicates that the risk of hanta virus is present in Nepal.
However, as in India, there is no confirmation of an outbreak in Nepal yet. Since this infection is not included in routine laboratory tests, we are unaware of the status of hanta virus in Nepal.
Blood tests of tourists infected with hanta virus in Nepal show a decrease in platelet count and an increase in liver enzymes, which the author has experienced is also widely seen in fever patients in Nepal.
However, the possibility of Hantavirus seems to be overlooked when sending for diagnostic tests for limited infections. Since a large number of fever patients are still not diagnosed in Nepal, there is a need to increase the scope of testing.
In the case of a new infection or a first-time infection, testing for that infection should also be included in routine testing. Since the initial symptoms of many infectious diseases are very similar to each other, laboratory testing is helpful in distinguishing infections. Only if the infection is diagnosed can treatment, prevention, and counseling be correct.
Currently, the World Health Organization has stated that the risk of further spread of this virus is low. However, the number of infections on a cruise ship at the same time is so high. And as the problem becomes more complicated and the mortality rate is higher, it cannot be ruled out that the contagiousness and lethality of this virus has increased compared to the past.
Nepal cannot completely ignore the risk of the virus, given the confirmed research on this virus and the frequent contact with rats, which is considered the source of the virus.
If national guidelines were developed in Nepal, prioritizing research on Hanta virus, it would be useful for health workers in diagnosis, treatment, and prevention.
