What is hantavirus?

Hantaviruses are a group of viruses that occur worldwide and are mainly transmitted by rodents (such as mice and rats). In Germany, two main types are relevant:

• Puumala virus (transmitted by the vole) – causes most cases.
• Dobrava-Belgrade virus (transmitted by the fire mouse).

Infection usually occurs by inhaling virus-containing dust from feces, urine or saliva of infected rodents (e.g. when mucking out barns, gardening or renovations). Human-to-human transmission is extremely rare in Europe. The disease is notifiable.

Symptoms

The incubation period is usually 1–4 weeks (sometimes up to 8 weeks). Many infections are mild or even unnoticed. Typical course in Central Europe (hemorrhagic fever with renal syndrome – HFRS):

1. First phase (flu-like, 3–4 days):

• Sudden high fever (>38 °C)
• Severe headache, back and aching limbs
• Chills, fatigue
• Nausea, vomiting, abdominal pain

1. Second phase:

• Drop in blood pressure
• kidney problems (less urine, foamy or bloody urine, acute kidney failure)
• Rarely bleeding or lung involvement

In North and South America, severe hantavirus pulmonary syndrome (HPS) can occur with life-threatening pneumonia and shortness of breath – very rare in Europe.

Most cases in Germany heal without consequences, severe courses requiring dialysis are possible, but rarely fatal.

Detection (diagnosis)

• Serology (antibody detection): Standard method. IgM antibodies (fresh infection) and IgG antibodies (ELISA, immunoblot) are detected in the blood. IgM can usually be detected at the onset of symptoms.
• Direct virus detection: PCR from blood possible in the very early phase, but rarely necessary.
• Blood tests for kidney values, blood counts, etc. support the diagnosis.

Important: If you suspect (e.g. after rodent contact + flu-like symptoms + kidney problems), see a doctor quickly!

Therapy

There is no specific antiviral drug against hantaviruses. Treatment is purely symptomatic and supportive:

• Fever reducers and painkillers (e.g. paracetamol)
• Sufficient fluids, circulation stabilization
• In case of kidney failure: dialysis (usually temporary)
• In severe cases: intensive care unit, oxygen, ventilation if necessary

Early detection significantly improves the prognosis. Ribavirin is tried in some severe cases (especially outside Europe), but it is not effective as standard.

No vaccination available.

Important notes

• Particularly risky: tidying up long unused rooms, gardening in spring/summer.
• Protection: Wear respiratory protection, wipe with a damp cloth instead of sweeping, keep rodents away.
• The number of cases fluctuates greatly depending on the mouse population.

The article was originally published by LabNews Media LLC

Further information:

RKI – RKI-Ratgeber – Hantavirus disease

Editor: X-Press Journalistenbüro GbR

Gender Notice. The personal designations used in this text always refer equally to female, male and diverse persons. Double/triple naming and gendered designations are used for better readability ected.