The Four Corners region is indicated by the red area on this map.
The virus killed 13 people – half of those it infected, for a mortality rate of 50%.[1][2]
The cause of the outbreak was found to be a previously unknown species of hantavirus, which was responsible for a new form of illness known as hantavirus pulmonary syndrome (HPS). The virus is carried by deer mice. Originally referred to as "Four Corners virus", "Muerto Canyon virus", and "Convict Creek virus",[3] it was later named Sin Nombre virus. Transmission to humans was found to have occurred through contact with aerosolized deer mice droppings in enclosed spaces in and around the homes of the victims.
In April 1993, a young Navajo woman arrived at the Indian Medical Center emergency room in Gallup, New Mexico, complaining of flu-like symptoms and sudden, severe shortness of breath. Doctors found the woman's lungs to be full of fluid, and she died soon after her arrival. An autopsy revealed the woman's lungs to be twice the normal weight for someone her age. The cause of her death could not be immediately determined, and the case was reported to the New Mexico Department of Health.[4]
Five days later, her fiancé, a young Navajo man, was en route to her funeral in Gallup when he suddenly became severely short of breath. By the time paramedics brought him to the Indian Medical Center emergency room, he had stopped breathing and the paramedics were performing cardiopulmonary resuscitation. The young man could not be revived by doctors and died. The physicians, recalling the similar symptoms and death of the young woman, reported his death to the New Mexico Department of Health.[4]
New Mexico state health officials notified the Centers for Disease Control (CDC). Within a week, a task force had formed in Albuquerque that included Bruce Tempest, chief of medicine at the Indian Medical Center. Tempest quickly discovered that five people, including the young man's fiancée, as well as an Arizona resident, all had experienced the same symptoms and all had died within a six-month period. Tempest learned from the young man's family members that his fiancée had the same symptoms and died on the Navajo Reservation five days earlier. Deaths on the reservations are not reported to the state health department because they are sovereign nations. Tempest had considered plague as the cause because it is endemic to the region, but it had already been ruled out by tests on all of the victims. Within a short time, a dozen more people contracted the mysterious illness, most of them young Navajos in New Mexico. This included two relatives of the young couple who had died within a week of each other.[4]
Discovery of Sin Nombre virusEdit
The 1993 Four Corners hantavirus outbreak in humans was traced to exposure to deer mouse droppings.
News outlets began reporting on the story of a mystery illness causing deaths among young Navajo, often using the term "Navajo Flu". Hearing a news report, a physician notified health officials to say that the illness had similarities to hantavirus, which he had observed in Korea in the 1950s.[5]
The Centers for Disease Control tested for hantavirus even though Asia and Europe were the only documented places hantavirus had been known to occur. No known cases had ever been reported in the United States. In addition, all the cases in Asia and Europe had involved hantaviruses that caused kidney failure, never respiratory failure. The testing revealed a previously unknown hantavirus which was eventually named Sin Nombre virus, Spanish for "No Name" virus. The disease became formally known as hantavirus cardiopulmonary syndrome (HCPS) or simply hantavirus pulmonary syndrome (HPS).[6][7]
Several theories were advanced to explain the emergence of the new virus. These included increased contact between humans and mice due to a "bumper crop" in the deer mouse population. Another theory was that something within the virus had changed, allowing it to jump to humans. A third theory was that nothing had changed, that hantavirus cases had in fact occurred previously but had not been properly diagnosed. This last theory turned out to be the correct one when it was discovered that the first known case had actually occurred in a 38-year-old Utah man in 1959.[7]
Like the Korean virus, Sin Nombre virus does not spread person-to-person. Instead, transmission occurs when humans are exposed to air contaminated with aerosolized mouse feces, usually within enclosed spaces. All of the Four Corners victims were found to have significant infestations of deer mice in and around their homes.[7]
Course of illness and death rateEdit
Doctors reported that all of the Four Corners patients had mild flu-like symptoms such as malaise, headache, cough, and fever, with a sudden onset of pulmonary edema necessitating ventilators before eventually causing death. From April to May 1993, there were 24 reported cases in the region. Twelve of those people died, resulting in a 50% mortality rate. Of the 24 patients, 14 were Native Americans, nine were non-Hispanic whites and one was Hispanic.[8]
Early cases in Navajo traditionEdit
Navajo leaders reported that similar outbreaks had occurred in 1918, 1933, and 1934. Navajo ethnological stories have identified mice as sources of bad luck and illness since the 19th century.[9]
^ abc"CDC – History of Hantavirus Pulmonary Syndrome (HPS) – Hantavirus". Cdc.gov. 2012-08-29. Retrieved 2013-03-25.
