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Update: Hantavirus-Associated Illness -- North Dakota, 1993

On August 27, 1993, a previously healthy 14-year-old North Dakota boy died suddenly after a brief unexplained febrile respiratory illness. Subsequent examination at CDC of specimens from this patient demonstrated the presence of serum immunoglobulin M antibody to hantavirus antigens, a positive polymerase chain reaction assay for hantavirus genetic sequences in multiple tissues, and a positive immunohistochemical stain for hantavirus antigen in lung tissue, confirming the diagnosis of acute hantavirus infection. The patient had no history of recent travel outside the west north central region. An ongoing investigation of this illness is being conducted by the state health department, the Indian Health Service, and CDC. Reported by: WB Kingree, MD, D Deegan, Fort Totten; RW Petty, MD, Devil's Lake; L Johnson, MD, Grand Forks; SL McDonough, MD, LA Shireley, MPH, State Epidemiologist, North Dakota State Dept of Health and Consolidated Laboratories. TK Welty, MD, Indian Health Service, Rapid City, South Dakota. Div of Viral and Rickettsial Diseases, National Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: The recognition of a case of hantavirus-associated respiratory illness in North Dakota, in addition to previously confirmed cases that have occurred outside of the four-corners region of the Southwest (1-4), reinforces the need for clinicians throughout the United States to maintain a high index of suspicion for this condition and to inform local or state health authorities of suspected cases. As of September 15, 36 cases, including the one reported here, have been confirmed in the United States. Interim recommendations to reduce the risk of exposure to potentially infected rodents in the southwestern United States have been published (5); these recommendations generally are applicable to rural settings in other parts of the country.


  1. CDC. Update: outbreak of hantavirus infection -- southwestern United States, 1993. MMWR 1993;42:495-6.

  2. CDC. Update: hantavirus infection -- United States, 1993. MMWR 1993;42:517-9.

  3. CDC. Update: hantavirus disease -- southwestern United States, 1993. MMWR 1993;42:570-2.

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

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

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