Hantavirus pulmonary syndrome

Hantavirus pulmonary syndrome is a severe respiratory disease resulting from hantavirus infection, characterized primarily by microvascular leakage and acute respiratory distress syndrome ^[1]. The entity is alternatively designated as hantavirus cardiopulmonary syndrome and is principally attributed to New World hantaviruses circulating within American populations ^[1].

Clinical presentation begins one to eight weeks post-exposure and unfolds across three stages: an initial phase featuring fever, myalgia, headache, dyspnea, and thrombocytopenia; a subsequent cardiopulmonary stage marked by tachycardia, arrhythmias, cardiogenic shock, and pulmonary capillary leakage that precipitates respiratory failure, hypotension, and pleural effusion; and a prolonged recovery period lasting months, though residual breathing impairments may endure for up to two years ^[1]. Mortality generally occurs abruptly between two and ten days after symptom onset, coinciding with the cardiopulmonary phase, with strain-specific fatality estimates hovering around 30–35% for Sin Nombre virus and approximately 40% for Andes virus ^[1]. A robust and durable antibody response develops early, producing neutralizing antibodies against viral surface glycoproteins ^[1].

Hantavirus pulmonary syndrome demonstrates a pronounced geographic concentration across the Americas, with Sin Nombre virus propagated by the western deer mouse accounting for the majority of cases in North America, while Andes virus disseminated by the long-tailed pygmy rice rat drives incidence in South America ^[1]. Human disease represents a zoonotic spillover from rodent reservoirs that harbor persistent, asymptomatic viral infections ^[1]. The condition imposes a significant mortality burden, evidenced by a documented case fatality rate spanning 30% to 60%, with fatalities typically arising abruptly during the acute cardiopulmonary stage ^[1].

1. 1Wikipedia contributors. Hantavirus pulmonary syndrome - Wikipedia [Internet]. Wikipedia. cited 2 Sept 2026.Available from: https://en.wikipedia.org/wiki/Hantavirus_pulmonary_syndrome
2. 2Afzal 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/