What is Hantavirus (Hantavirus) infection?

From the Guidelines

Hantavirus is a rare but potentially deadly virus that requires immediate medical attention if exposure is suspected, with a mortality rate of approximately 37% as of 2002 1.

Key Points

• The primary approach to managing hantavirus is prevention, as there is no specific treatment or vaccine available.
• Prevention measures include sealing homes against rodents, proper cleaning of rodent-infested areas using bleach solutions (1 part bleach to 10 parts water) while wearing rubber gloves and masks, avoiding sweeping or vacuuming rodent droppings, and maintaining cleanliness to discourage rodent infestations.
• Rodent control in and around the home remains the primary strategy in preventing hantavirus infection, with the interior and exterior of the home being carefully inspected at least twice per year for any openings where rodents could enter the home and for conditions that could support rodent activity 1.
• Persons who frequently handle or are exposed to wild rodents are probably at higher risk for hantavirus infection than the general public, and therefore, enhanced precautions are warranted to protect them against hantavirus infection 1.

Prevention and Precautions

• If exposure is suspected, seek medical attention immediately, as early supportive care in an intensive care setting can improve survival rates.
• The virus cannot spread from person to person in North America, though some South American variants can.
• Hantavirus is particularly dangerous because of its high mortality rate, making prevention and early detection crucial.
• Special precautions should be taken if a structure is associated with a confirmed case of hantavirus disease or if evidence of heavy rodent infestation is present, such as piles of feces or numerous nests or dead rodents 1.

From the Research

Hantavirus Overview

• Hantavirus is a significant and emerging global public health threat, impacting more than 200,000 individuals worldwide each year 2.
• The virus belongs to the Hantaviridae family and is responsible for causing two acute febrile diseases in humans: Hantavirus pulmonary syndrome (HPS) and hemorrhagic fever with renal syndrome (HFRS) 2.

Clinical Presentation and Diagnosis

• Hantavirus cardiopulmonary syndrome presents as a vague prodrome of fever, cough, myalgias, chills, and nausea followed by a rapidly worsening respiratory phase 3.
• Presumptive diagnosis can be made based on pulmonary interstitial edema on chest radiographs in association with leukocytosis, thrombocytopenia, and hemoconcentration 3.
• A wide range of different diagnostic tools including polymerase chain reaction (PCR), focus reduction neutralization test (FRNT), enzyme-linked immunosorbent assay (ELISA), immunoblot assay (IBA), immunofluorescence assay (IFA), and other molecular techniques are used as detection tools for hantavirus in the human body 4.

Treatment and Prevention

• Currently, there are no licensed treatments or vaccines available globally for HTNV infection 2.
• Various candidate drugs have shown efficacy in increasing survival rates during the early stages of HTNV infection, including lactoferrin, ribavirin, ETAR, favipiravir, and vandetanib 2.
• Immunotherapy utilizing neutralizing antibodies (NAbs) generated from Hantavirus convalescent patients show efficacy against HTNV 2.
• Extracorporeal membrane oxygenation (ECMO) has been used as a rescue therapy in adult patients with severe cardiopulmonary failure from Hantavirus pulmonary syndrome, with some patients showing survival and good outcome 5.
• Rodent control and public health education and promotion play a major role in preventing Hantavirus infection 6.

Therapeutic Approaches

• The development of vaccines and antivirals, used independently and/or in combination, is critical for elucidating hantaviral infections and the impact on public health 2.
• RNA interference (RNAi) has emerged as an antiviral therapy, with small interfering RNA (siRNA) and other immune-based therapies targeting specific gene segments of the Hantavirus 2.
• Monoclonal antibodies such as MIB22 and JL16 have demonstrated effectiveness in protecting against HTNV infection 2.