Hantavirus: What Is, Types, Causes, Treatment, and Prevention

Hantavirus infection may occur after you come in contact with an infected rat or mouse’s saliva, droppings, or urine. As a result, you may develop flu-like symptoms, such as cough, fever, chills, muscle aches, and more severe health issues that appear in the late stage of the infection, including rapid breathing and shortness of breath.

The article reviews the features of the hantavirus pulmonary syndrome – a hantavirus infection in North and South America. It includes factors that increase the risk of transmission, ways the virus spreads, how doctors treat it, what you can do to prevent it, and more.

How Common is Hantavirus?

In the United States, the data regarding hantavirus infections include the period between the first formal diagnosis in 1993 and the end of 2020. During these 27 years, 833 people have been reported to have hantavirus infection. 97% of these infections were caused by hantavirus pulmonary syndrome.

How Dangerous is Hantavirus?

While hantavirus infections are rare, they can be severe, and no specific treatment exists to address them. As the disease progresses, it can lead to severe respiratory problems, which can result in death.

Early detection and timely medical care are essential for improving the chances of recovery. While hantavirus can be a severe illness, the risk of infection is low, and practicing good hygiene and rodent control measures can help minimize that risk.

Is Hantavirus Contagious?

Person-to-person transmission of hantavirus is very rarely observed. It is uncommon and nearly impossible to get it through close contact with others, such as kissing, touching, or hugging. Sharing personal items also does not risk transmitting the hantavirus to another person.

Types of Hantavirus

Various diseases can cause hantavirus pulmonary syndrome (HPS). Examples of more common viruses and their locations are as follows:

• Andes virus: carried by the long-tailed pygmy rice rat (South America)
• Sin Nombre virus: carried by deer mice (Western and Central North America)
• New York virus: carried by white-footed mice (Northeastern United States)
• Black Creek Canal virus: carried by cotton mice (Southeastern United States)

Viruses that cause hemorrhagic fever with renal syndrome (HFRS) include:

• Seoul virus: carried by Norway rats (globally)
• Puumala virus: carried by the bank vole (Scandinavia, Western Europe, and Western Russia)
• Hantaan virus: carried by the striped field mouse (Eastern Asia and Russia)
• Saaremaa virus: carried by the striped field mouse (Central Europe and Scandinavia)
• Dobrava virus: carried by the yellow-necked field mouse (the Balkans)

Causes and Transmission

Rodents, including specific species of rats and mice, transmit Hantavirus pulmonary syndrome. This disease is found in South and North America and is caused by different kinds of viruses, depending on the region.

The virus is present in rodents’ saliva, droppings, and urine. Humans can get it in several ways, such as:

• Inhaling the particles present in infected rodent’s feces (the most common way)
• Getting bitten by an infected mouse or rat
• Touching surfaces or objects contaminated with infected rodent’s saliva, secretions, or poop and then touching your face
• Eating food contaminated by hantavirus

Risk Factors

Some occupations and activities put you at a greater risk of hantavirus infection. Here are the examples of activities that make you more likely to contract this disease:

• Working at a barn infested with mice
• Sweeping out ranch buildings such as barns, sheds, and storage
• Hiking or camping in rodent-infested areas
• Working in wooded areas
• Studying or trapping rodents
• Harvesting field crops
• Cleaning up wood waste in a sawmill
• Spending time in vacant buildings
• Living in rodent-infested buildings
• Engaging in activities that may make you come in contact with rodent droppings, saliva, and urine

Close contact with rodents or performing activities in rodent-prone areas is part of the job for many people. Although it may be impossible to prevent the infection from developing, employers must follow safety and occupational health regulations and provide their employees with the necessary equipment and instructions that reduce the risk of hantavirus to a minimum.

Signs and Symptoms

Because hantavirus infections are rare, there is not enough high-quality evidence to tell how long the incubation period of hantavirus is. According to the limited data, it is estimated to last 1 to 8 weeks. Within that time, a person is likely to develop the first hantavirus symptoms after exposure to infected rodents’ saliva, droppings, or urine.

Symptoms of Early Hantavirus

Early hantavirus, or the first stage of hantavirus, develops when the incubation period ends. During this period, a person starts experiencing the first signs and symptoms of the disease. They may include the following:

• Abdominal pain
• Chills
• Stomach pain
• Fever (high body temperature)
• Rash
• Diarrhea
• Tiredness
• Muscle aches
• Dizziness
• Vomiting
• Trouble breathing
• Dry cough

The above symptoms appear in approximately half of the affected people and last between two and eight days.

Symptoms of Late Hantavirus

Symptoms of late hantavirus appear four to ten days after the first stage. This phase of disease is considered severe and is associated with the following health issues:

• Coughing
• Shortness of breath
• Trouble breathing
• Chest tightness
• Internal bleeding
• Rapid heartbeat

In the worst-case scenario, hantavirus infection may lead to respiratory failure and death. According to the Centers for Disease Control and Prevention (CDC), hantavirus causes death in 38% of affected people.

Complications

Hantavirus infection is a serious condition that may quickly worsen and cause complications. Severe cases may lead to kidney, heart, or lung failure and even death.

