Ten years of major equestrian injury: are we addressing functional outcomes?

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Hantaviroses Hantaviruses

As hantaviroses constituem infecções zoonóticas amplamente distribuídas em todo o mundo. A febre hemorrágica com síndrome renal mostra-se endêmica na Ásia e Europa, acometendo milharea de pessoas anualmente. A síndrome cardiopulmonar pelo hantavírus, reconhecida como entidade clínica desde 1993, representa o protótipo das doenças emergentes e encontra-se distribuída em diversos países do continente americano, inclusive o Brasil. Ambas são transmitidas ao homem através da inalação de partículas virais eliminadas nas fezes e urina de roedores domésticos e silvestres. Trata-se de doenças sistêmicas febris que podem acometer vários órgãos, destacando-se o rim na febre hemorrágica com síndrome renal e os pulmões e o coração na síndrome cardiopulmonar. A taxa de letalidade da hantavirose americana alcança 50%. Diagnostica-se as hantaviroses através de provas sorológicas imunoenzimáticas ao identificar-se anticorpos específicos das classes IgM e IgG. Não há tratamento específico. Recomenda-se hidratação cuidadosa, indicação precoce de diálise nas formas renais e administração de drogas vasoativas nos períodos de hipotensão e choque. A administração de corticoesteróides e da ribavirina está sendo avaliada em estudos controlados. O número de casos dessas viroses tem crescido no Brasil ano a ano, e cumpre alertar os profissionais de saúde sobre a ocorrência dessas entidades nos vários estados do país, possibilitando diagnóstico precoce e tratamento adequado nos casos suspeitos da doença.<br>Hantaviruses are zoonotic diseases that affect humans and have a worldwide distribution. The hemorrhagic fever associated with renal syndrome occurs endemically in the Asian and European continents affecting housauds of people every year. Hantavirus cardiopulmonary syndrome, recognized as a clinical entity since 1993, represents the prototype of emerging diseases and is distributed in countries of the American continent, including Brazil. Both diseases are transmitted to man through the inhalation of viral particles, which are shed in feces and urine of wild and domestic rodents. They comprise a group of febrile diseases that can affect many organs, particularly the kidneys in the hemorrhagic fever associated with renal syndrome and the lungs and heart in the hantavirus cardiopulmonary syndrome. The lethality of American hantaviroses reaches 50%. The diagnosis of these diseases is performed using serological tests such as immunoenzymatic assays which detect specific antibodies of the IgG and IgM classes. There is no specific treatment. Therefore, special attention should be directed to restore and maintain fluid balance, timely indication of dialysis for renal failure and administration of vasoactive drugs during periods of hypotension and shock. The administration of corticosteroids and/or ribavirin are under evaluation. The number of cases of hantavirus infection has been increasing in Brazil year after year, and it is important to alert health personnel to the occurrence of these entities throughout the country. Awareness of their presence should improve the quality of medical care

Clinical Manifestations of New World Hantaviruses

Fil: Enria, Delia. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Fil: Briggiler, Ana M. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Fil: Pini, Noemí. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Fil: Levis, Silvana. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.In May 1993 a new clinical entity named hantavirus pulmonary syndrome (RPS) was first described in the United States during the investigation of an outbreak of a febrile disease of high mortality, characterized by acute respiratory insufficiency. RPS was found to be caused by a novel agent of the Hantavirus genus. Since the discovery of the disease, isolated cases and outbreaks of HPS have been registered all over the Americas, and other SNV-related hantaviruses (New World hantaviruses) were identified either causing human illnesses or circulating among native sigmodontine rodent species. In this chapter, we will discuss the clinical manifestations of New World hantaviruses, with an attempt to analyze the differences that have been observed among different geographic areas and viral genotypes