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Hantavirus Infection: Causes, Symptoms and Treatment

Hantavirus infection is a viral disease transmitted by rodents that can affect the lungs or kidneys. Early diagnosis and supportive treatment are essential for recovery.

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Things worth knowing about "Hantavirus Infection"

Hantavirus infection is a viral disease transmitted by rodents that can affect the lungs or kidneys. Early diagnosis and supportive treatment are essential for recovery.

What Is a Hantavirus Infection?

A hantavirus infection is an infectious disease caused by hantaviruses, which are transmitted to humans through contact with infected rodents or their excretions. Hantaviruses belong to the family Hantaviridae and are found worldwide. Depending on the geographic region, different virus types and clinical presentations occur. In Europe, particularly in Germany, the Puumala virus -- transmitted by the bank vole -- is the most common strain.

Causes and Transmission

Hantaviruses are primarily transmitted through direct or indirect contact with infected rodents. The main routes of transmission include:

Inhalation of contaminated dust (e.g., when sweeping barns, warehouses, or cabins where rodents have been present)
Direct contact with rodents or their urine, droppings, or saliva
Bite wounds from infected rodents (rare)

Human-to-human transmission is not known in Europe, but has been reported for the South American Andes virus. High-risk groups include forestry workers, farmers, and individuals cleaning barns, basements, or forest cabins.

Symptoms

Depending on the organ system affected, two main clinical syndromes are distinguished:

Hemorrhagic Fever with Renal Syndrome (HFRS)

This form, common in Europe, primarily affects the kidneys. Typical symptoms include:

Sudden high fever
Severe headache, back pain, and abdominal pain
Nausea and vomiting
Acute kidney injury (reduced urine output, fluid retention)
In severe cases: bleeding tendency (petechiae, nosebleeds)

Hantavirus Pulmonary Syndrome (HPS)

This form, predominantly seen in the Americas, affects the lungs and carries a higher mortality rate:

Fever, muscle aches, and fatigue
Rapid progression to severe respiratory failure (shortness of breath, cough)
Circulatory shock in severe cases

Diagnosis

Hantavirus infection is diagnosed through:

Blood tests: Detection of specific antibodies (IgM and IgG) using ELISA or indirect immunofluorescence assay
PCR testing (polymerase chain reaction): Direct viral detection in blood, especially in the early phase of illness
Laboratory findings: Elevated kidney retention values (creatinine, urea), thrombocytopenia (low platelet count)
Clinical history including questions about potential rodent exposure

Treatment

No specific approved antiviral therapy for hantavirus infections is currently available in Europe. Treatment is therefore symptomatic and supportive:

Strict bed rest and close monitoring of cardiovascular and kidney function
Fluid management: Careful hydration to support kidney function
For severe kidney failure: dialysis
Oxygen therapy and, if necessary, mechanical ventilation for pulmonary syndrome
The antiviral drug ribavirin is used in some countries, though scientific evidence for its benefit remains inconclusive

Most patients with the European form (HFRS) recover fully. The case fatality rate for HFRS in Europe is below 1%, while the American pulmonary syndrome carries a significantly higher mortality rate of up to 40%.

Prevention

Since no approved vaccine against hantavirus is available in Europe (vaccines exist in some Asian countries), prevention relies on behavioral measures:

Wearing respiratory protection masks when cleaning barns, basements, or cabins
Using gloves when handling potentially contaminated material
Controlling and preventing rodent infestations in living areas
Storing food safely to deter rodents
Washing hands thoroughly after outdoor activities or exposure to rodent-infested areas

References

Robert Koch Institut (RKI): Hantavirus diseases in Germany. RKI Advisory, 2023. Available at: www.rki.de
World Health Organization (WHO): Hantavirus disease. Fact Sheet, 2023. Available at: www.who.int
Krautkraemer E, Zeier M, Krueger DH: Hantavirus infection: an emerging infectious disease causing acute renal failure. Kidney International, 2013; 83(1): 23-27.

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