Hantavirus refers to a family of viruses carried by rodents that can cause serious illness or death in humans.
Hantavirus infections and illnesses are not common in the United States.
People usually get a hantavirus infection through close contact with rodents. Most often, this occurs by ingesting or inhaling infected particles from their feces, urine, or saliva.
A hantavirus infection can cause two main illnesses. One, known as hantavirus pulmonary syndrome (HPS), affects the lungs. The other, known as hemorrhagic fever with renal syndrome (HFRS), affects the kidneys. Both can be deadly.
There is no specific treatment for hantavirus illness. At UPMC, we can provide rapid, accurate diagnoses and supportive care for your symptoms.
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What Is Hantavirus?
Hantaviruses are a group of viruses carried by rodents that can spread to humans.
Although hantavirus infections are uncommon, they can cause severe, potentially deadly illnesses in people.
What are the types of hantavirus illness?
Hantavirus infections can cause two serious illnesses in humans:
- Hantavirus pulmonary syndrome (HPS) — HPS is a severe, potentially deadly illness that affects the lungs. According to the Centers for Disease Control and Prevention (CDC), 38% of people who develop respiratory symptoms may die. HPS is most common in North, Central, or South America.
- Hemorrhagic fever with renal syndrome (HFRS) — This serious illness affects the kidneys. The severity depends on the specific hantavirus that causes your infection, but it can be deadly. HFRS is most common in Europe and Asia.
Because HPS and HFRS can be deadly, preventing hantavirus infection is crucial.
How common is hantavirus infection?
Hantavirus infections and illnesses are not common in the United States.
According to the CDC, there were 890 reported cases of hantavirus disease in the United States between 1993 and 2023. Most of those cases were in states that are west of the Mississippi River.
While hantavirus illnesses aren't common, they can be serious — even deadly. Because of that, people should take great care to prevent infection.
What causes hantavirus infection?
Hantavirus is rodent-borne but can spread to humans. Usually, hantavirus is spread to humans when they have close contact with infected rodents (mice or rats).
Most often, hantavirus transmission happens when you inhale or ingest infected particles from rodents' saliva, feces (droppings), or urine. Less often, you can get a hantavirus infection after being bitten by an infected rodent.
The most common carriers of hantavirus in the United States are:
- Cotton rats
- Deer mice
- Rice rats
- White-footed mice
Human-to-human hantavirus spread is possible with one specific hantavirus called the Andes virus. This virus, found primarily in South America, requires close and extended contact to spread from person to person.
Hantavirus risk factors
The biggest risk factor for hantavirus is exposure to infected rodents.
You may be more at risk if you:
- Handle, clean up after, or dispose of rodents.
- Have rodents as pets.
- Work with live rodents.
Some people are more at risk of serious illness from a hantavirus infection.
These include:
- Children under the age of 5.
- People with weakened immune systems.
- Pregnant women.
People in these groups should avoid having pet rodents, according to the CDC.
Complications of hantavirus infection
Hantavirus infection can cause serious illnesses.
In severe cases, these diseases can cause:
- Acute kidney complications.
- Severe breathing problems.
- Death.
How can I prevent hantavirus infection?
The most effective way to prevent a hantavirus infection is by avoiding exposure to rodents.
You can do that at home by:
- Checking for entry points and sealing them — Rodents can enter your home through any gap wider than a pencil. Inspect your indoors and outdoors for potential rodent entry points. Seal the holes with steel wool, caulk, metal screens, or other patching material.
- Maintaining your outdoors — Keep items such as garbage bins, wood piles, and bird feeders away from your house. Keep your lawn and shrubs well-maintained and remove weeds and brush.
- Sealing away food — Keep human and pet food and birdseed in tightly sealed plastic or glass containers. Clean up quickly after cooking, eating, or spilling, and don't leave pet food and water bowls out overnight. Keep your garbage in a bin with a tight-fitting lid and take out your trash regularly.
Warning signs of rodent infestation indoors can include gnaw (chew) marks and rodent feces (droppings). If you notice these signs, it's important to take steps to safely trap the rodents and safely dispose of urine, feces, and nesting materials.
How to clean up rodent droppings and urine
- Wear rubber or plastic gloves.
- Spray the feces or urine with a disinfectant cleaning product or bleach solution. Let it soak for at least five minutes.
- Using paper towels, wipe up the feces, urine, and cleaning product. Place the paper towels in a tight-lidded garbage can that you regularly change.
- Using a disinfectant and mop or sponge, scrub the entire area. Make sure to scrub all hard surfaces.
