Dangerous disease transmitted by rats: Hantavirus Pulmonary Syndrome (HPS)

Have you ever seen rats while cleaning out a storage room or attic in your home? You might have seen rat droppings and urine that have dried up and mixed with dust. Although we often think of these as normal things, today we are talking about a very dangerous, even life-threatening disease that can be transmitted to us from these rats. This is Hantavirus Pulmonary Syndrome, or HPS for short.

What exactly is Hantavirus Pulmonary Syndrome (HPS)?

Simply put, HPS is a very rare, but very serious disease caused by a virus called Hantavirus. Once this virus enters our bodies, it mainly starts damaging our lungs, heart, and other organs.

The most dangerous thing about this disease is that it progresses very quickly . Also, if left untreated, there is a high chance of death. Sometimes this disease is also called Hantavirus Cardiopulmonary Syndrome (HCPS). The reason for this is that it affects both the heart (Cardio) and the lungs (Pulmonary) at the same time.

How do we get this disease?

This is the most important thing. This disease is spread by infected rats. But it does not mean that you will get infected just by touching a rat. It is mainly spread like this:

Imagine you are cleaning an old storage room, a roof, or an old house in the woods. In such places, dried rat urine, feces , and saliva may be mixed with dust. When you sweep the place, these dust particles are added to the air. If you breathe in these tiny dust particles containing the virus , the virus can enter your lungs directly. This is the main way the disease is transmitted.

In addition, it can be transmitted in several other ways:

• If a rat infected with the virus bites you.
• If you touch a surface that is contaminated with rat urine or feces and then touch your nose, mouth, or eyes with the same hand.
• If food or water contaminated with rat urine or feces is inadvertently ingested.

What happens when the virus enters the body?

Once the hantavirus enters the body, it begins to multiply silently, that is, to grow. It is only after a while that it begins to attack our organs.

1. What happens to the lungs: The virus first damages the small blood vessels in our lungs. This causes those blood vessels to 'leak', meaning they leak fluid. This fluid builds up directly inside the air sacs (small balloon-like structures that fill with air when we breathe) in the lungs. This creates a situation similar to drowning. It becomes difficult to breathe, and the body does not get the oxygen it needs.

2. What happens to the heart: This virus also damages the heart muscle. The blood vessels in the heart also weaken and start to leak. Then the heart is unable to properly pump oxygenated blood to the rest of the body. When this condition becomes severe, the body goes into shock . That is, the organs do not get enough blood and they start to fail one by one. This is very dangerous.

What are the symptoms of this disease?

The symptoms of this disease appear in several stages.

Early stage (between 2-8 days)

The initial symptoms are very similar to those of diseases like the common cold and dengue fever, which is why many people don't think it's something serious.

The table below shows the symptoms that can be seen in this early stage.

Acute phase (after 4-10 days)

Between 4 and 10 days after the initial symptoms begin, the disease can become very severe. This is the stage when it becomes life-threatening.

The main characteristics of this stage are:

• Severe difficulty breathing: Fluid fills the lungs, making it difficult to breathe.
• Cough: It may start as a dry cough and then turn into a cough with mucus.
• Chest tightness: A feeling as if the chest is being squeezed with an iron band.
• Heart palpitations.
• Bleeding may also occur inside the body .

If these symptoms occur, it is essential to go to a hospital's Emergency Treatment Unit (ETU) immediately .

How does a doctor diagnose this disease?

When you go to see a doctor, he or she will ask you a few questions, especially about your symptoms and whether you've recently been in an environment where rats are common. For example:

• Have you encountered rats or their droppings recently?
• Have you cleaned an old house or a place like a warehouse?
• Did you participate in something like camping in the woods?
• Are there rats around the area where you live or work?

This information is very important. Because the initial symptoms of this disease are similar to diseases like dengue and influenza, the doctor can suspect HPS based on this information you provide.

Then, a blood test is done to confirm the disease. This test looks for antibodies that the body makes against the hantavirus. Also, looking at changes in the number of white blood cells and platelets in the blood can give an idea of ​​​​this disease.

What are the treatments for this?

There is no specific medicine for HPS that says, "Take this medicine and the disease will be cured." The main goal of treatment is to provide support to the patient's body, or 'supportive care'. This is done to give the patient's body the strength and time it needs to fight the virus and win.

• Patients are often treated in an intensive care unit (ICU) .
• If there is difficulty breathing , oxygen therapy is given .
• If the condition is severe, they will be connected to a breathing machine (mechanical ventilation) .
• Fluid replacement and medications are given intravenously to control body fluid levels and blood pressure.
• In some cases, the antiviral drug Ribavirin is given.
• If the kidneys fail, dialysis may be necessary.
• In very severe cases, you may be connected to a special machine called ECMO (Extracorporeal Membrane Oxygenation) to give the heart and lungs a rest.

How can we protect ourselves from this disease?

There is no vaccine for this disease. Therefore, the best thing to do is to prevent the disease before it occurs. That means staying away from rats and their waste.

Let's see what to do and what not to do in the table below.