Person-to-person Hantavirus Outbreak – Epuyén, Chubut province, Argentina. 2018.

  • Zoonotic
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Between November and first days of December 2018, 5 cases of Andes Hantavirus were reported, one of them deceased. On December 5, an outbreak was declared, when an epidemiological link with the index case was established. Given the subsequent appearance of new cases, on December 13 the hypothesis of person to person transmission was proposed. The only known antecedent being the 1996 outbreak in El Bolsón, Rio Negro province, Argentina, with similar characteristics, but where the epidemiological link had not been clearly identified.

Characterize the Andes Hantavirus outbreak in Epuyén between November 2018 and March 2019.

Cross-sectional descriptive study. Semi-structured and in depth interviews were carried out with cases and contacts to clarify the epidemiological link and establish transmission dynamic. Blood samples were analyzed for detection of viral genome by RT-PCR for confirmation and the complete sequencing of the genome was obtained by Next-Generation Sequencing. The environmental risk of transmission was assessed by direct observation and rodent capture.

The outbreak counted 34 Hantavirus cases (20 female, 14 male), with eleven deceases. The overall fatality rate was of 32.4%, with differences between sexes, (21% in men and 40% in women). The median incubation period was 21 days. The epidemiological link was established in 32 cases. All cases had been exposed at least 30 minutes to an infected person, within the first two days of the beginning of fever and were mostly cohabitants or had coincided at a social event. No health workers were infected. The complete viral genome sequencing showed similarities higher than 99.9%. There was no evidence of the existence or presence of rodents related to secondary cases

Person to person transmission was confirmed by epidemiological link, genome sequencing, and environmental research. This represents a challenge to further identify transmission period and viral shedding routes with higher load. All close contacts exposed to a confirmed case must be isolated for 45 days and biosecurity measures must be guaranteed.

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