Hantavirus infection or hantavirus disease is an infectious disease of humans caused by viruses in the Orthohantavirus genus of viruses. It can result in hemorrhagic fever with renal syndrome (HFRS) or hantavirus pulmonary syndrome (HPS). Symptoms of HFRS generally include headache, abdominal pain, fever, nausea, bleeding, and kidney failure. Symptoms of HPS include tiredness, fever, muscle pain, cough, and shortness of breath. Onset of initial symptoms is generally 1 to 8 weeks following exposure. HFRS is due to Old World hantaviruses while HPS is due to New World hantaviruses. More than 28 specific hantaviruses cause disease in humans. The disease is typically spread when people breathe in air contaminated by rodent droppings. The underlying mechanism of both forms of the disease involves low platelets and leaky blood vessels. Diagnosis is based on blood tests, typically serology. Treatment is primarily supportive care. This may include oxygen therapy, mechanical ventilation, dialysis, or platelet transfusions. Ribavirin may be useful if given early in HFRS. The risk of death is around 12% with HFRS and around 40% with HPS. About 100,000 cases of HFRS occur a year, while about 1,000 cases of HPS have been identified since it was first detected in 1993. While descriptions of what is believed to be hantavirus infections date back to around 1000 AD, the virus that causes the disease was not discovered until 1976, in the Hantan River area of South Korea. In April 2026, an outbreak of hantavirus infection caused by the Andes virus was identified on the Dutch cruise ship MV Hondius.
Signs and symptoms
Initial symptoms After an incubation period of 2–4 weeks, the typical illness for all hantaviruses starts with non-specific symptoms which may include high fever, chills, headache, backache, abdominal pains, nausea, and vomiting.
Hemorrhagic fever with renal syndrome
Hemorrhagic fever with renal syndrome (HFRS) is caused chiefly by hantaviruses in Asia and Europe. Clinical presentation varies from subclinical to fatal, depending on the virus. After an incubation period of 2 to 4 weeks, symptoms appear. Then bleeding under the skin begins, often paired with low blood pressure, followed by further internal bleeding throughout the body. Renal dysfunction leading to further health issues, which may cause death, then begins. A milder form of HFRS occurs in Europe, and is called "nephropathia epidemica" (NE). Immune dysregulation, including a mixed Th1/Th2 cytokine response with elevated sTNFR1, IL-6, IL-8, and IL-10, has been proposed to contribute to the severity of HFRS.
Hantavirus pulmonary syndrome
Hantavirus pulmonary syndrome (HPS), also called hantavirus cardiopulmonary syndrome (HCPS), is usually caused by hantaviruses in the Americas. After an incubation period of 16 to 24 days, symptoms appear. After a few days of symptoms similar to HFRS, there is a sudden onset of progressive, or productive, coughing, shortness of breath, and elevated heart rate, due to fluid buildup in the lungs. These symptoms are accompanied by impairment of lymphoid organs. Death from cardiovascular shock may occur rapidly after the appearance of severe symptoms. While HCPS is typically associated with New World hantaviruses, the Puumala virus in Europe has also, albeit rarely, caused the syndrome.
Cause The cause is viruses within Orthohantavirus, a genus of single-stranded, enveloped, negative-sense RNA viruses in the family Hantaviridae of the order Elliovirales. They normally cause infection in rodents, but do not cause disease in them. Humans may become infected with hantaviruses through contact with rodent urine, saliva, or feces. While many hantaviruses cause either of the two diseases, some are not known to cause illness, such as the Prospect Hill virus.
Transmission
Hantaviruses are transmitted by contact with the bodily fluids of rodents, particularly from saliva from bites and especially from inhalation of viral particles from urine and feces in aerosols. The manner of transmission is the same for both diseases caused by hantaviruses. Among the HCPS-causing hantaviruses is the Andes virus, which is the only hantavirus confirmed to be capable of spreading from person to person, though this is rare. Infections have almost entirely been linked to contact with rodent excrement; however, in 2005 and 2019, human-to-human transmission of the Andes virus was reported in South America.
Diagnosis
In terms of the evaluation of this infection, the following is done:
Chest X-ray (pulmonary edema) Blood workup (thrombocytopenia) Immunofluorescent or immunoblot assay (ELISA utilizing IgM)
Prevention The best prevention against contracting hantavirus is to eliminate or minimize contact with rodents in the home, workplace, or campsite. As the virus can be transmitted by rodent saliva, excretions, and bites, control of rats and mice in areas frequented by humans is key for disease prevention. General prevention can be accomplished by disposing of rodent nests, sealing any cracks and holes in homes where mice or rats could enter, setting traps, laying down poisons, or using natural predators such as cats in the home. The duration that hantaviruses remain infectious in the environment varies based on factors such as the rodent's diet, temperature, humidity, and whether indoors or outdoors. The viruses have been demonstrated to remain active for two to three days at normal room temperature, while ultraviolet rays in direct sunlight kill them within a few hours. However, rodent droppings or urine of indeterminate age should always be treated as infectious. It is advisable to treat most of groceries - especially canned items - as infectious because in spite of all control measures, rodents sneak into the supply chains. Therefore, the disinfection of infection-suspected surfaces is an important prevention measure. Diluted solutions of quaternary ammonium compounds ("quacs"), iodine, sodium hypochlorite (bleach) are highlighted as effective disinfectants. Unlike the traditionally used hypochlorite and iodine, diluted hydrogen peroxide is a non-toxic, less corrosive and environmentally friendlier antimicrobial agent. In addition, a diluted aqueous solution of hydrogen peroxide can be produced in areas located far away from supply chains to meet needs for virus prevention.
Vaccine
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