Hantavirus in humans: a review of clinical aspects and management

Hantavirus infections are part of the broad group of viral haemorrhagic fevers. They are also recognised as a distinct model of an emergent zoonotic infection with a global distribution. Many factors influence their epidemiology and transmission, such as climate, environment, social development, eco...

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Published in:The Lancet infectious diseases Vol. 23; no. 9; pp. e371 - e382
Main Authors: Vial, Pablo A, Ferrés, Marcela, Vial, Cecilia, Klingström, Jonas, Ahlm, Clas, López, René, Le Corre, Nicole, Mertz, Gregory J
Format: Journal Article
Language:English
Published: United States Elsevier Ltd 01.09.2023
Elsevier Limited
Subjects:
Algorithms
Antiviral drugs
Blood vessels
Clinical aspects
Disease
Endothelial cells
Epidemiology
Hantaviridae
Hantavirus
Hemorrhage
Hemorrhagic fever with renal syndrome
Infections
Infectious diseases
Pathogenesis
Permeability
RNA polymerase
Rodents
Serology
Viruses
Argentina
South Korea
Sweden
Asia
United States > US
Panama
Europe
China
Finland
Chile
Germany
Russia
ISSN:1473-3099, 1474-4457, 1474-4457
Online Access:Get full text
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Summary:Hantavirus infections are part of the broad group of viral haemorrhagic fevers. They are also recognised as a distinct model of an emergent zoonotic infection with a global distribution. Many factors influence their epidemiology and transmission, such as climate, environment, social development, ecology of rodent hosts, and human behaviour in endemic regions. Transmission to humans occurs by exposure to infected rodents in endemic areas; however, Andes hantavirus is unique in that it can be transmitted from person to person. As hantaviruses target endothelial cells, they can affect diverse organ systems; increased vascular permeability is central to pathogenesis. The main clinical syndromes associated with hantaviruses are haemorrhagic fever with renal syndrome (HFRS), which is endemic in Europe and Asia, and hantavirus cardiopulmonary syndrome (HCPS), which is endemic in the Americas. HCPS and HFRS are separate clinical entities, but they share several features and have many overlapping symptoms, signs, and pathogenic alterations. For HCPS in particular, clinical outcomes are highly associated with early clinical suspicion, access to rapid diagnostic testing or algorithms for presumptive diagnosis, and prompt transfer to a facility with critical care units. No specific effective antiviral treatment is available.
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ISSN:1473-3099
1474-4457
1474-4457
DOI:10.1016/S1473-3099(23)00128-7