Hantavirus Pulmonary Syndrome (HPS) and the workplace

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Hantavirus Pulmonary Syndrome (HPS) and the
workplace

April, 2010
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Topics covered

• Description of Illness
• Source of virus
• How its Transmitted to People
• Personal and Occupational Risk
• Prevention and Control
• DOSH Policies

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What are the symptoms of Hantavirus Pulmonary
Syndrome?

• Begin 1 to 6 weeks after inhaling the virus
• Symptoms are usually apparent within 2-6 days
  flu-like illness including fever, sore muscles,
  headaches, nausea, vomiting, and fatigue.
• Will cause shortness of breath due to fluid
  filled lungs as the disease gets worse. Hospital
  care is then required.
• It is usually a serious infection and about 1 out
  of 3 people diagnosed with HPS have died.

Link to Washington Dept. of Health hantavirus
fact sheet
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Source of Hantavirus

• Deer mice
• Small, native rodents 5 to 8 inches long. Their
  fur resembles deer, dark on the back and white on
  the legs and underside. The tail is also dark on
  top and white underneath.
• (Major reservoir in western US)
• Cotton rats
• Build their nests out of cotton. They have small
  ears and dark coats. Found primarily in southern
  U.S.

Deer Mouse
Cotton Rat
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The Hantavirus

• Hantaviruses have been shown to be viable in the
  environment for 2 to 3 days at normal room
  temperature.
• Affected by conditions of environment such as
  temperature, humidity, and whether indoors or
  outdoors.
• Also affected by the rodents diet affects the
  chemistry of the urine.
• Ultraviolet rays in sunlight kill hantaviruses.

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Transmission to People

• Exposure by infected deer mice, cotton rat
  through inhalation of aerosolized virus excreted
  in
• Urine
• Feces
• Saliva
• Exposure to hantavirus through
• contaminated dust after disturbing or cleaning
  rodent droppings or nests,
• living or working in rodent-infested settings
  such as cabins, homes, barns, vehicles,
  outbuildings
• handling of wild rodents without protection

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RISK - Who can get Hantavirus

• Any man, woman or child who is around mice or
  rats that carry the harmful virus.
• Person to person spread has not occurred in the
  United States.

Through 2009 there have been 41reported cases of
HPS among residents of Washington State, 14 (36)
of which were fatal. Between one and five cases
occur annually. Cases occur in both western and
eastern parts of the state. The median age of
cases in Washington State is 35 years (range
1475 years). The death rate and median age of
cases in Washington are similar to the national
rates. Click here Reported Cases
in United States
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Exposure Precautions

• If you have been exposed to rodents or rodent
  infestations and have symptoms of
• fever,
• deep muscle aches,
• severe shortness of breath
• See physician immediately and inform your
• doctor of possible exposure to hantavirus from
  rodents.

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Activities associated with cases of Hantavirus
infection

• Sweeping out a barn and other ranch buildings
• Trapping and studying mice
• Entering a barn infested with mice
• Planting or harvesting field crops
• Occupying previously vacant dwellings
• Disturbing rodent-infested areas while hiking or
  camping
• Living in dwellings with a sizable indoor rodent
  population
• Using compressed air and dry sweeping to clean up
  wood waste in a sawmill
• Handling grain contaminated with mouse droppings
  and urine

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Occupational Risk

• Some occupations may be at more risk than others
• Telephone installers, maintenance workers,
  plumbers, electricians, and certain construction
  workers.
• Workers in these jobs might have to enter
  buildings, crawl spaces, or other sites that are
  potentially rodent-infested, and Hantavirus has
  been reported among these workers.

For workers that might be exposed to rodents as
part of their normal job duties, employers are
required to comply with relevant occupational
health and safety regulations. Employers are
required to develop and implement an exposure
control plan to eliminate or reduce the risk and
hazard of Hantavirus in their workplace.
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DOSH Policies on Hantavirus

• During a workplace inspection, compliance staff
  will be required to issue a citation if there is
  clear evidence of potential hantavirus exposure
  for employees by contaminated aerosols or
  materials as outlined in WRD 11.55

Click here to view DOSH standard on pest control
To view the L I Employer information Bulletin
on HPS (2000), click here
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Prevention Rodent Control
Rodent control in and around the home, offices
and work areas remains the primary strategy for
preventing hantavirus infection.

• Seal up building holes and gaps
• Do continuous or frequent trapping
• Clean up rodent food sources and nesting sites
  using appropriate gloves and respirator.
• Eliminate debris in and around buildings and
  grounds.

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Prevention Rodent Control
Store food 12 to 15 inches off the floor and
12 to 18 inches away from the wall. Use
rodent-proof containers when possible. Screen
dumpster drainage holes with hardware
cloth Don't leave pet food out overnight
Eliminate water sources available to rodents
Eliminate possible nesting sites grass,
woodpiles etc.
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Disease Prevention

• Employers need to evaluate and control employee
  exposure to hantavirus respiratory hazards by
  identifying and controlling the hazards. It is
  the responsibility of the employer to ensure
  workers are protected.
• One method of avoiding employee exposure is to
  use proper respiratory protection where exposure
  could occur.
• Respirator Rule- click here

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Cleaning

• Use rubber, latex, vinyl or nitrile gloves.
• Thoroughly wet contaminated areas with a bleach
  solution or household disinfectant (1 ½ cups
  bleach in 1 gallon water).
• Swipe up contaminated materials with damp towel
  then mop or sponge the area with bleach solution
  or disinfectant.
• Spray dead rodents with disinfectant then
  double-bag.
• Bury, burn or throw out rodent in appropriate
  waste disposal system.
• Disinfect gloves with disinfectant or soap and
  water before removing.
• Thoroughly wash hands with warm water soap.

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Cleaning (continued)

• DO NOT use a vacuum of any type including one
  equipped with HEPA filters for cleaning dried
  rodent droppings or other dry debris.
• It blows air around and may create virus
  aerosols.

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In Conclusion

• What is known about this topic?
• Hantavirus pulmonary syndrome (HPS) is an
  uncommon but severe disease that can occur after
  contact with an infected rodent or
  rodent-infested area.
• What about children?
• Although reports of HPS are uncommon in children,
  they can experience severe morbidity and a
  clinical course similar to that of adults.
• What are the implications for public health
  practice?
• HPS should be considered in children and adults
  with unexplained acute respiratory distress,
  especially if rodent exposure is noted
  preventive measures include rodent control in
  homes and workplaces, and play areas where
  children may be present.
• Important to instruct children to avoid contact
  with rodents or areas of infestation.

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For more information about Hantavirus or rodent
control, call your state or local health
department.Pam EdwardsDept. Labor Industries
DOSH360-902-6457edwp235_at_lni.wa.govOr see
the CDC web page at http//www.cdc.gov/ncidod/dis
eases/hanta/hps/index.htmOr see the Washington
State Department of Health at
https//www.doh.wa.gov/Portals/1/Documents/5100/42
0-002-epitrends2017-05.pdfL I DOSH
Hantavirus factsheet
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Adapted from PowerPoint developed by Cindy
Smith, PHR City of Ellensburg, HR Director
http//www.ci.ellensburg.wa.us/  
Additional information from Center for Disease
Control Prevention (CDC)