Diagnosis and Tests

Hantavirus infections are challenging to diagnose. Most people with hantavirus pulmonary syndrome experience flu-like symptoms, which can indicate many bacterial and viral infections. Based on the physical examination alone, it is uncommon to get the correct answer immediately. Your healthcare provider may suspect COVID-19 or a respiratory condition if you are experiencing shortness of breath.

However, your doctor may want to learn more about your daily life if you have a history of exposure to rodents or a job in rodent-infested areas. You may be asked the following questions:

• Do you live or work in wooded areas?
• Have you recently had contact with rodents?
• Do you live or spend time in mice or rat-infested areas?
• Have you recently noticed a rodent’s urine or droppings at your home or job site?

Answering these questions will help your healthcare provider determine if a test for viruses carried by rodents is necessary.

Blood Test

Hantavirus infection can be revealed with a blood test. In this procedure, a healthcare provider obtains a small sample of a person’s blood and analyses it under a microscope. If a person has a viral infection, their immune system produces antibodies to fight the virus. A blood test can identify antibodies and, thus, the virus that triggered their production.

Treatment

There are no specific treatment strategies that address hantavirus infections. The goal of available options is to reduce the severity of the disease, help manage symptoms, and decrease the risk of late hantavirus pulmonary syndrome. It is vital to get diagnosed early to prevent that phase of the infection from happening.

Extracorporeal Membrane Oxygenation (ECMO)

You are at risk of severe respiratory issues if severe hantavirus infection occurs. Approximately 40% of people who need hospitalization due to lung problems need mechanical ventilation. However, if that doesn’t improve your symptoms, you may require extracorporeal membrane oxygenation (ECMO) treatment. This life support technique ensures that your body receives a sufficient supply of oxygen-filled blood.

Supportive Therapy

Some people with a serious case of hantavirus infection require care in an intensive care unit to support their breathing and control the fluid in their lungs. Life-supporting techniques may involve mechanical ventilation and intubation – a process in which a healthcare provider places a breathing tube through a patient’s nose or mouth into their airway (windpipe).

When You Should Seek Emergency?

Hantavirus pulmonary syndrome may progress to a severe illness that may require immediate medical help. Call emergency immediately if you experience the following symptoms:

• A high fever that doesn’t improve
• Severe breathing difficulties
• Rapid heartbeat
• Chest pain

Prognosis for Hantavirus Patients

The outlook for hantavirus infection varies from person to person. This is because several factors decide whether a specific case of hantavirus is mild or serious. These include the severity of symptoms, how quickly medical attention is sought, and whether the complications have developed.

In general, receiving medical attention early improves the outlook, while untreated cases and cases that progressed to the late stage are more difficult to treat.

How to Prevent Hantavirus?

Preventing hantavirus infection involves reducing the risk of exposure to the virus, primarily transmitted through contact with the urine, droppings, or saliva of infected rodents. Here are some guidelines to help prevent hantavirus infection:

• Be aware of the regions where hantavirus is more common and take extra precautions.
• Workers in occupations with potential exposure to rodents, such as farmers and utility workers, should take appropriate precautions, including wearing protective gear and following safety guidelines.
• Avoid sleeping directly on the ground when camping or hiking; use tents with floors.
• Keep campsites clean and store food in sealed containers to prevent attracting rodents.
• Wear gloves and a mask when cleaning areas with rodent droppings or urine.
• Seal any cracks or gaps in buildings, as rodents can enter through small openings.
• Store food in rodent-proof containers, and avoid leaving food out in the open.
• Keep garbage in sealed containers and dispose of it regularly.

Hantavirus – Key Facts You Should Know

Hantavirus is a virus that causes Hantavirus pulmonary syndrome (HPS) and hemorrhagic fever with renal syndrome (HFRS). HPS is found in North and South America, while HFRS is observed in other parts of the world. Infection occurs through contact with infected rodents’ saliva, droppings, or urine, leading to flu-like symptoms and, in severe cases, respiratory issues such as shortness of breath and chest pain.

Early symptoms include abdominal pain, chills, fever, rash, fatigue, and muscle aches, lasting 2-8 days. Late-stage symptoms involve severe respiratory issues, coughing, chest tightness, and internal bleeding, potentially leading to death.

Hantavirus infections are diagnosed through blood tests, which can identify antibodies produced to fight the virus. Treatment focuses on managing symptoms, with severe cases requiring extracorporeal membrane oxygenation (ECMO) or supportive therapy in an intensive care unit.

Sources

• NIH. (2023). Hantavirus Syndrome.
  https://www.ncbi.nlm.nih.gov/books/NBK513243/
• CDC. (2013). Hantavirus Pulmonary Syndrome (HPS).
  https://www.cdc.gov/hantavirus/hps/index.html
• European Centre for Disease Prevention and Control. Facts about hantavirus.
  https://www.ecdc.europa.eu/en/hantavirus-infection/facts
• American Lung Associacion. (2022). Learn About Hantavirus Pulmonary Syndrome.
  https://www.lung.org/lung-health-diseases/lung-disease-lookup/hantavirus-pulmonary-syndrome/learn-about-hantavirus-pulmonary-syndrome-hps
• NIH. (2023). Hemorrhagic Fever Renal Syndrome.
  https://www.ncbi.nlm.nih.gov/books/NBK560660/#:~:text=Hemorrhagic%20fever%20renal%20syndrome%20(HFRS,which%20use%20rodents%20as%20hosts.