Andes virus
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''Andes orthohantavirus'' (ANDV), a species of '' Orthohantavirus,'' is a major causative agent of
hantavirus cardiopulmonary syndrome Hantavirus pulmonary syndrome (HPS) is one of two potentially fatal syndromes of zoonotic origin caused by species of hantavirus. These include Black Creek Canal virus (BCCV), New York orthohantavirus (NYV), Monongahela virus (MGLV), ''Sin Nomb ...
(HCPS) and hantavirus pulmonary syndrome (HPS) in
South America South America is a continent entirely in the Western Hemisphere and mostly in the Southern Hemisphere, with a relatively small portion in the Northern Hemisphere at the northern tip of the continent. It can also be described as the southe ...
. It is named for the
Andes The Andes, Andes Mountains or Andean Mountains (; ) are the longest continental mountain range in the world, forming a continuous highland along the western edge of South America. The range is long, wide (widest between 18°S – 20°S ...
mountains of
Chile Chile, officially the Republic of Chile, is a country in the western part of South America. It is the southernmost country in the world, and the closest to Antarctica, occupying a long and narrow strip of land between the Andes to the east a ...
and
Argentina Argentina (), officially the Argentine Republic ( es, link=no, República Argentina), is a country in the southern half of South America. Argentina covers an area of , making it the second-largest country in South America after Brazil, th ...
, where it was first discovered. Originating in the reservoir of rodents, ''Andes orthohantavirus'' is easily transmitted to humans who come into contact with infected rodents or their fecal droppings. However, infected rodents do not appear ill, so there is no readily apparent indicator to determine whether the rodent is infected or not. Additionally, ''Andes orthohantavirus'', specifically, is the only hantavirus that can be spread by human to human contact via bodily fluids or long-term contact from one infected individual to a healthy person.


Discovery

''Andes orthohantavirus'' was first identified when outbreaks of this new infection spread throughout Chile and Argentina. In 1995, it was finally characterized in Argentina on the basis of specimens from a patient who had died from HPS complications, a severe consequence of infection from Andes viruses. As an emerging virus, it is more lethal than that of some of the other hantaviruses having a mortality rate between 40% and 50% in South America. By far, it has been responsible for the most recorded cases of HPS in Argentina, Chile, and Uruguay combined and contributes to a large number of
kidney failure Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ...
cases. Although it can be carried by both humans and rodents, ''Andes orthohantavirus'' is most commonly found in the ''
Oligoryzomys longicaudatus ''Oligoryzomys longicaudatus'', also known as the long-tailed colilargo or long-tailed pygmy rice rat, is a species of rodent in the genus '' Oligoryzomys'' of the family Cricetidae. It is found in the southern Andes of Chile and Argentina, with ...
'', a species of pygmy rat native to the Chile-Argentina region, and in other cases, in the ''
Abrothrix longipilis ''Abrothrix longipilis'', also known as the long-haired grass mouse or long-haired akodont,Musser and Carleton, 2005, p. 1089 is a species of rodent in the family Cricetidae. It is found in central and southern Argentina and Chile. The south ...
,'' a long-haired grass mouse.


Classification

''Andes orthohantavirus'' is a species of Hantavirus, a group of enveloped, Negative-sense single-stranded RNA virus, belonging to the family Hantaviridae and genus orthohantavirus. All genera excluding hantavirus are air-borne viruses while the hantavirus is rodent-borne. Transmission of the hantaviruses are through aerosol exposure to rodent bodily fluids. Additionally, Hantaviruses seem to cause no detectable cytopathology in vertebrate cell cultures.


