Hantavirus Infection - Infections - Merck Manuals Consumer Version

Hantavirus infection is a viral disease that is transmitted from rodents to people. The virus can cause serious infections of the lungs (with cough and difficulty breathing) or kidneys (with abdominal pain and sometimes kidney failure).

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Hantaviruses are transmitted through contact with infected rodents or their droppings.
The infection begins with a sudden fever, headache, muscle aches, and sometimes abdominal symptoms, which may be followed by cough and difficulty breathing or kidney problems.
Blood tests to identify the virus can confirm the diagnosis.
If the lungs are affected, oxygen and medications are used to stabilize blood pressure, and dialysis may be necessary if the kidneys are affected.

(See also Overview of Arbovirus, Arenavirus, and Filovirus Infections.)

Hantaviruses infect several species of rodents around the world. The virus is present in the urine and feces of rodents. The infection is transmitted when people have contact with rodents, their droppings, or urine, or possibly when they inhale virus particles in places with large amounts of rodent droppings. Most hantaviruses are not transmitted from person to person; In rare cases, Andean hantavirus in southern South America spreads directly between people in close physical contact. Hantavirus infections are becoming more common.

There are several species of hantavirus. Depending on the species, the virus affects different organs:

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

However, many symptoms of the 2 infections overlap.

He pulmonary syndrome It has been found in the western United States and Canada, as well as in countries in Central and South America.

He kidney syndrome It occurs mainly in parts of Europe, Korea, China and Russia. This virus is transmitted by Norway brown rats and has spread around the world by rats on ships. In the United States, Canada and Europe, there have been some cases of HFRS hantavirus infection, transmitted by pets or laboratory rats.

Symptoms of hantavirus infection

Symptoms of hantavirus infection begin with a sudden fever, headache, and muscle aches, usually about 2 weeks (but possibly up to 6 weeks) after exposure to rodent droppings or urine. People may also have abdominal pain, diarrhea, or vomiting.

These symptoms continue for several days.

People with pulmonary syndrome develop cough and difficulty breathing, which can worsen within hours. Fluid builds up around the lung and blood pressure drops.

Pulmonary syndrome causes death in up to approximately 50% of people. Those who survive the first few days improve quickly and make a full recovery in about 2 to 3 weeks.

In some people with hemorrhagic fever with renal syndrome, the infection is mild and causes no symptoms.

In others, vague symptoms (such as high fever, muscle aches, headache, and nausea) begin suddenly. People with mild symptoms make a full recovery.

In others, the symptoms become severe. Very low blood pressure (shock) develops in a few people. kidney failure develops and urine production may stop (called anuria). People may have blood in their urine and/or stool and bruises on their skin. Death occurs in up to 15%, depending on the strain of the virus and the person’s underlying medical problems. Of those who survive, most recover in 3 to 6 weeks, but recovery can take up to 6 months.

Diagnosis of hantavirus infection

A hantavirus infection is suspected when people who may have been exposed to the virus develop characteristic symptoms.

Blood tests to identify the virus can confirm the diagnosis.

Doctors perform other blood tests to evaluate the function of the kidneys and other organs. If pulmonary syndrome is suspected, a chest x-ray may be performed. Echocardiography (ultrasound of the heart) is usually done to exclude other cardiac causes of fluid around the lungs.