Bunyaviridae contain the genus Hantavirus, which consists of at least 4 serogroups with 9 viruses causing 2 major, sometimes overlapping, clinical syndromes:
Hemorrhagic fever with renal syndrome (HFRS)
Hantavirus pulmonary syndrome (HPS)
(See also Overview of Arbovirus, Arenavirus, and Filovirus Infections.)
Viruses causing HFRS are Hantaan, Seoul, Dobrava (Belgrade), and Puumala. Those causing HPS in North America are Sin Nombre, Black Creek Canal, Bayou, Choclo in Panama, Andes in Argentina, Chile, eastern Bolivia, and Leguna Negra in Bolivia (1).
Hantaviruses occur throughout the world in wild rodents, which shed the virus throughout life in urine and feces. Transmission occurs between rodents. Transmission to humans is through inhalation of aerosols of rodent excreta or, rarely through rodent bites. Recent evidence suggests human-to-human transmission may occur with Andes virus. Naturally and laboratory-acquired infections are becoming more common.
Laboratory diagnosis of hantavirus infection is established by serologic tests and reverse transcriptase–polymerase chain reaction (RT-PCR). Serologic tests include enzyme-linked immunosorbent assay (ELISA) and Western and strip immunoblot assays. Serologic diagnosis in North America must be able to differentiate between Seoul and Sin Nombre virus infections due to potential cross-reactivity. Growth of the virus is technically difficult and requires a biosafety level 3 laboratory.