{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:16:05Z","timestamp":1790284565395,"version":"4.1.0"},"reference-count":38,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>From 1993 to 2018, hantavirus infections were reported in 39 states, with hantavirus pulmonary syndrome (HPS) as the most common and fatal manifestation. To identify differences in the presentation of HPS between children and adults, we hypothesized that children with HPS would be diagnosed later in their illness course given the nonspecific clinical features of HPS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This was an evaluation of the clinical and demographic characteristics of national HPS cases from 1993 to 2018. Data were from the Centers for Disease Control and Prevention database and 1 state department of health, comprising 97% of US cases. We compared children (0 to 12 years), adolescents (13 to 18 years), and adults using nonparametric and parametric analyses, with additional exploratory analyses to identify clinical variables associated with mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 719 HPS patients, 22 (3.0%) were aged \u226412 years, 47 (6.5%) were 13 to 18 years old, and the remaining 650 (90.4%) were adults. Overall mortality was 35.4% and did not differ between age groups (P = .8). The time between symptom onset and death differed by age group, with children living a median of 2 days (interquartile range [IQR] 2 to 3), adolescents 4 days (IQR 3 to 5), and adults 5 days (IQR 4 to 8; P = .001). The mean highest hematocrit and median highest creatinine level were significantly associated with mortality in those 0 to 18 years old but not adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In our dataset representing the largest study of HPS in the United States, we found that children with HPS died more quickly than adults and that highest hematocrit and creatinine levels were associated with death only among those &amp;lt;19 years old.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2022-059352","type":"journal-article","created":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T03:09:59Z","timestamp":1677640199000},"source":"Crossref","is-referenced-by-count":22,"title":["Hantavirus Pulmonary Syndrome: 1993\u20132018"],"prefix":"10.1542","volume":"151","author":[{"given":"Lauren","family":"Thorp","sequence":"first","affiliation":[{"name":"aDivision of Pediatric Emergency Medicine"},{"name":"bDepartment of Emergency Medicine, School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne","family":"Fullerton","sequence":"additional","affiliation":[{"name":"bDepartment of Emergency Medicine, School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Whitesell","sequence":"additional","affiliation":[{"name":"cViral Special Pathogens Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Dehority","sequence":"additional","affiliation":[{"name":"dDivision of Infectious Diseases, Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2023,3,1]]},"reference":[{"issue":"11","key":"2023111014053455200_B1","doi-asserted-by":"crossref","first-page":"2056","DOI":"10.3201\/eid2411.180381","article-title":"Hantavirus pulmonary syndrome\u2014the 25th anniversary of the four corners outbreak","volume":"24","author":"Van Hook","year":"2018","journal-title":"Emerg Infect Dis"},{"key":"2023111014053455200_B2","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1542\/9781610025225-part03-ch051","article-title":"Hantavirus Pulmonary Syndrome","volume-title":"Red Book: 2021-2024 Report of the Committee on Infectious Diseases\/Committee on Infectious Diseases, American Academy of Pediatrics","author":"Kimberlin","year":"2021","edition":"32nd ed"},{"issue":"12","key":"2023111014053455200_B3","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.3201\/eid1912.131217","article-title":"Twenty-year summary of surveillance for human hantavirus infections, United States","volume":"19","author":"Knust","year":"2013","journal-title":"Emerg Infect Dis"},{"key":"2023111014053455200_B4","unstructured":"Centers for Disease Control and Prevention . 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