New Exposure Location for Hantavirus Pulmonary Syndrome Case

California, USA, 2018

Anne M. Kjemtrup; Sharon Messenger; Amy M. Meza; Tina Feiszli; Melissa Hardstone Yoshimizu; Kerry Padgett; Sunita Singh


Emerging Infectious Diseases. 2019;25(10):1962-1964. 

In This Article


The prevalence of hantavirus in deer mice in the counties surrounding Santa Cruz ranged from 0% to 12% during 1975–2017;[4] however, human HPS cases have not been documented previously from this area. Typically, HPS cases are associated with higher elevations.[8,9] The rural workplace was the first focus of this exposure investigation because it was at a higher elevation and the initial interview with the family suggested rodent exposure. Ultimately, however, the environmental investigation identified the most likely exposure location was the case-patient's farm in Santa Cruz County. The high abundance of deer mice reported by the family, coupled with the presence of SNV in the mice found near the case-patient's farm, likely contributed to elevated exposure risk. The environmental investigation of this case highlights the importance of evaluating all possible places of exposure to minimize future risk for illness and death from HPS. Molecular analysis of case-patient and rodent sequences was a valuable tool to identify the likely exposure locale.

The comprehensive epidemiologic investigation, including molecular sequencing, prompted public health messaging on hantavirus prevention to the public and medical community in a region where a hantavirus case had not previously been identified. Evaluation of the case-patient's residence provided an opportunity for recommendations to decrease risk for ongoing exposure to the case-patient's family. Findings from this environmental investigation might guide future public health interventions in California, including surveillance and public health messaging.