^CDC, "Outbreak of Acute Illness-Southwestern United States, 1993," Morbidity and Mortality Weekly Report, June 11, 1993, 42 (22): 421–424
^Fimrite, Peter (2012-09-23). "Hantavirus outbreak puzzles experts". SFGate. Retrieved 2013-04-09.
External linksEdit
Sloan Science and Film / Short Films / Muerto Canyon by Jen Peel, 29 minutes
CDC's Hantavirus Technical Information Index page
Viralzone: Hantavirus
Virus Pathogen Database and Analysis Resource (ViPR): Hantaviridae
October 21, 2023
1993, four, corners, hantavirus, outbreak, outbreak, hantavirus, that, caused, first, known, human, cases, hantavirus, disease, united, states, occurred, within, four, corners, region, geographic, intersection, states, utah, colorado, mexico, arizona, southwes. The 1993 Four Corners hantavirus outbreak was an outbreak of hantavirus that caused the first known human cases of hantavirus disease in the United States It occurred within the Four Corners region the geographic intersection of the U S states of Utah Colorado New Mexico and Arizona of the Southwestern United States in mid 1993 This region is largely occupied by Native American tribal lands including the Hopi Ute Zuni and Navajo reservations from which many of the cases were reported The Four Corners region is indicated by the red area on this map The virus killed 13 people half of those it infected for a mortality rate of 50 1 2 The cause of the outbreak was found to be a previously unknown species of hantavirus which was responsible for a new form of illness known as hantavirus pulmonary syndrome HPS The virus is carried by deer mice Originally referred to as Four Corners virus Muerto Canyon virus and Convict Creek virus 3 it was later named Sin Nombre virus Transmission to humans was found to have occurred through contact with aerosolized deer mice droppings in enclosed spaces in and around the homes of the victims Contents 1 Background 2 Discovery of Sin Nombre virus 3 Course of illness and death rate 4 Early cases in Navajo tradition 5 In popular culture 6 See also 7 References 8 External linksBackground EditIn April 1993 a young Navajo woman arrived at the Indian Medical Center emergency room in Gallup New Mexico complaining of flu like symptoms and sudden severe shortness of breath Doctors found the woman s lungs to be full of fluid and she died soon after her arrival An autopsy revealed the woman s lungs to be twice the normal weight for someone her age The cause of her death could not be immediately determined and the case was reported to the New Mexico Department of Health 4 Five days later her fiance a young Navajo man was en route to her funeral in Gallup when he suddenly became severely short of breath By the time paramedics brought him to the Indian Medical Center emergency room he had stopped breathing and the paramedics were performing cardiopulmonary resuscitation The young man could not be revived by doctors and died The physicians recalling the similar symptoms and death of the young woman reported his death to the New Mexico Department of Health 4 New Mexico state health officials notified the Centers for Disease Control CDC Within a week a task force had formed in Albuquerque that included Bruce Tempest chief of medicine at the Indian Medical Center Tempest quickly discovered that five people including the young man s fiancee as well as an Arizona resident all had experienced the same symptoms and all had died within a six month period Tempest learned from the young man s family members that his fiancee had the same symptoms and died on the Navajo Reservation five days earlier Deaths on the reservations are not reported to the state health department because they are sovereign nations Tempest had considered plague as the cause because it is endemic to the region but it had already been ruled out by tests on all of the victims Within a short time a dozen more people contracted the mysterious illness most of them young Navajos in New Mexico This included two relatives of the young couple who had died within a week of each other 4 Discovery of