ANALYSIS OF FATAL PULMONARY HANTAVIRAL INFECTION IN NEW-YORK BY REVERSE-TRANSCRIPTASE IN-SITU POLYMERASE CHAIN-REACTION

The purpose of this study was to analyze the histological distribution of polymerase chain reaction (PCR)-amplified hantaviral cDNA in three cases of fatal hantaviral infection that occurred 2 years ago in Long Island, NY. The three otherwise healthy patients had a rapid death ch aracterized by fever and pulmonary failure and were identified from th e autopsy files at University Hospital, Stony Brook. Six autopsy contr ols with either no pulmonary disease (three) or fatal pneumonitis of k nown etiology (three) were also studied. PCR-amplified hantaviral cDNA was detected in the lung tissue of the three cases and none of the si x controls using the reverse transcriptase in situ PCR technique. In t he positive cases, viral RNA was detected in approximately 20% of pneu mocytes and alveolar endothelial cells as determined with a consensus and Four Corners-specific primer pair. Infected endothelial cells were identified in a wide variety of other sites, but at rates much lower than in the lungs. The selective localization of the viral RNA in many pneumocytes and pulmonary endothelial cells using a highly, sensitive PCR-based test demonstrates a correlation between direct viral infect ion in the lung and the disease process.