Symptoms & Clinical Syndromes
Hantaviruses cause two distinct clinical syndromes depending on the viral strain and geographic region. Both can progress rapidly — early recognition is critical.
⚠
Medical Emergency
If you experience sudden fever, severe fatigue, and breathing difficulty after potential rodent exposure, seek emergency care immediately. Hantavirus illness can progress from mild symptoms to life-threatening respiratory or kidney failure within hours.
Quick Comparison
| Feature | HPS | HFRS |
|---|---|---|
| Primary organ affected | Lungs | Kidneys |
| Geographic range | Americas | Europe, Asia |
| Example viruses | Sin Nombre, Andes | Hantaan, Puumala, Seoul |
| Case fatality rate | 35–40% | 0.1–15% |
| Incubation period | 1–8 weeks | 1–8 weeks |
| Person-to-person spread | Andes virus only | Not documented |
| Treatment | Supportive (ECMO) | Supportive + dialysis |
HPS
Hantavirus Pulmonary Syndrome
Causative viruses
Sin Nombre, Andes, Choclo, Juquitiba
Regions
North America, South America
Incubation
1–8 weeks (average 2–4 weeks)
Case fatality rate
35–40%
Transmission
Inhalation of aerosolized rodent excreta; Andes virus also spreads person-to-person
Clinical Phases
Phase 1: Prodromal Phase
3–5 days- –High fever (38–40°C / 100–104°F)
- –Severe fatigue and myalgia
- –Headache
- –Dizziness
- –Chills
- –Nausea, vomiting, diarrhea, or abdominal pain (30–40% of cases)
Phase 2: Cardiopulmonary Phase
Hours to days after prodrome- –Rapidly progressing cough
- –Shortness of breath (dyspnea)
- –Pulmonary edema (fluid in lungs)
- –Severe hypoxia
- –Hypotension and cardiogenic shock
- –Bradycardia progressing to atrial fibrillation or ventricular tachycardia
Phase 3: Convalescent Phase
Weeks to months- –Gradual resolution of pulmonary edema
- –Diuresis (increased urination)
- –Persistent fatigue
- –Shortness of breath during exertion may persist
HFRS
Hemorrhagic Fever with Renal Syndrome
Causative viruses
Hantaan, Puumala, Seoul, Dobrava
Regions
Europe, Asia
Incubation
1–8 weeks (typically 2–4 weeks)
Case fatality rate
0.1% (Puumala) to 15% (Hantaan)
Transmission
Inhalation of aerosolized excreta from infected rodents
Clinical Phases
Phase 1: Febrile Phase
3–7 days- –Abrupt-onset high fever
- –Severe headache
- –Back and abdominal pain
- –Flushing of face and neck
- –Blurred vision
- –Petechiae (small red spots) on palate and skin
Phase 2: Hypotensive Phase
Hours to 2 days- –Sudden drop in blood pressure
- –Nausea and vomiting
- –Leakage of plasma from capillaries
- –Thrombocytopenia (low platelet count)
- –Hemorrhagic manifestations
Phase 3: Oliguric Phase
3–7 days- –Severely reduced urine output
- –Kidney failure
- –Fluid overload
- –Electrolyte imbalances
- –Risk of pulmonary edema
Phase 4: Diuretic Phase
Days to weeks- –Excessive urine output (up to 8L/day)
- –Risk of dehydration and electrolyte imbalance
- –Gradual improvement in kidney function
Phase 5: Convalescent Phase
Weeks to months- –Gradual recovery
- –Persistent fatigue
- –Some patients develop chronic kidney disease
Transmission & Prevention
How Hantavirus Spreads
- → Inhaling dust contaminated with rodent urine, feces, or saliva
- → Touching contaminated surfaces then touching eyes, nose, or mouth
- → Rodent bites (rare)
- → Andes virus: person-to-person contact (unique among hantaviruses)
Hantavirus is NOT spread by coughing, sneezing, or casual person-to-person contact (except Andes virus).
Prevention Measures
- ✓ Seal gaps and cracks where rodents can enter structures
- ✓ Store food and garbage in rodent-proof containers
- ✓ Remove brush, woodpiles, and debris near the home
- ✓ Use N95 respirator when cleaning infested areas
- ✓ Wet-mop or spray disinfectant before sweeping (prevents dust)
- ✓ Trap rodents using snap traps rather than disturbing nests
- ✓ Wear rubber gloves when handling traps or cleaning
- ✓ Camp away from rodent burrows and dense brush
Frequently Asked Questions
What is hantavirus?
Hantaviruses are a family of RNA viruses (family Hantaviridae) transmitted to humans primarily through contact with infected rodents or their excreta. They cause two main illnesses: hantavirus pulmonary syndrome (HPS) in the Americas and hemorrhagic fever with renal syndrome (HFRS) in Europe and Asia.
How do you catch hantavirus?
Most infections occur when people inhale dust contaminated with the urine, droppings, or saliva of infected rodents. Other routes include touching contaminated surfaces and then the face, and rarely, rodent bites. Andes virus is the only hantavirus with documented person-to-person transmission.
What are the early symptoms of hantavirus?
Initial symptoms typically appear 1 to 8 weeks after exposure and include high fever, severe muscle aches (especially in the thighs, hips, back, and shoulders), fatigue, headache, dizziness, chills, and sometimes nausea, vomiting, diarrhea, or abdominal pain.
Is hantavirus contagious between people?
With one exception, hantaviruses do not spread from person to person. The Andes virus, found in Argentina and Chile, has documented person-to-person transmission in close, sustained-contact settings and is the strain implicated in the 2026 MV Hondius cruise-ship outbreak.
How is hantavirus treated?
There is no FDA-approved antiviral therapy. Treatment is intensive supportive care in an ICU. HPS may require mechanical ventilation or extracorporeal membrane oxygenation (ECMO). HFRS often requires intravenous fluids, electrolyte management, and dialysis for acute kidney failure. Early hospital admission improves outcomes substantially.
Can you survive hantavirus?
Yes — survival depends heavily on the viral strain and how quickly intensive care begins. HPS case-fatality rates are around 35–40%; HFRS ranges from about 0.1% for Puumala virus to 15% for Hantaan virus. With early ICU admission, survival in HPS exceeds 60%.
Is there a vaccine for hantavirus?
No vaccine is licensed in North America or Europe. South Korea and China use inactivated vaccines (such as Hantavax in Korea) for high-risk occupational groups. Several mRNA and recombinant vaccine candidates are in preclinical and early-phase clinical trials.
How do I prevent hantavirus exposure?
Seal rodent entry points in homes, sheds, and outbuildings; store food and trash in rodent-proof containers; wear gloves and an N95 respirator when cleaning areas with rodent droppings; wet down droppings with disinfectant before cleaning rather than sweeping; and ventilate enclosed spaces for at least 30 minutes before entering.
Diagnosis & Treatment
Diagnosis
- RT-PCR: Detects viral RNA in blood during acute phase
- ELISA serology: IgM and IgG antibodies (most common test)
- Immunohistochemistry: Used on tissue in fatal cases
- Plaque reduction neutralization test (PRNT): Confirmatory gold standard
Treatment
There is no FDA-approved antiviral therapy. Treatment is intensive supportive care:
- HPS: Mechanical ventilation, ECMO (extracorporeal membrane oxygenation), careful fluid management
- HFRS: Intravenous fluids, electrolyte management, dialysis for kidney failure
- Ribavirin: Some evidence for HFRS in early stages; not proven for HPS