Prospective Evaluation of Household Contacts of Persons with Hantavirus Cardiopulmonary Syndrome in Chile
Abstract
Background.Andes virus (ANDV) infection, which has a case fatality rate of 37% in Chile, often occurs in household clusters and may be transmitted from person to person. Methods.To determine the incidence and risk factors for additional household cases, we conducted a prospective study among recent household contacts of persons with hantavirus cardiopulmonary syndrome (HCPS) in Chile, including testing of serum for anti-hantavirus antibodies and blood cells for ANDV RNA by reversetranscription polymerase chain reaction (RT-PCR).Results.We enrolled 76 index case patients and 476 household contacts, of whom 16 (3.4%)developed HCPS; 32.6% of 92 cases occurred in household clusters.The risk of HCPS was 17.6% among sex partners of index case patients, versus 1.2% among other household contacts (). Person-to-person transmission was definite in P !.0013, probable in 9, and possible in 2 of the 16 additional household case patients.We detected ANDV RNA by RT-PCR in peripheral blood cells 5-15 days before the onset of symptoms or the appearance of anti-hantavirus antibodies. Conclusions.In recent household contacts of persons with HCPS in Chile, the risk of HCPS was greatest among sex partners.Among the household contacts who developed HCPS, viremia preceded the onset of symptoms and the appearance of anti-hantavirus antibodies by up to 2 weeks.Hantavirus cardiopulmonary syndrome (HCPS) occurs throughout much of the Americas [1][2][3][4][5][6][7].More cases (480) have been reported in Chile, where the case fatality rate is 37%, than in the United States (451), and Andes virus (ANDV), the etiologic agent of all known cases in Chile and of most cases in Argentina, is the
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The cohort study by Ferres and colleagues included 476 household contacts, of which only 16 subsequently developed HPS, 3 claimed to be definitely due to human-to-human transmission and 9 probably due to human-to-human transmission; the remaining 460 household contacts did not.
“For example, the cohort study by Ferres and colleagues included 476 household contacts, of which only 16 subsequently developed HPS, 3 of which were claimed to be definitely due to human-to-human transmission and 9 probably due to human-to-human transmission; the remaining 460 household contacts did not [29].”
From Evidence for Human-to-Human Transmission of Hantavirus: A Systematic Review (2022) · cites this paper as [29]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredEvidence from comparative studies does not support human-to-human transmission of hantavirus infection, with the exception of 1 prospective cohort study in Chile with serious risk of bias and no unexposed comparison group.
“Evidence from comparative studies (the strongest level of evidence available) does not support human-to-human transmission of hantavirus infection [12, 15, 27, 34, 36, 38], with the exception of 1 prospective cohort study in Chile with serious RoB and no unexposed comparison group [29].”
From Evidence for Human-to-Human Transmission of Hantavirus: A Systematic Review (2022) · cites this paper as [29]
In the Ferres 2007 cohort, of 476 household contacts, 16 (3.4%) developed HPS and seropositivity, and 460 (96.6%) were seronegative.
“Of 476 household contacts, only 16 (3.4%) developed HPS and seropositivity. The remaining 460 (96.6%) were seronegative.”
From Evidence for Human-to-Human Transmission of Hantavirus: A Systematic Review (2022) · cites this paper as [29]
One prospective cohort study of ANDV in Chile with serious risk of bias showed increased risk of human-to-human transmission in household contacts for sex partners and with exposure to saliva (deep kissing).
“Three of the 8 comparative designs were conducted in Argentina [12] or Chile [15, 29], of which 1 cohort study conducted in Chile but with a serious RoB showed increased risk of human-to-human transmission of ANDV in household contacts for sex partners and with exposure to saliva (deep kissing) [29] (Table 4).”
From Evidence for Human-to-Human Transmission of Hantavirus: A Systematic Review (2022) · cites this paper as [29]
In the Ferres 2007 cohort, the risk of HCPS was 17.6% among sex partners of index case patients versus 1.2% among other household contacts (P < .001).
“The risk of HCPS was 17.6% among sex partners of index case patients vs 1.2% among other household contacts (P < .001).”
