Hantavirus hemorrhagic fever

汉他病毒出血热

Evidence-backed informationEN 5/7 applicable sections · ZH 5/7 applicable sectionsUpdated Sep 3, 2026

Hantavirus hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne hemorrhagic disease caused by several hantavirus species and characterized by a five-stage clinical course and variable severity. The main causative viruses and their rodent reservoirs differ by geography, with Hantaan virus predominant in East Asia and Puumala virus most common in Russia and much of Europe. In the Americas, related hantaviruses more often cause a distinct cardiopulmonary syndrome (HCPS) rather than HFRS ^[1]^[2].

Read the full clinical and epidemiological profile6

Definition

HFRS is a hemorrhagic fever caused by hantavirus infection, with disease driven by microvascular leakage and renal involvement ^[1]. Hantaviruses are members of the Bunyaviridae family and can produce two main clinical patterns in humans—HFRS in Eurasia and hantavirus cardiopulmonary syndrome (HCPS) on the American continent ^[2].

Clinical features

Symptoms typically appear about two weeks after exposure and progress through febrile (toxic), hypotensive, oliguric, diuretic, and convalescent phases ^[1]. Early manifestations include headache, lower back pain, nausea, vomiting, diarrhea, bloody stool, cutaneous petechiae, respiratory tract bleeding, and renal findings such as kidney swelling, proteinuria, and hematuria; the hypotensive phase reflects microvascular leakage and the oliguric phase reflects renal failure ^[1]. Severity ranges from mild illness to severe disease, with case fatality rates of less than 1% up to 15% depending on the causative virus ^[1].

Epidemiology

HFRS is caused mainly by four viruses with distinct geographic distributions: Hantaan virus in East Asia (severe disease, reservoir: striped field mice), Seoul virus worldwide (moderate disease, reservoir: brown rat, accounting for roughly a quarter of cases), Puumala virus in Russia and northern/central Europe (mild disease, reservoir: bank vole), and Dobrava-Belgrade virus in southern Europe (variable severity by genotype) ^[1]. A mild form often called nephropathia epidemica is associated with Puumala virus ^[1]. In the Americas, hantavirus disease is dominated by HCPS rather than HFRS, with Andesvirus being endemic in Chile ^[2].

Transmission

Humans acquire hantavirus infection through direct or indirect contact with infected rodents' urine, saliva, or feces, including inhalation of aerosolized virus particles ^[2]. Rodents typically sustain asymptomatic persistent infections and can spread the virus among themselves via aerosols or droplets from excreta and secretions, contaminated food, skin or fur shedding, grooming, and biting or scratching; transmission can also occur by the fecal-oral route and across the placenta from mother to offspring ^[1].

Prevention

Prevention centers on reducing human exposure to rodents and their excreta at home, in workplaces, and during camping, through rodent control (rodenticides, traps, and cats), sealing homes against rodent entry, removing food sources and nesting sites, covering trash, cutting grass, wetting areas before cleaning to suppress dust, and disinfecting contaminated surfaces ^[1].

References

1Wikipedia contributors. Hantavirus hemorrhagic fever with renal syndrome - Wikipedia [Internet]. Wikipedia. cited 4 Sept 2026.Available from: https://en.wikipedia.org/wiki/Hantavirus_hemorrhagic_fever_with_renal_syndrome
2Ulloa-Morrison R et al. Critical care management of hantavirus cardiopulmonary syndrome. A narrative review. J Crit Care. 2024 Dec. PMID: 39024823. doi: 10.1016/j.jcrc.2024.154867.PubMed: https://pubmed.ncbi.nlm.nih.gov/39024823/

Coding Register

ICD-10: A98.5
ICD-11: 1D67

Key Statistics

Total cases: 4K
Peak month: 2021-12
Coverage: 3 reporting countries · 1981-01-01 → 2026-09-01

Coverage

Reporting countries and regions

3 locations

Trends by reporting country

Monthly patterns over time

Rows12,373

Updated2026-09-01

Coverage—

Partitions10

Source4 series · 6,210 observations

Official sourcesAuthority, cadence, notes65