| Treatment
There is no specific treatment or cure for hantavirus infection.
Treatment of patients with HPS remains supportive in nature. Patients
should receive appropriate, broad-spectrum antibiotic therapy while
awaiting confirmation of a diagnosis of HPS. Care during the initial
stages of the disease should include antipyretics and analgesia
as needed.
If there is a high degree of suspicion of HPS, patients should be
immediately transferred to an emergency department or intensive
care unit (ICU) for close monitoring and care. Patients presenting
with fulminant illness due to HPS have a poor prognosis despite
ICU care. ICU management should include careful assessment, monitoring
and adjustment of volume status and cardiac function, including
inotropic and vasopressor support if needed. Fluids should be administered
carefully due to the potential for capillary leakage. Supplemental
oxygen should be administered if patients become hypoxic. Equipment
and materials for intubation and mechanical ventilation should be
readily available since onset of respiratory failure may be precipitous.
Intravenous ribavirin, a guanosine analogue, has not been shown
to be effective for treatment of HPS despite its effects on a related
disease, hemorrhagic fever with renal syndrome (HFRS), which is
caused by Old World hantaviruses. Controlled trials showed a reduction
in case-fatality for HFRS patients treated with ribavirin. However,
despite in vitro activity of ribavirin against SNV, neither an open-label
trial conducted during the 1993 outbreak nor an attempted placebo-controlled
trial demonstrated clinical benefit for HPS. Ribavirin is not recommended
for treatment of HPS and is not available for this use under any
existing research protocol.
Take-home Message for Care Providers
Rapid transfer to ICU
Careful monitoring
Fluid balance
Electrolyte balance
Blood pressure
|
National
Center for Infectious Diseases
