224.4 📌 章末速蚘

224.4.0.0.1 Hantavirus
  • ssRNA segmented Bunyavirales
  • Rodent reservoir specific to species
  • Aerosol rodent excreta transmission
  • NOT person-to-person (except rare Andes)
224.4.0.0.2 HFRS (Asia + Europe)
  • Hantaan, Seoul, Puumala, Dobrava
  • 5 phases: febrile → hypotensive → oliguric → polyuric → convalescent
  • Renal failure + hemorrhage prominent
  • Dialysis + supportive
  • Hantavax in Korea
224.4.0.0.3 HPS (Americas)
  • Sin Nombre (USA, deer mouse, 1993 Four Corners)
  • Andes (S America, rare person-to-person)
  • Rapid prodrome → cardiopulmonary collapse
  • Mortality 30-50%
  • ECMO critical for severe
  • No vaccine
224.4.0.0.4 Both
  • Supportive care primary
  • Ribavirin limited evidence (HFRS more than HPS)
  • Prevention: rodent control + wet down + PPE for cleaning
  • 盧醫垫 hint: 旅遊 rural / cabin + 急 ARDS / AKI → 考 hantavirus depending geography