How is hantavirus treated?

Hantavirus disease is managed in an intensive care unit. For HPS, the priority is meticulous fluid management — patients are exquisitely prone to pulmonary edema, so fluids that would be routine in septic shock can be lethal. Mechanical ventilation is frequently required; in severe cases, extracorporeal membrane oxygenation (ECMO) has improved survival, especially when started before circulatory collapse. For HFRS, supportive treatment focuses on volume resuscitation, electrolyte correction, and dialysis during the oliguric phase. Ribavirin has shown benefit in HFRS when started early (within the first 5 days), but has not demonstrated benefit in HPS. Several investigational antivirals and monoclonal antibodies are in clinical development. No licensed hantavirus vaccine exists in North America or Europe; inactivated vaccines are used in South Korea (Hantavax) and China for high-risk occupational groups.