Hantavirus pulmonary syndrome: the infection that killed Betsy Arakawa, Gene Hackman's wife
Authorities said on Friday that actor Gene Hackman died of heart disease days after his wife, Betsy Arakawa, died from hantavirus pulmonary syndrome. But what exactly is this rare illness?
Hantavirus pulmonary syndrome is a rare but serious viral disease that can damage the heart, lungs, and other organs. The syndrome progresses quickly and can be fatal, according to the Cleveland Clinic, one of the largest and most respected medical centers in the US.
Hantaviruses cause two syndromes, including HPS and hemorrhagic fever with renal syndrome, according to the Centers for Disease Control and Prevention. People can contract HPS by inhaling, eating, drinking, or coming into contact with infected mouse or rat feces, urine, or saliva. Although not all mice and rats carry hantaviruses, some species, including deer mice, white-footed mice, rice rats and cotton rats, are known carriers in North America.
'Between one and eight weeks after that exposure, someone might begin to feel like they have a flu-like illness,' Dr Sonja Bartolome of UT Southwestern Medical Center in Dallas, told the Guardian.
In the United States, most cases of HPS occur in states west of the Mississippi River.
'It's mostly in rural areas, because that's where most of the rodents carrying the disease live,' Bartolome said.
HPS remains rare in the US despite its severe symptoms. Between 1993 and 2022, there were 864 reported US cases. New Mexico had the highest number over that time, at 122, followed by Colorado at 119.
Person-to-person transmission is extremely rare and has only been documented in cases of a hantavirus strain found in Argentina and Chile.
Once the hantavirus enters the body, it replicates and spreads, which can cause a severe amount of damage in the lungs. The virus weakens blood vessels and causes leakage and fluid buildup in the air sacs, making breathing difficult.
In the heart, it damages the heart muscle and weakens blood vessels while reducing the heart's ability to pump oxygen-rich blood to the body's organs. If untreated, these effects can lead to shock, organ failure, and death.
HPS symptoms work in three phases. The first is the incubation phase, lasting up to eight weeks, during which the virus is present in the body but no noticeable symptoms are present.
The second phase develops quickly and includes fever, chills, fatigue, muscle aches, stomach pain, nausea, vomiting, diarrhea, rash, dry cough, headache, and dizziness. This stage lasts between two and eight days.
About four to 10 days after these initial symptoms, the third and most severe phase begins. This last phase includes internal bleeding, fluid-filled lungs, difficulty breathing, a rapid heartbeat, and chest tightness. These symptoms can be life-threatening and require immediate medical attention.
There is no specific treatment or cure, but early medical attention can increase the chance of survival. Patients usually require oxygen therapy, fluid replacement, medications to stabilize blood pressure, antiviral medications like ribavirin, among other care. If patients survive the late-stage symptoms, recovery typically takes a few weeks.
Although no vaccine exists for HPS, the Cleveland Clinic recommends taking prevention strategies to help reduce risk. These include avoiding wild rodents, sealing entry points in homes, properly cleaning and disinfecting rodent-contaminated areas, using protective gear when handling droppings, and keeping food securely stored.
Sweeping or vacuuming droppings is not recommended because it could release virus particles into the air.
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