Sin Nombre virus Edit nbsp The 1993 Four Corners hantavirus outbreak in humans was traced to exposure to deer mouse droppings Main article Sin Nombre virus News outlets began reporting on the story of a mystery illness causing deaths among young Navajo often using the term Navajo Flu Hearing a news report a physician notified health officials to say that the illness had similarities to hantavirus which he had observed in Korea in the 1950s 5 The Centers for Disease Control tested for hantavirus even though Asia and Europe were the only documented places hantavirus had been known to occur No known cases had ever been reported in the United States In addition all the cases in Asia and Europe had involved hantaviruses that caused kidney failure never respiratory failure The testing revealed a previously unknown hantavirus which was eventually named Sin Nombre virus Spanish for No Name virus The disease became formally known as hantavirus cardiopulmonary syndrome HCPS or simply hantavirus pulmonary syndrome HPS 6 7 Several theories were advanced to explain the emergence of the new virus These included increased contact between humans and mice due to a bumper crop in the deer mouse population Another theory was that something within the virus had changed allowing it to jump to humans A third theory was that nothing had changed that hantavirus cases had in fact occurred previously but had not been properly diagnosed This last theory turned out to be the correct one when it was discovered that the first known case had actually occurred in a 38 year old Utah man in 1959 7 Like the Korean virus Sin Nombre virus does not spread person to person Instead transmission occurs when humans are exposed to air contaminated with aerosolized mouse feces usually within enclosed spaces All of the Four Corners victims were found to have significant infestations of deer mice in and around their homes 7 Course of illness and death rate EditDoctors reported that all of the Four Corners patients had mild flu like symptoms such as malaise headache cough and fever with a sudden onset of pulmonary edema necessitating ventilators before eventually causing death From April to May 1993 there were 24 reported cases in the region Twelve of those people died resulting in a 50 mortality rate Of the 24 patients 14 were Native Americans nine were non Hispanic whites and one was Hispanic 8 Early cases in Navajo tradition EditNavajo leaders reported that similar outbreaks had occurred in 1918 1933 and 1934 Navajo ethnological stories have identified mice as sources of bad luck and illness since the 19th century 9 In popular culture EditThe outbreak was covered in the Forensic Files episode With Every Breath citation needed See also Edit nbsp Viruses portalSin Nombre virusReferences Edit The virus that rocked the Four Corners reemerges aaas org 1 August 2013 Retrieved 15 May 2020 Hantavirus Outbreaks hantawatch Retrieved 15 May 2020 Hjelle B et al Emergence of Hantaviral Disease in the Southwestern United States Western Journal of Medicine 1994 161 5 467 473 a b c Death at the Corners DiscoverMagazine com 1993 12 01 Retrieved 2013 03 25 Doctors still trying to diagnose mysteries of hantavirus Los Angeles Times Articles latimes com 2012 09 10 Retrieved 2013 03 25 BioScience November 2002 Vol 52 No 1 989 a b c CDC History of Hantavirus Pulmonary Syndrome HPS Hantavirus Cdc gov 2012 08 29 Retrieved 2013 03 25 CDC Outbreak of Acute Illness Southwestern United States 1993 Morbidity and Mortality Weekly Report June 11 1993 42 22 421 424 Fimrite Peter 2012 09 23 Hantavirus outbreak puzzles experts SFGate Retrieved 2013 04 09 External links EditSloan Science and Film Short Films Muerto Canyon by Jen Peel 29 minutes CDC s Hantavirus Technical Information Index page Viralzone Hantavirus Virus Pathogen Database and Analysis Resource ViPR Hantaviridae Occurrences and deaths in North and South America Retrieved from https en wikipedia org w index php title 1993 Four Corners hantavirus outbreak amp oldid 1176622132, wikipedia, wiki, book, books, library,
