Hantavirus is a disease caused by one of several types of hantaviruses. Hantaviruses can cause a range of flu-like symptoms that progress over days and weeks. In the later stages of the disease, hantavirus can cause difficulty breathing as fluid builds up in your lungs.

Wild rodents, including mice and rats, can carry hantaviruses. People are most commonly exposed to hantaviruses when they come into contact with rodents and their urine, droppings, or saliva. This can be through food, contaminated air, or, rarely, a rodent bite.

In the United States, most people with hantavirus live west of the Mississippi River, though there have been reports of some people with it to the east of the river.

In North and South America, some hantaviruses can progress into a rare but severe lung disease called hantavirus pulmonary syndrome (HPS). HPS may begin with mild flu-like symptoms but can rapidly progress in a few days.

In other parts of the world, several strains of hantavirus are known to cause hemorrhagic fever with renal syndrome (HFRS).

This article will review the effects of HPS and HFRS, how doctors or other healthcare professionals manage these conditions, and what you can do to protect yourself against hantavirus infections.

Hantavirus is mainly an airborne virus. That means you come in contact from breathing in air that the virus has contaminated. The virus gets into the air when forces, such as the elements or other animal or human activity, stir up rodent urine, droppings, or nests.

But experts believe you can also contract the virus in other ways, including:

  • touching a contaminated object and then touching your nose or mouth
  • eating contaminated food
  • rodent bites, although rare

Types of hantaviruses and their carriers

Several different viruses can lead to hantavirus infection. Here are some of the more common hantaviruses along with their locations and hosts.

Viruses that cause HPS include:

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

Viruses that cause HFRS include:

  • Hantaan virus: carried by the striped field mouse in Eastern Asia and Russia
  • Saaremaa virus: carried by the striped field mouse in Central Europe and Scandinavia
  • Dobrava virus: carried by the yellow-necked field mouse in the Balkans
  • Puumala virus: carried by the bank vole in Scandinavia, Western Europe, and Western Russia
  • Seoul virus: carried by Norway rats globally
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A person with a hantavirus infection, including those that may cause HPS and HFRS, may develop symptoms anywhere between 1 to 3 weeks after exposure.

Symptoms often begin as mild and progress over a matter of days and weeks. As the disease progresses, the defining signs are:

The two most common diseases associated with hantavirus infections are HPS and HFRS. Let’s take a look at their symptoms.

Hantavirus pulmonary syndrome (HPS)

While many people experience a mild hantavirus infection, some hantavirus infections progress into HPS. HPS can eventually lead to fluid buildup, causing severe lung issues.

At first, a person with HPS may experience flu-like symptoms such as:

  • fever
  • fatigue
  • muscle aches
  • headache
  • dizziness
  • chills
  • nausea
  • vomiting
  • diarrhea
  • abdominal pain

Later, a person with HPS may develop coughing and shortness of breath caused by fluid buildup in the lungs. Such symptoms tend to develop 4 to 10 days after the earliest symptoms.

For some people, HPS can progress to respiratory failure and death. The mortality rate for HPS is high but can depend on the virus you have and where you are. According to the Centers for Disease Control and Prevention (CDC), is fatal in about 38% of people who contract it.

Hemorrhagic fever with renal syndrome (HFRS)

HFRS is a serious disease with early symptoms that resemble those of HPS. Symptoms usually develop in 2 to 4 weeks, but they can take up to 8 weeks to appear.

Once they appear, early flu-like symptoms last for 1 to 7 days. After that, more serious symptoms can develop. These include:

Some of the hantavirus strains known to cause HFRS can be fatal in up to 15% of people who contract it.

Even after recovering from the most serious symptoms, you may still experience mild symptoms for another 3 to 6 months.

People who come into contact with rodents carrying hantavirus are at risk of infection. Because different hantaviruses exist worldwide, the risk of infection exists for most people, though infections tend to be sporadic. But some people may be more prone than others.

You may be at higher risk of hantavirus infection if:

  • You live in a rural area where farms, fields, and forests serve as habitats for rodents who carry hantavirus.
  • You have a barn, shed, garage, basement, or other extension or part of your house that rodents use.
  • You have a rodent infestation inside of your house.
  • You often engage in activities where you might come into contact with rodent droppings, urine, saliva, or nesting materials.
  • You often engage in activities where you might stir the virus into the air, such as cleaning with a vacuum or gardening with a rake in areas where rodents live or have lived.
  • You’re cleaning or opening a long-unused building that rodents may inhabit.
  • You’re a construction, utility, or pest control worker who may come into contact with rodents, especially in small or unventilated crawlspaces.
  • You often camp or hike, especially if you use infested trail shelters or camp in other rodent habitats.

Overall, males appear to be more at risk. This is likely due to a higher percentage of males being involved in at-risk activities.

People 70 years old and older seem to be at greater risk of more serious disease and death.

It’s important for a doctor to diagnose a hantavirus infection early. Early diagnosis can help ensure the best possible treatment and outcome.

