Actor Gene Hackman died of heart disease around a week after his wife Betsy Arakawa died of a rare infectious disease at their home, a pathologist has said. But what do we know about the rare virus?
The couple were found dead on 26 February in separate rooms of their Santa Fe home, along with one of their dogs, and on Friday the results of medical tests were released in New Mexico.
Two-time Oscar winner Hackman was in the advanced stages of Alzheimer’s when he died of heart disease, and it was likely he was at home alone with the body of his wife for a week before he passed away himself.
Dr Heather Jarrell, chief medical examiner for New Mexico, told reporters Betsy Arakawa is believed to have died around 11 February.
The post-mortem examination showed Ms Arakawa, also known as Betsy Hackman, died of hantavirus pulmonary syndrome – a rare but potentially fatal disease.
But, what is it – and how do you get infected?
HPS, commonly referred to as hantavirus disease, is a respiratory disease caused by hantaviruses which are carried by several types of rodents.
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It is a rare condition in the US, with most cases concentrated in the western states of New Mexico, Arizona, Colorado and Utah.
The New Mexico Department of Health says hantaviruses are spread by the saliva, droppings and urine of infected rodents, which in North America is most likely to be the eastern deer mouse (Peromyscus maniculatus).
The virus is often transmitted through the air when people sweep out sheds or clean closets where mice have been living, or by eating food contaminated with mouse droppings.
It is not transmissible from person to person, Dr Jarrell said.
What are the symptoms?
Symptoms, which vary between people, are thought to develop between one and eight weeks after exposure and the likelihood of death in the southwest of the US is about 38% to 50%.
Early symptoms of HPS include fatigue, fever, and myalgia (muscle aches), with about half of patients also experiencing malaise, headaches, dizziness, lightheadedness, chills, sweats, and abdominal problems including nausea, vomiting and diarrhoea, according to the American Lung Association.
Later symptoms include coughing, shortness of breath, and pneumonia (lungs filling with fluid). Rapid breathing and rapid heartbeat are also typical.
At this stage, the disease progresses rapidly, requiring hospital treatment and often mechanical ventilation to help with breathing.
What is the treatment for HPS?
There is no specific cure, treatment, or vaccine for HPS, but patients have a better chance of survival when they are diagnosed early.
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How common is it in the US?
The Centers for Disease Control and Prevention began tracking the virus after a 1993 outbreak in the Four Corners region – the area where Arizona, Colorado, New Mexico and Utah meet.
The agency said that, as of the end of 2022, 864 cases of hantavirus disease were reported in the US since that tracking began.
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What about the UK?
The most recent information about cases in the UK was released by Public Health England (PHE) in 2014.
The health body described how acute kidney injury (AKI), caused by hantaviruses in rodents, was linked to exposure to pet or wild rats – but there have only been a handful of cases.
It added that certain hantaviruses present in Europe, Asia and Africa tend to cause haemorrhagic and kidney disease, while new world hantaviruses in the Americas tend to cause severe respiratory disease, including HPS.