From Evidence for Human-to-Human Transmission of Hantavirus: A Systematic Review (2022) · cites this paper as [29]
In the Ferres 2007 cohort, for sex partners, the adjusted odds ratio for hantavirus transmission was 9.71 (95% CI, 1.72-54.67).
“For sex partners: adjusted OR, 9.71 (95% CI, 1.72–54.67).”
From Evidence for Human-to-Human Transmission of Hantavirus: A Systematic Review (2022) · cites this paper as [29]
In the Ferres 2007 cohort, for exposure to saliva (deep kissing), the adjusted odds ratio for hantavirus transmission was 5.05 (95% CI, .89-28.52).
“For exposure to saliva (deep kissing): adjusted OR, 5.05 (95% CI, .89–28.52).”
From Evidence for Human-to-Human Transmission of Hantavirus: A Systematic Review (2022) · cites this paper as [29]
In the Ferres 2007 cohort, human-to-human transmission was classified as definite in 3, probable in 9, possible in 2, and 2 had shared environmental exposure.
“Human-to-human transmission appeared definite in 3 (ie, no environmental co-exposure, urban residence), probable in 9 (ie, close contact with the index case patient, including 7 of 9 who were sex partners, and a lack of major risk factors for environmental exposure), and possible in 2 of the 16 additional household case patients. The remaining 2 had a shared environmental exposure.”
From Evidence for Human-to-Human Transmission of Hantavirus: A Systematic Review (2022) · cites this paper as [29]
The possible confounding effect of environmental exposure to the excreta/secreta of infected rodents was not considered in Ferres et al's model, though it was considered qualitatively.
“However, the possible confounding effect of environmental exposure to the excreta/secreta of infected rodents, which is a known cause of infection, was not considered in this model, though it was considered qualitatively [29].”
From Evidence for Human-to-Human Transmission of Hantavirus: A Systematic Review (2022) · cites this paper as [29]
Ferres et al's multivariate logistic regression model showed that the odds of infection among contacts were increased for sex partners and with exposure to saliva (deep kissing).
“Their multivariate logistic regression model showed that the odds of infection among contacts were increased for sex partners and with exposure to saliva (deep kissing).”
From Evidence for Human-to-Human Transmission of Hantavirus: A Systematic Review (2022) · cites this paper as [29]
An important known risk factor for person-to-person transmission of ANDV is prolonged or close contact with symptomatic persons.
“An important known risk factor for person-to-person transmission of ANDV is prolonged or close contact with symptomatic persons.17,18,21”
From "Super-Spreaders" and Person-to-Person Transmission of Andes Virus in Argentina (2020) · cites this paper as [17]
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- Authors
- Ferrés, M., Vial, P., Marco, C., Yañez, L., Godoy, P., Castillo, C., Hjelle, B., Delgado, I., Lee, S., Mertz, G. J., & Andes Virus Household Contacts Study Group
- Affiliations
- Universidad de La Frontera (CL)
- University of New Mexico (US)
- Universidad del Desarrollo (CL)
- Corresponding author
- Mertz, Gregory J.
- Venue
- The Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-06
- Volume
- 195
- Issue
- 11
- Pages
- 1563-1571
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- OpenAlex
- W2127170357
- Cited by
- 210
- References
- 21
- Citations by year
- 2026: 46 · 2025: 9 · 2024: 7 · 2023: 8 · 2022: 7 · 2021: 11 · 2020: 15 · 2019: 12 · 2018: 3 · 2017: 4 · 2016: 6 · 2015: 9 · 2014: 14 · 2013: 11 · 2012: 7
- FWCI
- 6.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (AI 45452)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Vectors
- Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Outbreaks Research
- Keywords
- hantavirus pulmonary syndrome, Andes virus, household contacts, household transmission, human-to-human transmission, sexual partners, household clusters, viremia
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Antibodies, Viral, Child, Child, Preschool, Chile, Family Characteristics, Female, Orthohantavirus, Humans, Infant, Infant, Newborn, Male, Middle Aged, Prospective Studies, Risk Factors, RNA, Viral, Viremia, Incidence, Contact Tracing, Hantavirus Pulmonary Syndrome, Reverse Transcriptase Polymerase Chain Reaction
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