Hantavirus fever without pulmonary syndrome in Panama

Am J Trop Med Hyg. 2013 Sep;89(3):489-94. doi: 10.4269/ajtmh.12-0334. Epub 2013 Jul 8.


In Panama, hantavirus pulmonary syndrome (HPS) is caused by Choclo virus, a species phylogenetically related to Andes and Maporal viruses. Up to 60% of the population has been positive for specific serum antibody in community-based surveys, but mortality is very uncommon. In four western Panama clinics, we tested individuals presenting with a severe febrile prodrome for acute hantavirus (HV) infection by immunoglobulin M enzyme-linked immunosorbent assay and reverse transcription polymerase chain reaction as well as clinically similar infections, such as dengue and leptospirosis. From 2006 to 2009, at least 21% of 117 patients diagnosed with HV infection had HV Fever (HF) with no evidence of pulmonary edema (no respiratory distress or radiographic lung infiltrates), and 44% of patients had very mild HPS (radiographic pulmonary edema but no respiratory insufficiency). HV infection caused by Choclo virus in Panama presents often as HF, which contrasts with HV in the Americas but is consistent with the high seroprevalence in endemic regions.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Viral / blood
  • Child
  • Child, Preschool
  • Female
  • Hantavirus Pulmonary Syndrome / diagnosis*
  • Hantavirus Pulmonary Syndrome / epidemiology*
  • Hemorrhagic Fever with Renal Syndrome / diagnosis*
  • Hemorrhagic Fever with Renal Syndrome / epidemiology*
  • Humans
  • Immunoglobulin M / blood
  • Male
  • Middle Aged
  • Orthohantavirus / genetics
  • Orthohantavirus / isolation & purification*
  • Panama / epidemiology
  • RNA, Viral / isolation & purification
  • Seroepidemiologic Studies
  • Young Adult


  • Antibodies, Viral
  • Immunoglobulin M
  • RNA, Viral

Supplementary concepts

  • Hantavirosis