224.2 📚 國考版

224.2.0.1 必背 — Hantavirus Family

  • ssRNA Hantaviridae, segmented genome
  • Rodent reservoirs (specific to each species)
  • Aerosolized rodent excreta transmission
  • NOT person-to-person (except rare Andes virus in S America)

224.2.0.2 必背 — 2 Major Syndromes

Syndrome Geography Virus Reservoir
HFRS Asia + Europe Hantaan, Seoul, Puumala, Dobrava Various rodents
HPS Americas Sin Nombre, Andes, others Deer mouse (SNV), others

224.2.0.3 必背 — HFRS 5 Phases

  1. Febrile (3-7d)
  2. Hypotensive (hours-days, vascular leak shock)
  3. Oliguric (3-7d, AKI, hypertension, hemorrhage)
  4. Polyuric (1-2 wk)
  5. Convalescent (weeks-months)

224.2.0.4 必背 — HPS

  • Rapid progression from prodrome to cardiopulmonary collapse
  • Non-cardiogenic pulmonary edema + shock
  • Mortality 30-50%
  • ECMO for severe
  • Sin Nombre USA discovery 1993 Four Corners region

224.2.0.5 必背 — Reservoir Examples

  • Hantaan: striped field mouse (Korea, China)
  • Seoul: rat (urban worldwide)
  • Puumala: bank vole (Europe)
  • Sin Nombre: deer mouse (USA)
  • Andes: long-tailed pygmy rice rat (Argentina/Chile)

224.2.0.6 必背 — Treatment

  • Supportive primarily
  • HPS: ECMO for severe
  • HFRS: dialysis for AKI; ribavirin limited evidence
  • No specific licensed antiviral

224.2.0.7 必背 — Prevention

  • Rodent control (indoor exclusion)
  • Wet down + PPE for cleaning rodent-contaminated areas
  • Avoid sweeping/vacuuming dry rodent excreta
  • Hantavax in Korea (HFRS)