Genome and structure

The spherical virion of the Hantavirus is typically 80-120 nm long and contains the segmented single-stranded genome. The tri-segmented genome includes a S (small), M (medium), and L (large) segment that code for nucleocapsid (N), glycoproteins G1 and G2, and L protein respectively. The S segment of the Andes virus contains 1876 nucleotides in total, while encoding a 547 nucleotide-long N protein. Upon comparison of S and M segments to other variants, the Andes virus was found to form a lineage with viruses such as ESQ H-1/96, CH H-1/96 Bayou, and Black Creek Canal viruses. When expressed, the M segment generates the glycoprotein precursor (GPC) which can be cleaved into the envelope Gn and Gc proteins. The L protein encoded by the L segment possesses enzymatic functions that are involved within transcription and replication. In addition to these segments, the virion also contains RdRP which are all enclosed in an envelope. Unlike the other four genera in the family the hantavirion segments also contain a complementary 3'-terminal nucleotide sequence to the 5'-terminal sequence. These nucleotide sequences are AUCAUCAUCUG... at the 3′ end and UAGUAGUAUGC... at the 5′ end.


Entry and replication cycle

The Hantavirus replication takes place strictly in the cytoplasm of a host cell primarily targeting endothelial cells. During early infection, Andes virus can produce a weak, innate immune response in the cell. The entry and uncoating of the virus begins when the virion attaches to cell receptors on the surface of the host cell, which then brings in the virus via endocytosis. By a process called pH-dependent fusion between the virion and the endosomal membrane, nucleocapsids enter the cytoplasm. The virus genome contains its own RNA-dependent RNA polymerase (RdRp) which directs both transcription and replication of the viral genome. Once the nucleocapsids are released, RdRp initiates transcription by binding to the encapsidated segments. While M segment mRNAs are translated by membrane-bound ribosomes, L and S segment mRNAs are translated by free ribosomes. Once transcribed, the mRNA is capped by L proteins via Cap snatching. These capped RNA fragments can then be transferred to L protein, to be further trimmed in length by the endonuclease and used by the RdRp to initiate viral mRNA synthesis. Replication is terminated when the plasma membrane begins to fuse with cytoplasmic vesicles and mature virions are released.


Signs and symptoms

Initial signs of an ''Andes orthohantavirus'' infection can easily be mistaken for the flu. Signs and symptoms can appear as early as 4 days and up to 6 weeks after exposure. The only way to diagnose ''Andes orthohantavirus'' as the cause for these symptoms is by testing the patient's blood for ''Andes orthohantavirus'' genetic material or for corresponding antibodies of ''Andes orthohantavirus''. Individuals are typically only infectious while they are showing symptoms such as having one or more of the following:


Early symptoms

* Nausea or vomiting * Headache * Diarrhea * Muscle aches * Fever


Severe symptoms

* Coughing * Shortness of breath * Fluid in lungs Although there are only two possible vectors of the virus, humans and rodents, there are multiple routes of infection to be aware of. These include: * Breathing in the virus aerosols; stirred up rodent feces or urine * Direct contact with eyes, nose, or mouth after touching infected rodent, its feces, urine, or nesting material * Bite from infected rodent * Although rare, through direct or close contact with an infected person * Bodily fluids (blood, saliva, urine, or semen)


Associated Diseases, Prevention, and Treatment


Andes Hantavirus Pulmonary Syndrome (HPS)

Hantavirus pulmonary syndrome is an acute, severe, and sometimes fatal respiratory disease caused by an infection from the ''Andes orthohantavirus''. Four to ten days after initial symptoms begin, respiratory symptoms indicating HPS can appear. Such symptoms include muscle aches, fatigue, shortness of breath, and fever. HPS symptoms can develop quickly, therefore, it is imperative to seek healthcare immediately. Early care is more beneficial to the patient as there is no vaccine or specific treatment for HPS. In extreme cases, infected individuals may be intubated and receive oxygen therapy. Although hantavirus infections are prevalent in the United States, there currently are very few recorded cases of HPS due to infection from the Andes virus in the United States and the rest of North America; however, there have been several cases reported in Chile and Argentina.