But it can be challenging to diagnose early hantavirus. The early symptoms tend to resemble symptoms of the flu or coronavirus disease 19 (COVID-19). If you have a fever and shortness of breath, along with a history of potential rodent exposure, you may have a hantavirus infection.

If you’re experiencing flu-like symptoms and think you’ve recently been exposed to rodents, it’s important to bring this up with a doctor. They can order an enzyme-linked immunosorbent assay (ELISA) to confirm hantavirus.

A doctor may also order the following tests to look for other symptoms:

How common are hantavirus infections in the United States?

In the United States, public health experts have tracked cases of people with hantavirus since the earliest formal diagnoses in 1993. As of the end of 2020, the most recent year for which data is available, there have been 833 people with a hantavirus infection across the country over 27 years. Close to 97% of those people’s infections resulted in HPS.

In 2020, there were 17 people with a hantavirus infection. One was in New York, but the other 16 were in states west of the Mississippi River. Hantavirus is considered rare.

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Hantavirus infection can progress into severe disease. The goal of treatment for hantavirus is to manage your symptoms to lower the risk of damage to your lungs and heart.

Due to severe pulmonary (lung) symptoms, many people will need help breathing. About 40% of people who go to the hospital with hantavirus symptoms require mechanical ventilation. If your symptoms don’t improve, your medical team might try extracorporeal membrane oxygenation (ECMO).

People who develop HFRS may require hemodialysis. This is a way to filter your blood until your kidneys recover.

A doctor may consider prescribing antiviral medication to help remove the virus from your system. No large human trial has shown any antiviral to be effective at treating various hantavirus strains. But some studies have seen positive results.

  • Ribavirin: Some studies suggest that ribavirin effectively treats the Hantaan and Andes viruses. But these effects seem to be useful only before pulmonary symptoms begin. It also has significant side effects. A 2021 animal study found positive results when using ribavirin together with favipiravir to treat the Hantaan virus.
  • Chloroquine: Known as an antimalaria drug, chloroquine has been seen to be effective against the Hantaan and Andes viruses in studies with rodents. There have been no human trials.
  • Monoclonal antibodies: Recent research suggests that monoclonal (human-made) antibodies could prevent infection from the Andes and Puumala viruses in rodents.

Note that these treatments are still being investigated. There’s no FDA-approved treatment for hantavirus.

The best way to prevent hantavirus infection is to lower your risk of exposure to rodents and the various ways they spread disease. Some tips include:

  • Wash your hands after spending time outdoors, such as when hiking. Wash them frequently when doing prolonged outdoor activities such as camping.
  • When camping, keep food and food supplies, as well as trash, contained and covered.
  • Avoid touching rodents or their urine or droppings. If you come into contact, wash your hands afterward.

About half of all infections stem from exposure to the virus around your home. There are steps you can take to protect your home as well.

  • Close up potential rodent entryways into your home.
  • Set traps or hire a pest control professional if you have a rodent infestation.
  • When cleaning an area potentially occupied by rodents, wear a properly fitting respirator mask (such as an N95) and gloves.
  • Keep your kitchen clean and store food off the counters to deter rodents.

Hantavirus is a rare but serious disease. Below are the answers to some common questions about hantavirus.

How long does it take for hantavirus symptoms to show?

Symptoms of hantavirus can start emerging around 1 week following exposure. But some people may not see symptoms until up to 8 weeks after exposure.

How long do hantavirus symptoms last?

The early stage of hantavirus symptoms can last up to 10 days. Symptoms can then progress rapidly.

If your hantavirus infection leads to HFRS and affects your kidneys, the most serious symptoms can last from 2 to 6 days. There will be another 2 weeks where you start to recover. But mild symptoms can linger for up to 1 year in some people.

Can humans transmit hantavirus?

Scientists haven’t observed human-to-human transmission of the hantaviruses that circulate in the United States. This means you can’t catch the disease from being around or interacting with someone who has the virus.

The Andes virus, found in South America, is the only hantavirus known to show human-to-human transmission.

Does hantavirus affect your brain?

Very early research suggested a link between HPS and reduced memory or cognitive impairment. Researchers at the time thought that hantavirus might damage your brain directly.

Recent research suggests that the Puumala virus may affect your central nervous system (CNS). Researchers found that people who developed a mild form of HFRS experienced CNS symptoms such as headache, insomnia, and vertigo. This may be due to the virus damaging people’s blood-brain barrier, but this isn’t clearly understood.

Is there a hantavirus vaccine?

There’s no vaccine for hantavirus available in the United States. While there have been many vaccine candidates, none have yet to be seen as effective or to surpass early clinical trials.

Hantaviruses are rare but serious diseases carried by rodents and transmitted to humans worldwide. Hantaviruses cause a progression of flu-like symptoms followed by respiratory symptoms that can be severe or fatal.

Some people’s infections of hantavirus may progress into HPS, a serious lung-related complication. Some develop into HFRS, a kidney-related complication.

The focus of hantavirus treatment is supportive care to manage your symptoms and prevent damage to your body.

The best way to prevent hantavirus is to avoid contact with rodents and their urine, droppings, and nesting materials.