Hantavirus infection

[Mary Mallozziberg]

Hantavirus infection is a viral disease that is spread from rodents to people. The virus can cause severe infections of the lungs (with cough and shortness of breath) or kidneys (with rash, abdominal pain, and sometimes kidney failure).

Hantavirus is spread through contact with infected rodents or their droppings.
The infection starts with sudden fever, headache, muscle aches, and sometimes abdominal symptoms, which may be followed by a cough and shortness of breath or by a rash and kidney problems.
Blood tests to identify the virus can confirm the diagnosis.
Oxygen and drugs to stabilize blood pressure are used if the lungs are affected, and dialysis may be needed if the kidneys are affected.

(See also Overview of Arbovirus, Arenavirus, and Filovirus Infections.)
Hantaviruses infect various species of rodents throughout the world. The virus is present in the urine and feces of the rodents. The infection is spread when people have contact with rodents or their droppings or urine or possibly when they inhale virus particles in places with large amounts of rodent droppings. Some evidence suggests that rarely, the virus spreads from person to person. Hantavirus infections are becoming more common.
There are several strains of hantavirus. Depending on the strain, the virus affects different organs:

The lungs, causing hantavirus pulmonary syndrome (HPS)
The kidneys, causing hemorrhagic fever with renal syndrome (HFRS)

However, many symptoms of the two infections overlap.
The pulmonary syndrome was first recognized in the southwestern United States in 1993. As of 2017, about 697 cases have occurred in the United States, most in the western states. Cases have also occurred in Canada and several Central and South American countries.
The renal syndrome occurs primarily in parts of Europe, Korea, China, and Russia. Seoul hantavirus causes the renal syndrome. The virus is spread by brown Norway rats and has been spread throughout the world by rats on ships. A few cases of hantavirus infection, spread by pet rats, have occurred in the United States, Canada, and Europe.

[Tracie Lynn]

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.