Hantavirus Cardiopulmonary Syndrome (HCPS)

HCPS as a result of ''Andes orthohantavirus'' infection has a case fatality rate of about 25–35% in Argentina and 37% in Chile. ANDV, lineage ANDV-Sout, is the only hantavirus for which person-to-person transmission has been described; all other human hantavirus infections are transmitted exclusively from animals to humans. Several ANDV strains are co-circulating in Argentina (e.g. Bermejo, Lechiguanas, Maciel, Oran and Pergamino). HCPS cases have also been reported in nearby
Bolivia , image_flag = Bandera de Bolivia (Estado).svg , flag_alt = Horizontal tricolor (red, yellow, and green from top to bottom) with the coat of arms of Bolivia in the center , flag_alt2 = 7 × 7 square p ...
,
Brazil Brazil ( pt, Brasil; ), officially the Federative Republic of Brazil (Portuguese: ), is the largest country in both South America and Latin America. At and with over 217 million people, Brazil is the world's fifth-largest country by area ...
,
Paraguay Paraguay (; ), officially the Republic of Paraguay ( es, República del Paraguay, links=no; gn, Tavakuairetã Paraguái, links=si), is a landlocked country in South America. It is bordered by Argentina to the south and southwest, Brazil to th ...
and
Uruguay Uruguay (; ), officially the Oriental Republic of Uruguay ( es, República Oriental del Uruguay), is a country in South America. It shares borders with Argentina to its west and southwest and Brazil to its north and northeast; while bordering ...
, but only for Chile and Argentina can they be strictly associated with ANDV. In Argentina and Chile, the long-tailed rice rat, ''
Oligoryzomys longicaudatus ''Oligoryzomys longicaudatus'', also known as the long-tailed colilargo or long-tailed pygmy rice rat, is a species of rodent in the genus '' Oligoryzomys'' of the family Cricetidae. It is found in the southern Andes of Chile and Argentina, with ...
'', and other species of the genus ''
Oligoryzomys ''Oligoryzomys'' is a genus of rodents in the tribe Oryzomyini of family Cricetidae. Many species are known as pygmy rice rats or colilargos.Musser and Carleton, 2005 The genus is found from Mexico to Tierra del Fuego and includes approximately 1 ...
'', have been documented as the
reservoir A reservoir (; from French ''réservoir'' ) is an enlarged lake behind a dam. Such a dam may be either artificial, built to store fresh water or it may be a natural formation. Reservoirs can be created in a number of ways, including contro ...
for ANDV. Another unique characteristic of ANDV is the availability of an animal model. ANDV causes lethal disease in the Syrian hamster (''Mesocricetus auratus'') that closely models the course of disease progression in humans, including a rapid progression from first symptoms to death, which is characterized by fluid in the pleural cavity and the histopathology of the lungs and spleen. Lethality of ANDV in hamsters is not true of all viruses causing HCPS; hamsters infected with Sin Nombre virus, for example, show no symptoms of disease. The availability of this model allows for the study of various drugs and other treatments that may affect the treatment of all HCPS-causing hantavirus infections.


Prevention

When visiting geographical locations where ''Andes orthohantavirus'' has been documented, such as South America, people should avoid areas of high rodent populations where the virus is more likely to be found and transmitted quickly and easily from rodent to the next. Properly disinfecting living spaces and areas where rodents may have been present will kill the virus before it is able to be contracted. To prevent transmission from contact with infected humans, individuals, infected or not, should hand-wash frequently, abstain from kissing or sexual activity with one another, and avoid sharing spaces of close confinement for long periods of time.


Treatment

There is no current treatment, cure, or vaccine available for illness caused by Andes virus. However, if patients seek medical attention quickly, early symptoms can be abated through intensive care or intubation, if necessary, for patients with severe breathing difficulties.


References


External links


CDC's Hantavirus Technical Information Index page



Virus Pathogen Database and Analysis Resource (ViPR): Hantaviridae


{{DEFAULTSORT:Andes Orthohantavirus Viral diseases Hantaviridae Rodent-carried diseases