HANTAVIRUS ECOLOGY AND DISEASE IN CHILE

汉坦病毒心肺综合征（HCPS）是一种急性病毒感染，病死率为50%，于1993年在新墨西哥州首次发现。野生啮齿动物把它传染给人类。北美和南美都经历了HCPS的暴发和散发病例，目前已确认有500例。新墨西哥大学（UNM）的教师是HCPS及其生态学、诊断、分子生物学、疫苗开发、治疗和发病机制研究的领导者。他们曾前往南美、欧洲、以色列和澳大利亚的5个国家教授课程和举办研讨会，其中一些人曾在美国国立卫生研究院和美国疾病控制与预防中心的HCPS委员会任职。新墨西哥大学目前每年拥有超过100万美元的直接费用，用于汉坦病毒研究的联邦赠款，以及其他含有汉坦病毒成分的大笔赠款。该申请描述了汉坦病毒研究的国际传染病研究合作（ICIDR）计划，该计划将新墨西哥大学的专业知识和资源与智利类似的令人印象深刻的专业知识和资源相匹配。智利合作者在圣地亚哥的联邦卫生部，包括其实验室分支机构公共卫生研究所；天主教大学和智利大学；以及科伊海克和特穆科的地区医院，这两个地方是卫生保健cps患者接受治疗的主要地点。在所有地点都确定了高素质和训练有素的合作者。卫生部迅速开发资源和人力，以处理卫生保健cps的暴发，这些暴发直到1997年8月才首次得到承认。他们在国家卫生服务中心建造了一个新的实验室，用于开展涉及非常危险的安第斯汉坦病毒毒株的生物控制工作，并从联邦政府获得了每年60万美元的稳定资金，专门用于汉坦病毒的预防和治疗。这些款项中的大部分可视为本申请的配套资金。该申请涉及4个密切相关的项目，分别是野生啮齿动物中汉坦病毒的生态学、HCPS的人际传播、严重HCPS的遗传基础和HCPS的治疗。另外两所美国大学也提供专门的研究专业知识。每个项目都将强大的美国技术和经验与高度积极和经验丰富的智利合作者结合起来。每个项目都有明确和可实现的具体目标，将大大推动该领域的发展。每个项目的一个主要目标是迅速和尽早地向智利转让技术，以促进有关HCPS的科学知识，从而使智利和美国的公共卫生共同受益。这些项目将促进远远超出汉坦病毒研究领域的智利科学。由于智利和美国的大量成本匹配，以及目前有关汉坦病毒生态学、传播、疾病病因和治疗的知识相对较少，该ICIDR应用具有独特的地位，可以在科学知识方面产生巨大回报。

Hantavirus cardiopulmonary syndrome (HCPS) is an acute viral infection with a 50% case-fatality that was first recognized in 1993 in New Mexico. Wild rodents transmit it to man. Both North and South America have experienced outbreaks and sporadic cases of HCPS, with 500 cases now recognized. University of New Mexico (UNM) faculty are leaders in the study of HCPS and its ecology, diagnosis, molecular biology, vaccine development, treatment, and pathogenesis. They have traveled to 5 countries in South America, Europe, Israel and Australia to teach courses and conduct workshops, and several have served on NIH and CDC committees on HCPS. UNM currently holds more than $1 million/year in direct costs in federal grants that are directed solely in hantavirus research, as well as other large grants with a hantavirus component. This application describes an International Collaboration in Infectious Diseases Research (ICIDR) program for hantavirus research that matches UNM expertise and resources with similar impressive expertise and resources in Chile. Chilean collaborators are in Santiago at the federal Ministry of Health, including its laboratory branch, the Institute of Public Health (ISP); at Catholic University and University of Chile; and at regional hospitals in Coyhaique and Temuco, two of the primary sites at which HCPS patients are treated. Highly qualified and well-trained collaborators have been identified at all sites. The Ministry of Health rapidly developed resources and manpower to address the HCPS outbreaks, which were first recognized only in August 1997. They have constructed a new laboratory for biological containment work involving the very dangerous Andes hantavirus strain at the ISP and have secured a steady funding stream of $600,000/year from the federal government solely for hantavirus prevention and treatment. Most of these monies can be considered matching funds for the present application. The application involves 4 very strongly linked projects on the ecology of hantaviruses in wild rodents, the interpersonal transmission of HCPS, the genetic basis for severe HCPS and the treatment of HCPS. Two other US universities also provide specific research expertise. Each project pairs strong US technology and experience with highly motivated and experienced Chilean collaborators. Each project has clear and achievable specific aims that will advance the field considerably. A major goal of each project is the rapid and early transfer of technology to Chile to advance scientific knowledge about HCPS for the mutual benefit of both Chilean and US public health. The projects will foster Chilean science well beyond the hantavirus research arena. This ICIDR application is uniquely situated to produce a tremendous return in scientific knowledge because of the substantial cost-matching in Chile and the US and because there is currently relatively little knowledge regarding hantavirus ecology, transmission, disease causation, and treatment.