The hantaviruses found in Europe and Asia cause a form of kidney disease called hemorrhagic fever with renal syndrome (HFRS). The hantaviruses in the Americas attack the lungs, causing hantavirus pulmonary syndrome (HPS).
Old world hantaviruses infect the highly specialized and differentiated endothelial cells of the kidney, causing acute renal failure with tubular and glomerular involvement, which is referred to as hemorrhagic fever with renal syndrome (HFRS).
Although hantaviruses are not generally considered neurotropic, neurological complications have been reported occasionally in patients with hemorrhagic fever renal syndrome (HFRS).
These symptoms include cough and shortness of breath, which are the result of leaky blood vessels and lead to collection of fluid in the lungs, bleeding and failure of the heart to pump. The combination of these changes can lead to shock, failure of several organs and even death.
Anyone who comes into contact with rodents that carry hantaviruses is at risk of HPS. Rodent infestation in and around the home remains the primary risk for hantavirus exposure. Even healthy individuals are at risk for HPS infection if exposed to the virus.
HPS is more common in South America than in North America. Cases have been identified in Argentina, Chile, Uruguay, Paraguay, Brazil, and Bolivia. Andes virus causes HPS in Argentina and Chile and is the only hantavirus known to have been transmitted from person to person.
Hantaviruses in the Americas are known as “New World” hantaviruses and may cause hantavirus pulmonary syndrome (HPS). Other hantaviruses, known as “Old World” hantaviruses, are found mostly in Europe and Asia and may cause hemorrhagic fever with renal syndrome (HFRS).
In summary, hantavirus infection induces a typical myocarditis that may be responsible for myocardial depression and shock in fatal HPS.
Most patients recover totally from the disease. Long-term consequences, however, can occur. Cardiovascular, nephrological, endocrinological, and some other consequences have been reported (Table 2).
Hantavirus pulmonary syndrome is a rare infectious disease that begins with flu-like symptoms and progresses rapidly to more severe disease. It can lead to life-threatening lung and heart problems. The disease is also called hantavirus cardiopulmonary syndrome.
People who are ill with hantavirus pulmonary syndrome and do not get help quickly may die. Those that survive recover quickly, though full recovery often takes several months.
There is no specific treatment or cure for hantavirus infection. Treatment of patients with HPS remains supportive in nature. Patients should receive appropriate, broad-spectrum antibiotic therapy while awaiting confirmation of a diagnosis of HPS.
Hantavirus antibody-positive rodents have been found across Australia although, to date, there are no reports of infections in humans. This could be due to misdiagnosis clinically and/or inadequate laboratory technique/skills.
Icterus is not commonly reported, but hepatitis caused by hantavirus could lead to inflammation of hepatocytes and cause intrahepatic cholestasis. The use of NAC in patients with transaminitis is described in leptospirosis and dengue fever complicated with acute liver failure [9, 10, 18].
Hantavirus infections can be fatal. Fatality rates may reach up to 60%. There is no available treatment. Early diagnostic may reduce fatality rates by half.
In the year 2020, 833 cases of hantavirus infection had been reported, with 35% mortality rate in the US [8]. In April 2022, a 57-year-old man died with proven Hantavirus infection.
Laboratory Studies
Specific diagnosis of Hantavirus pulmonary syndrome (HPS) may be achieved by serological techniques, polymerase chain reaction (PCR), and immunohistochemistry (IHC) studies, as follows: RT-PCR can help detect viral RNA in blood and tissues and is the criterion standard for diagnosis.
As the illness progresses, the main symptom of hantavirus infection is difficulty in breathing, which is caused by fluid build-up in the lungs, and which quickly progresses to an inability to breathe. Infected people sometimes die of respiratory failure or shock.
Hantavirus infection can have no symptoms or cause mild to severe illness. Fever is the most common symptom in all three types of disease and lasts about 3-7 days.
Immunohistochemistry (IHC) IHC testing of formalin-fixed tissues with specific monoclonal and polyclonal antibodies can be used to detect hantavirus antigens and has proven to be a sensitive method for laboratory confirmation of hantaviral infections.
It causes a rare but serious lung disease called hantavirus pulmonary syndrome (HPS). The virus does not remain active for long once outside of its host -- less than 1 week outdoors and a few hours when exposed to direct sunlight.
Any man, woman, or child who is around mice or rats that carry harmful hantaviruses can get HPS. You do not have to already be sick to be at risk for HPS. Healthy people have become ill with HPS.
The virus, which is able to survive in the environment for a few hours or days (for example, in dirt and dust in the shade or in rodent nests), can be killed by most household disinfectants, such as bleach, detergents or alcohol. Exposure to the sun's UV rays can also kill the virus.
And even though 15-20 percent of deer mice are infected with hantavirus, Cobb explains, it's a rare disease for humans to contract, mostly because the virus dies shortly after contact with sunlight, and it can't spread from one person to another.