Whitewater Arroyo virus
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''Whitewater Arroyo mammarenavirus'' (WWAV) is a
zoonotic A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a bacterium, virus, parasite or prion) that has jumped from a non-human (usually a vertebrate) to a human. ...
Arenavirus An arenavirus is a bisegmented ambisense RNA virus that is a member of the family ''Arenaviridae''. These viruses infect rodents and occasionally humans. A class of novel, highly divergent arenaviruses, properly known as reptarenaviruses, have ...
associated with
hemorrhagic fever Viral hemorrhagic fevers (VHFs) are a diverse group of animal and human illnesses in which fever and hemorrhage are caused by a viral infection. VHFs may be caused by five distinct families of RNA viruses: the families ''Filoviridae'', ''Flav ...
with liver failure.


Discovery

WWAV is an emerging virus; previously, it was widely distributed among
woodrat A pack rat or packrat, also called a woodrat or trade rat, are any species in the North and Central American rodent genus ''Neotoma''. Pack rats have a rat-like appearance, with long tails, large ears, and large, black eyes. Pack rats are notice ...
s (''Neotoma'' spp.), its
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 ...
, in the
American Southwest The Southwestern United States, also known as the American Southwest or simply the Southwest, is a geographic and cultural region of the United States that generally includes Arizona, New Mexico, and adjacent portions of California, Colorado, N ...
and was not known to infect humans. However, during June 1999-May 2000, three female patients, aged 14, 30, and 52, developed similar fatal illnesses. The illnesses were associated with nonspecific
febrile Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using val ...
symptoms including fever, headache, and
myalgia Myalgia (also called muscle pain and muscle ache in layman's terms) is the medical term for muscle pain. Myalgia is a symptom of many diseases. The most common cause of acute myalgia is the overuse of a muscle or group of muscles; another likel ...
s and
acute respiratory distress syndrome Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs. Symptoms include shortness of breath (dyspnea), rapid breathing (tachypnea), and bluish skin colo ...
. Two developed liver failure and
hemorrhagic fever Viral hemorrhagic fevers (VHFs) are a diverse group of animal and human illnesses in which fever and hemorrhage are caused by a viral infection. VHFs may be caused by five distinct families of RNA viruses: the families ''Filoviridae'', ''Flav ...
. All three patients died 1–8 weeks after the onset of symptoms. Arenavirus-specific RNA was detected in each patient using
RT-PCR Reverse transcription polymerase chain reaction (RT-PCR) is a laboratory technique combining reverse transcription of RNA into DNA (in this context called complementary DNA or cDNA) and amplification of specific DNA targets using polymerase cha ...
. The
nucleotide sequence A nucleic acid sequence is a succession of bases signified by a series of a set of five different letters that indicate the order of nucleotides forming alleles within a DNA (using GACT) or RNA (GACU) molecule. By convention, sequences are usu ...
of the patients were essentially identical and was 87% similar to the WWA virus prototype strain (obtained from a white-throated woodrat ('' Neotoma albigula'') from
New Mexico ) , population_demonym = New Mexican ( es, Neomexicano, Neomejicano, Nuevo Mexicano) , seat = Santa Fe , LargestCity = Albuquerque , LargestMetro = Tiguex , OfficialLang = None , Languages = English, Spanish ( New Mexican), Navajo, Ker ...
in the early 1990s). According to a family member, one patient had cleaned rodent droppings in her home during the two weeks before the onset of illness, while the other patients had no known contact with rodents. None of the patients traveled outside of
California California is a U.S. state, state in the Western United States, located along the West Coast of the United States, Pacific Coast. With nearly 39.2million residents across a total area of approximately , it is the List of states and territori ...
within four weeks of illness.


Epidemiology

Previous cases of infection were from California. However, the virus has been found in woodrats in New Mexico and, more recently, in
Utah Utah ( , ) is a state in the Mountain West subregion of the Western United States. Utah is a landlocked U.S. state bordered to its east by Colorado, to its northeast by Wyoming, to its north by Idaho, to its south by Arizona, and to it ...
,
Oklahoma Oklahoma (; Choctaw language, Choctaw: ; chr, ᎣᎧᎳᎰᎹ, ''Okalahoma'' ) is a U.S. state, state in the South Central United States, South Central region of the United States, bordered by Texas on the south and west, Kansas on the nor ...
, and
Texas Texas (, ; Spanish language, Spanish: ''Texas'', ''Tejas'') is a state in the South Central United States, South Central region of the United States. At 268,596 square miles (695,662 km2), and with more than 29.1 million residents in 2 ...
.


Clinical

WWAV infection is associated with hemorrhagic fever with liver failure. It is often associated with a mild febrile illness, with symptoms such as fever, headache, and myalgias.


Transmission and Prevention

Like other arenaviruses, WWAV appears to be transmitted through rodents. Therefore, direct contact with rodents, their feces, and their nesting materials should be avoided. Surfaces contaminated with rodent feces should be disinfected. In addition, control of rodents near homes can help prevent infection. Rodent carcasses and materials should be double-bagged before disposal. Although it is unclear if WWAV can be transmitted
nosocomial A hospital-acquired infection, also known as a nosocomial infection (from the Greek , meaning "hospital"), is an infection that is acquired in a hospital or other health care facility. To emphasize both hospital and nonhospital settings, it is ...
ly, other arenaviruses have been transmitted through contact with an infected patient's blood, urine, or pharyngeal secretions.


References

{{Use dmy dates, date=April 2017 Arenaviridae