hantaviruses

Hantaviruses are a group of rodent-borne viruses in the family Hantaviridae. They are enveloped, negative-sense RNA viruses with three genome segments (L, M and S). In humans they can cause two major diseases: hemorrhagic fever with renal syndrome (HFRS), mainly in Europe and Asia, and hantavirus pulmonary syndrome (HPS) in the Americas.

Transmission to humans occurs primarily through inhalation of aerosolized excreta from infected rodents, such as urine, feces or saliva. Less commonly, direct contact or bites can transmit the virus. Humans are incidental hosts and do not maintain onward transmission in general, though rare human-to-human transmission has been reported for Andes virus. Each hantavirus has one principal rodent reservoir species, for example Hantaan and Dobrava viruses in Apodemus mice, Puumala in bank voles, Seoul virus in Rattus norvegicus, and Sin Nombre virus in Peromyscus species.

Clinical features and diagnosis: HFRS typically begins with fever, headache and abdominal pain, followed by hypotension and renal impairment. HPS begins with fever, myalgia and fatigue and can rapidly progress to severe pulmonary edema and respiratory failure. Incubation periods are usually 1–5 weeks. Diagnosis relies on serology (IgM and IgG) and molecular tests (PCR); management is largely supportive.

Prevention and treatment: There is no universally available hantavirus vaccine; vaccines exist in limited use in select countries. Prevention focuses on reducing rodent populations and minimizing exposure to rodent excreta, including safe cleaning practices and use of personal protective equipment. Ribavirin has limited benefit for some HFRS cases when given early and is not established for HPS.