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Newly Identified Hantavirus -- Florida, 1994

On October 22, 1993, a previously healthy 33-year-old resident of Dade County, Florida, was hospitalized for an illness associated with hypotension, bilateral pulmonary infiltrates, rhabdomyolysis, thrombocytopenia, and an elevated serum creatinine level; onset of severe manifestations followed a 4-day febrile prodrome. His azotemia rapidly resolved, but he required prolonged ventilatory and circulatory support before discharge.

Routine bacterial cultures were negative. A serum sample collected 11 days after onset of illness contained immunoglobulin G (IgG) antibody when tested with Muerto Canyon virus (MCV) antigen, but no antibody could be detected by immunoglobulin M (IgM) capture enzyme-linked immunosorbent assay (ELISA); moreover, the IgG titer was unchanged when a serum sample obtained 6 weeks later was tested at CDC. The patient had not traveled outside of Dade County within 6 months of onset of illness, but previously had lived in a state where cases of hantavirus pulmonary syndrome (HPS) and MCV-infected Peromyscus maniculatus have been confirmed (1).

The state, district, and county health departments and CDC initiated an investigation to fully characterize the illness and the prevalence of hantavirus seropositivity in the local rodent population. Preliminary serologic findings indicated the presence of hantavirus antibody in 12 (13%) of 90 Sigmodon hispidus (cotton rat) trapped in Dade County as part of the investigation. Hantavirus sequences were amplified by polymerase chain reaction (PCR) from lung tissues of three cotton rats. Nucleotide sequence analysis of amplified viral genetic material indicates that this is a previously unrecognized hantavirus most closely related to but distinct from both MCV (2,3) and the hantavirus identified in Louisiana (4).

Reported by: H Anapol, MD, R Greenman, MD, M Kolber, MD, Jackson Memorial Hospital, Univ of Miami School of Medicine; ED Sfakianaki, MD, M Fernandez, MD, M Ares, MD, W Livingstone, MPH, L Rivera, Dade County Public Health Unit, Miami; AM Bock, AR Neasman, MS, District XI, WG Hlady, MD, RS Hopkins, MD, State Epidemiologist, Florida Dept of Health and Rehabilitative Svcs. GE Glass, PhD, Johns Hopkins Univ, Baltimore. Hantavirus Task Force, Special Pathogens Br, Div of Viral and Rickettsial Diseases, National Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: The findings in this report indicate that evidence of infection with a newly recognized strain of hantavirus is present in rodents in Dade County. Although the prodrome and clinical illness in the patient in Dade County resembled HPS, the laboratory findings were not diagnostic of an acute hantavirus infection. Molecular studies are ongoing to determine whether the lack of IgM ELISA reactivity at CDC potentially resulted from use of available heterologous hantavirus antigens.

Since the identification of the first pathogenic U.S. hantavirus in June 1993, HPS has been well characterized, its etiologic agent (MCV) isolated, its primary rodent reservoir (P. maniculatus) identified, and specific diagnostic assays developed (1,5). In addition, in August 1993, the sequence of a second unique hantavirus was identified in tissues of a Louisiana resident who died of HPS-like illness (4); however, the reservoir associated with this hantavirus has not been determined. The results of the PCR analysis described in this report are consistent with a third new U.S. hantavirus from a distinct rodent reservoir, S. hispidus, with an ecologic range extending throughout the southeastern and the southcentral United States (6).

The pathogenicity of the new hantavirus to humans is unknown. Therefore, residents of the southeast as well as persons residing within range of P. maniculatus (7) should minimize exposure to rodents and their excreta (8). Suspected cases of HPS should be reported to CDC through state health departments (1).


  1. CDC. Hantavirus pulmonary syndrome -- United States, 1993. MMWR 1994;43:45-8.

  2. Hjelle B, Jenison S, Torrez-Martinez N, et al. A novel hantavirus associated with an outbreak of fatal respiratory disease in the southwestern United States: evolutionary relationships to known hantaviruses. J Virol 1994;68:592-6.

  3. Nichol ST, Spiropoulou CF, Morzunov S, et al. Genetic identification of a hantavirus associated with an outbreak of acute respiratory illness. Science 1993;262:914-7.

  4. CDC. Update: hantavirus disease -- United States, 1993. MMWR 1993;42:612-4.

  5. Feldmann H, Sanchez A, Morzunov S, et al. Utilization of autopsy RNA for the synthesis of the nucleocapsid antigen of a newly recognized virus associated with hantavirus pulmonary syndrome. Virus Res 1993;30:351-67.

  6. Cameron GN, Spencer SR. Sigmodon hispidus. Mammalian Species 1981;158:1-9.

  7. Hall RE. Peromyscus maniculatus. In: Mammals of North America. 2nd ed. New York: Wiley, 1981;670-83.

  8. CDC. Hantavirus infection -- southwestern United States: interim recommendations for risk reduction. MMWR 1993;42(no. RR-11).

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