Hantavirus infection

Hantavirus infection refers to human disease caused by orthohantaviruses, a genus within the family Hantaviridae. These viruses are maintained in nature through persistent, typically asymptomatic infections in rodent reservoirs, with each hantavirus species exhibiting strict host specificity to a particular rodent species. The genus includes all hantaviruses capable of causing disease in humans, though human-to-human transmission does not occur. The viral genome consists of three segments of single-stranded negative-sense RNA: the large (L), medium (M), and small (S) segments, encoding the RNA-dependent RNA polymerase, glycoprotein precursors, and nucleocapsid protein, respectively.

Orthohantaviruses cause two primary clinical syndromes in humans. Hemorrhagic fever with renal syndrome is characterized by kidney involvement including renal swelling, proteinuria, and hematuria, with case fatality rates ranging from less than 1% to 15% depending on the infecting virus species; Puumala virus typically causes a mild form termed nephropathia epidemica, while Hantaan virus causes severe disease and Seoul virus causes moderate disease. Hantavirus pulmonary syndrome presents initially with flu-like symptoms including fever, headache, and muscle aches, but progresses to severe cardiopulmonary complications with substantially higher mortality, reaching 30–60% in confirmed cases. The clinical severity of Dobrava-Belgrade virus infection varies from mild to severe depending on the viral genotype.

Hantavirus infection exhibits distinct geographic distribution patterns corresponding to viral lineages: Old World hantaviruses causing HFRS are endemic across Africa, Asia, and Europe, while New World hantaviruses causing HPS are found throughout the Americas. Rodent reservoir species occupy diverse habitats including desert environments, tropical and equatorial forests, swamps, savannas, agricultural fields, and coastal salt marshes. Seroprevalence studies indicate infection rates of 5.9% to 38% among rodent populations in the Americas and approximately 3% to 19% globally, varying by detection method and geographic location. Environmental factors including rainfall patterns, temperature, and humidity influence rodent population dynamics and viral transmission risk, with high humidity in warm climates promoting vegetation growth and supporting increased rodent abundance.

Human hantavirus infection occurs primarily through inhalation of aerosols containing viral particles from rodent excreta, including feces, urine, saliva, and blood. Transmission may also occur through direct contact with contaminated materials, consumption of food contaminated by rodent secretions, virus particles shed on skin or fur, and through grooming behaviors of infected rodents. Bites and scratches from infected animals represent additional transmission routes, and vertical transmission across the placenta during pregnancy has been documented. The virus demonstrates environmental persistence, surviving for at least 10 days at room temperature, 15 days in temperate conditions, and exceeding 18 days at 4°C, facilitating indirect transmission from contaminated environments.

Individuals with occupational or recreational exposure to rodent-infested environments face elevated risk of hantavirus infection, including farmers, pest control workers, wildlife researchers, and individuals engaging in outdoor activities such as camping, hiking, or exploring structures with rodent activity. Household members in dwellings with active rodent infestation are also at increased risk through routine exposure to contaminated environments. The geographic distribution of specific hantavirus species determines regional risk profiles, with HFRS risk concentrated in rural and agricultural areas of Asia and Europe where contact with rodent excreta is more common, and HPS risk associated with forested and rural regions of the Americas where New World hantavirus reservoirs thrive.

Prevention of hantavirus infection centers on minimizing exposure to rodent excreta and controlling rodent populations in and around human dwellings. Recommended measures include sealing structural entry points to prevent rodent infestation, avoiding sweeping or vacuuming areas with visible rodent droppings to prevent aerosolization, using appropriate protective equipment when handling potentially contaminated materials, and maintaining food storage in rodent-proof containers. Environmental management strategies that reduce rodent habitat availability around residential areas contribute to prevention efforts. No vaccine is widely available for general population use, though vaccination programs exist in some endemic regions of Asia.

Hantavirus surveillance relies on environmental monitoring of rodent populations combined with human case detection. Some countries, such as South Korea, conduct routine trapping of wild rodents to assess viral circulation and identify emerging strains. Human surveillance focuses on recognition of the two distinct clinical syndromes, with HFRS cases concentrated in Eurasia and Africa while HPS cases are primarily reported from the Americas. Environmental surveillance indicators include rodent population density, seroprevalence rates in reservoir species, and ecological factors such as forest coverage and climate conditions that influence transmission dynamics. The absence of human-to-human transmission simplifies case containment but requires robust environmental investigation to identify exposure sources.

1. 1 Wikidata. Hantavirus infectious disease.
2. 2 Wikipedia. Orthohantavirus - Wikipedia.

ICD-10

ICD-11

Total cases

5

Peak month

2023-05

Coverage

2 reporting countries · 2012-09-14 → 2026-05-09