Person-to-person transmission of Andes virus

Abstract

Despite the fact that rodents are considered to be the infectious source of hantavirus for humans, another route of transmission was demonstrated. Andes virus (ANDV) has been responsible for most of the cases recorded in Argentina. Person-to-person transmission of ANDV Sout lineage was described during an outbreak of hantavirus pulmonary syndrome in southwest Argentina. In this study, we analyzed 4 clusters that occurred in 2 disease-endemic areas for different ANDV lineages. We found new evidence of interhuman transmission for ANDV Sout lineage and described the first event in which another lineage, ANDV Cent BsAs, was implicated in this mechanism of transmission. On the basis of epidemiologic and genetic data, we concluded that person-to-person spread of the virus likely took place during the prodromal phase or shortly after it ended, since close and prolonged contact occurred in the events analyzed here, and the incubation period was 15-24 days.

Figure 1

Location of residences and possible sites of exposure of hantavirus pulmonary syndrome patients in the provinces of Buenos Aires and Neuquén and Andes virus (ANDV)–endemic regions, 2002.

Figure 2

Contact events and incubation period of hantavirus pulmonary syndrome patients, Argentina, 2002. One line was drawn per case for C1 and C4; dotted lines represent the incubation period since the established moment of contact between contiguous case-patients. The onset of illness for each patient is indicated by day 0. Triangles indicate contacts between patients. | | indicates day of death.