Hantavirus infection

Hantaviruses are a group of rodent-associated viruses that can cause severe human disease, with each virus typically linked to a specific reservoir species that carries long-term infection without apparent illness ^[2]. Only a limited number of identified hantavirus species are known to cause human disease, transmitted principally through contact with infected rodents or their excreta ^[2][5]. The infection is classified as a zoonotic pathogen found in parts of Europe, Asia, South America, and North America ^[4].

Early symptoms are nonspecific and overlap with other febrile or respiratory illnesses, commonly including fever, headache, muscle aches, and gastrointestinal complaints such as abdominal pain, nausea, or vomiting ^[2]. Hantavirus pulmonary syndrome may progress rapidly to cough, shortness of breath, pulmonary fluid accumulation, and shock, whereas hemorrhagic fever with renal syndrome can involve low blood pressure, bleeding, and kidney failure in later stages ^[2]. Severe disease can result in renal or respiratory failure with fatality rates reported up to 40% ^[4].

Worldwide, an estimated 10,000 to over 100,000 hantavirus infections occur each year, with the largest burden in Asia and Europe ^[2]. The two principal human diseases show geographic divergence: hantavirus pulmonary syndrome is predominantly reported in the Americas and hemorrhagic fever with renal syndrome mainly in Europe and Asia ^[2]. Zoonotic transmission has been documented in parts of Europe, Asia, South America, and North America, with fatality rates reaching 40% in severe cases ^[4].

People usually acquire infection through contact with infected rodents or their urine, droppings, or saliva, and rodent exposure is the principal route, including among travellers via zoonotic contact with excretions ^[2][5]. Health-care associated transmission is very low when standard precautions are applied, though aerosol-generating procedures warrant airborne precautions ^[1]. Limited human-to-human spread has been documented only for Andes virus in parts of the Americas ^[2].

Primary prevention relies on reducing human contact with rodents and their excreta, alongside early identification and isolation of suspected cases and monitoring of close contacts during outbreaks ^[1]. In health-care settings, standard precautions including hand hygiene, environmental cleaning, and safe handling of body fluids are advised, with transmission-based and airborne precautions for suspected or confirmed cases and aerosol-generating procedures ^[1][4]. No licensed vaccines or specific antivirals are available, so avoidance of rodent exposure and consistent infection prevention measures remain the main protective strategies ^[1][3][4].

1. 1 World Health Organization. Hantavirus [Internet]. cited 23 Oct 2026. Available from: https://www.who.int/news-room/fact-sheets/detail/hantavirus
2. 2 World Health Organization. Hantavirus [Internet]. cited 23 Oct 2026. Available from: https://www.who.int/health-topics/hantavirus
3. 3 Afzal S et al. Hantavirus: an overview and advancements in therapeutic approaches for infection. Front Microbiol. 2023. PMID: 37901807. doi: 10.3389/fmicb.2023.1233433. PubMed: https://pubmed.ncbi.nlm.nih.gov/37901807/
4. 4 Engdahl TB et al. Humoral Immunity to Hantavirus Infection. mSphere. 2020 Jul 15. PMID: 32669473. doi: 10.1128/mSphere.00482-20. PubMed: https://pubmed.ncbi.nlm.nih.gov/32669473/
5. 5 Geerdes-Fenge HF et al. [Travel-associated pneumonias]. Pneumologie. 2014 Oct. PMID: 25290923. doi: 10.1055/s-0034-1378081. PubMed: https://pubmed.ncbi.nlm.nih.gov/25290923/