Two Critical Viral Threats: A Clinical Guide to Hantavirus and Ebola
Both diseases require strict infection prevention and control (IPAC) measures and present with similar early symptoms.
Hantavirus
Nationally notifiable in Canada — 4–5 cases are confirmed annually, typically acquired from rodents in agricultural settings in Manitoba, Saskatchewan, Alberta, and British Columbia.
Key Facts:
- The Andes strain is unique for its potential for person-to-person transmission.
- American strains (including Andes) cause hantavirus cardiopulmonary syndrome; European and Asian strains cause hemorrhagic fever with renal syndrome.
- Incubation period: 2–4 weeks.
- Symptoms: Fever, headache, myalgia, abdominal pain.
- Diagnosis: Serology and PCR testing at the National Microbiology Laboratory in Winnipeg.
- Treatment: Supportive care only; no specific antiviral or vaccine exists.
Infection Prevention and Control (IPAC):
If Andes strain is suspected, implement airborne, droplet, and contact precautions immediately. Involvement of infectious diseases experts and notification of public health are required.
Ebola Virus Disease
Sporadic outbreaks have occurred in Central and West Africa since 1976. Three main viruses infect humans, likely originating from fruit bats.
Key Facts:
- Transmission: Person-to-person via bodily fluids (vomit, sperm, diarrhea, blood) and contaminated surfaces/objects.
- Current outbreak in DR Congo involves Bundibugyo ebolavirus; fatality rate is 30%–50%.
- Fewer than 50% of patients have hemorrhagic symptoms. Typical symptoms include fever (≥38°C), fatigue, myalgia, and gastrointestinal distress.
- Incubation: 2–21 days.
- Diagnosis: PCR testing.
Testing is indicated for individuals with symptoms and an exposure risk — including travel to affected areas, contact with infected persons, or contact with bats, primates, or game.
Infection Prevention and Control (IPAC):
Health Canada protocol requires fit-tested N95 respirator, face shield, gloves, and fluid-impermeable gear.
Prevention & Management:
- Vaccines and antivirals exist for Zaire ebolavirus but not for Bundibugyo ebolavirus.
- Supportive care is the primary treatment for Bundibugyo.