A 12-year-old boy from Colaba died of the hantavirus infection on Saturday. This is the first ever case of the infection in Mumbai, said public health officials.
Hantavirus infection, known as Hantavirus Pulmonary Syndrome (HPS) is a lung infection caused by viruses found in the saliva, urine, and droppings of rodents. The illness is rare but has a high morbidity and mortality rate.
Brihanmumbai Municipal Corporation (BMC) officials confirmed that the child’s blood tested positive for the virus after being tested at a local laboratory. They are awaiting test results from the National Institute of Virology (NIV), Pune.
The child, who was admitted to Bhatia Hospital, Tardeo, on September 29, succumbed after his parents discharged him against medical advice. Doctors who treated the child said the case baffled them. “The child was brought to the hospital with complaints of breathlessness, cough, fever and a dropping platelet count. For the first five days, we conducted tests for leptospirosis, dengue and malaria but the results were negative,” said Dr Aditya Agarwal, chest physician at the hospital.
Agarwal said the child was put on antibiotics, but developed severe stomach pain that was diagnosed as abdominal pancreatitis (inflammation of the pancreas). “He started coughing up blood from the next day onwards. Within 24 hours, his health deteriorated to the point where we had to put him on a ventilator,” said Agarwal.
The child began bleeding profusely from both lungs. “We kept running tests for vector-borne diseases, but all of them came back negative thrice,” said Agarwal. The child’s response to the treatment was slow and he continued bleeding from both lungs.
“Finally, after a week of the tests coming back negative, we suspected that it could possibly be a case of hantavirus and conducted tests including chest X-rays, a complete blood count, and an oxygen saturation test,” said Agarwal. Experts said the test results took about a week to confirm the diagnosis but the family discharged the child beforehand.
The family, intending to take the boy to their native village in Karnataka, discharged him at 6pm on Friday, in a cardiac ambulance with ventilator facilities, while his condition was still critical. The doctors said that half-an-hour after the family left, the private laboratory confirmed their diagnosis. It is not known whether the child died in Mumbai.
Dr Padmaja Keskar, executive health officer, BMC said the child had also been suffering from leptospirosis. As soon as we were notified about the case, we immediately conducted preventive measures for rodent extermination in the locality. “We are taking the utmost care. Rats are the commonest carrier of the virus as their urine or dung can be infected. The virus is also air-borne. We detected two cases of fever in the same area and the patients are receiving treatment,” said Keskar. She added that to confirm the diagnosis, they are waiting for the NIV report, which will take a week.
Dr Om Shrivastava, infectious diseases expert, said the morbidity and mortality of the virus multiplies dangerously when the patient’s condition escalates to the haemorrhaging stage. “I have treated symptomatic cases of the virus long ago, but they both tested negative. This is extremely rare. The major issue is that the symptoms indicate multiple ailments, making it difficult for the doctor to arrive at an accurate diagnosis,” said Shrivastava. He added that people need to be more careful about coming in contact with rodents, keeping this case in mind.