hemorrhagic fever with renal syndrome in South Dakota

• Sudden onset of high fever, chills, and headache.
• Intense muscle aches, back pain, and abdominal pain.
• Nausea, vomiting, and facial flushing.
• Decreased urine output (oliguria) and signs of acute kidney injury (renal failure).
• Low blood pressure (hypotension).
• Hemorrhagic manifestations such as petechiae (small red spots), bleeding from gums or nose, and sometimes internal bleeding.

HFRS is transmitted to humans primarily through the inhalation of aerosolized particles contaminated with the urine, feces, or saliva of infected rodents. Direct contact with infected rodents or their droppings, or consuming contaminated food or water, can also lead to infection. The disease is *not* transmitted from person to person.

• Avoid contact with rodents, their urine, feces, or nesting materials.
• Seal holes and gaps in homes and workplaces to prevent rodent entry.
• Clean up rodent droppings and urine carefully using wet methods and disinfectants to avoid aerosolizing particles.
• Store food in rodent-proof containers and keep outdoor areas free of debris.
• *Vaccines* are available in some highly endemic regions (e.g., China, South Korea) for high-risk populations.