Chad Whitaker

[Chad Whitaker @C_Whitaker22]

@morellifit Calc

[Chad Whitaker @C_Whitaker22]

@RealKidPoker She is a real one for sure!

[Robert W Malone, MD @RWMaloneMD]

Hantaviruses: Virology and Clinical Presentation

Virology
Hantaviruses are enveloped, single-stranded, negative-sense RNA viruses belonging to the family Hantaviridae (order Bunyavirales). Their genome is segmented into three parts (S, M, and L) encoding the nucleocapsid protein, two glycoproteins (Gn and Gc), and an RNA-dependent RNA polymerase, respectively. Unlike most other bunyaviruses, hantaviruses are not arthropod-borne; instead, each viral species is associated with a specific rodent (or occasionally shrew or bat) reservoir host, in which infection is persistent and asymptomatic. Humans are accidental hosts, typically infected through inhalation of aerosolized excreta (urine, feces, saliva) from infected rodents. Person-to-person transmission is rare, with the notable exception of Andes virus in South America.

Clinical Presentation
Hantavirus infections in humans cause two main clinical syndromes, divided roughly along Old World/New World lines.

Hemorrhagic Fever with Renal Syndrome (HFRS) is caused predominantly by Old World hantaviruses such as Hantaan, Seoul, Puumala, and Dobrava viruses. After an incubation period of roughly 1–4 weeks, illness classically progresses through five phases: febrile, hypotensive, oliguric, diuretic, and convalescent. Symptoms include fever, headache, back and abdominal pain, conjunctival injection, petechiae, and acute kidney injury, sometimes with hemorrhagic manifestations. Severity varies widely, with Hantaan and Dobrava causing more severe disease (case fatality up to 5–15%) and Puumala causing a milder form known as nephropathia epidemica.

Hantavirus Cardiopulmonary Syndrome (HCPS) is caused by New World hantaviruses, most notably Sin Nombre virus in North America and Andes virus in South America. After a 1–5 week incubation, patients experience a nonspecific prodrome of fever, myalgias, and gastrointestinal symptoms lasting several days, followed by abrupt onset of cough, dyspnea, and rapidly progressive noncardiogenic pulmonary edema due to capillary leak. Cardiogenic shock often follows in severe cases. Case fatality is high, around 35–40%, and treatment is largely supportive, with extracorporeal membrane oxygenation (ECMO) used in severe cases.

Laboratory clues common to both syndromes include thrombocytopenia, leukocytosis with a left shift, elevated hematocrit (from hemoconcentration), and the presence of immunoblasts on peripheral smear. Diagnosis is confirmed by serology (IgM/IgG) or RT-PCR. No specific antiviral therapy is approved, though ribavirin has shown some benefit in HFRS if given early.

[Chad Whitaker @C_Whitaker22]

@JoshuaArieh Might be my new spirit animal. 😂

[Chad Whitaker @C_Whitaker22]

@megynkelly @MelissaAFrancis Dunkin’ wasn’t too bad. Nostalgic.

[Chad Whitaker @C_Whitaker22]

@VicLombardi @Broncos So he’s fresh!

[Chad Whitaker @C_Whitaker22]

@garyowencomedy Look at his post game speech after Dillon’s only win… then reevaluate your point of view

[Chad Whitaker @C_Whitaker22]

@bstokley14 Celebrating someone’s death because of politics or political disagreement is bananas. Charlie was a decent human being with a wife and two kids. They will grow up with stories of their dad, but no memories. Sad and my heart breaks for them!

[Chad Whitaker @C_Whitaker22]

@KurtBenkert Let’s go! Can’t wait!

[Chad Whitaker @C_Whitaker22]

@helloitslynne I love your perspective and appreciation for this country! 👊

[Chad Whitaker @C_Whitaker22]

@jasonwhitlock Agree with this sentiment 100%. I started watching the Fever and the WNBA because of the way she plays the game.. very intriguing. however, she is starting to wear me out with her attitude and body language. They do maul her but She acts like a spoiled brat so I get the no calls

[Chad Whitaker @C_Whitaker22]

@jasonwhitlock She did it last year as well! But she was playing better and it seemed to be overlooked by many! Her behavior is juvenile and selfish! Too bad because she has a lot of talent and could be a fun player to watch!

[Chad Whitaker @C_Whitaker22]

@stoolpresidente I think Sophie is my new favorite player! Love this!

[Chad Whitaker @C_Whitaker22]

@stoolpresidente A little hyperbole! I’m a Clark fan.. but Maybrey is just sticking up for her teammate. The Fever should be doing the same. Should she get ejected? Yes.. but not kicked out of the league.

[Chad Whitaker @C_Whitaker22]

@andrewneeme Welcome back!! My favorite poker vlog for sure! Congrats on the move and your business success!

[Chad Whitaker @C_Whitaker22]

@DougPolkVids @KILLTONY @TonyHinchcliffe Looked comfortable, poised under pressure. Great job and props to you for getting out of your comfort zone.. and killing it!

[Chad Whitaker @C_Whitaker22]

@bstokley14 No lies detected!

[Chad Whitaker @C_Whitaker22]

@DNVR_Nuggets Did he prove himself to be a NBA head coach? probably. But the new GM should pick the next coach IMO.

[Chad Whitaker @C_Whitaker22]

@NBABlackburn All of them!

[Chad Whitaker @C_Whitaker22]

@bstokley14 Incredibly sad and appalling at the same time!