- Wash your gloved hands with soap and water or disinfectant before removing the gloves.
- Wash your hands with soap and water after removing your gloves.
Do not vacuum or sweep up rodent droppings or urine. Doing so can release potentially harmful particles into the air.
What Are the Signs and Symptoms of Hantavirus Illness?
Hantavirus pulmonary disease and hemorrhagic fever with renal syndrome cause different symptoms.
The early signs of hantavirus illness are typically flu-like symptoms. They then progress to more severe symptoms involving the lungs (HPS) and kidneys (HFRS).
Hantavirus pulmonary syndrome symptoms
HPS typically begins with flu-like symptoms before progressing to respiratory symptoms.
The early symptoms begin one to eight weeks after hantavirus exposure and include:
- Abdominal pain.
- Diarrhea.
- Dizziness.
- Fatigue.
- Fever and chills.
- Headaches.
- Muscle aches — Especially in areas like the back, hips, thighs, and shoulders.
- Nausea and vomiting.
The later symptoms appear four to 10 days after the early symptoms.
These symptoms involve the respiratory system and include:
- Chest tightness.
- Cough.
- Shortness of breath.
According to the CDC, 38% of people who develop respiratory symptoms may die from HPS.
Hemorrhagic fever with renal syndrome symptoms
Like HPS, hemorrhagic fever with renal syndrome usually begins with flu-like symptoms. The early symptoms usually appear one to two weeks after exposure to hantavirus. Sometimes, they can take as long as eight weeks to appear.
Early symptoms of HFRS include:
- Abdominal pain.
- Back pain.
- Blurry vision.
- Eye problems — inflammation or redness.
- Face flushing.
- Fever and chills.
- Nausea.
- Rash.
- Severe headaches.
Later symptoms involve the renal system (kidneys) and include:
- Acute shock.
- Internal bleeding.
- Kidney failure.
- Low blood pressure.
When should I see a doctor about my hantavirus disease symptoms?
Both HPS and HFRS can be deadly. If you have been exposed to a rodent or rodent excretions and have symptoms, call a medical provider immediately.
How Do You Diagnose Hantavirus Infection?
A medical history and laboratory tests can help diagnose a hantavirus infection. Early symptoms of HPS and HFRS can resemble many other illnesses, so a detailed medical history is important.
Your provider will ask you about your symptoms and when they first appeared. If you had a known exposure to rodents or their excretions or traveled to a location where hantavirus is circulating, it's important to mention those details.
Your provider will order blood tests.
Tests to diagnose hantavirus infection
Your symptoms and exposure to rodents can give your provider an idea that you may have a hantavirus infection. However, laboratory blood testing is needed to confirm a diagnosis.
You will have blood drawn and sent for testing. Hantavirus antibodies and other markers in your blood can confirm a hantavirus infection.
Hantavirus disease prognosis
Both hantavirus pulmonary syndrome and hemorrhagic fever with renal syndrome can be severe and deadly.
The survival rate of hantavirus illness depends on factors like:
- The type of hantavirus-related disease you have.
- The specific virus causing your infection.
- The severity of your symptoms.
- How quickly you began treatment.
Hantavirus pulmonary syndrome can be very deadly. According to the CDC, 38% of people who develop respiratory symptoms may die.
Hemorrhagic fever with renal syndrome can also be deadly. According to the CDC, the survival rate depends on the type of hantavirus causing the illness. For example, the Hantaan and Dobrava viruses cause severe symptoms with higher death rates. The Seoul, Saaremaa, and Puumala viruses cause more moderate illness and a lower death rate.
How Do You Treat Hantavirus Illness?
There are no specific treatments for hantavirus diseases. Treatment options for hantavirus usually focus on managing symptoms and preventing complications. Rest and hydration are also important.
Medicines for hantavirus illness
Your provider may prescribe medications to manage your symptoms and prevent complications.
Examples include:
- Blood pressure medications.
- Fever-reducing medications.
- Pain-relieving medications.
- Ribavarin — An antiviral medication. When given to people with HFRS early, it can be effective in preventing severe complications and death.
Respiratory support for hantavirus pulmonary syndrome
If you develop breathing problems from HPS, you may need respiratory support. This typically occurs in a hospital setting, often in intensive care.
You may need intubation, which is a tube that helps you breathe.
A form of life support known as extracorporeal membrane oxygenation (ECMO) can also be effective.
Dialysis for hemorrhagic fever with renal syndrome
Because HFRS can affect kidney function, people who have the illness may need dialysis. Dialysis helps remove toxins from the blood and keeps body fluids balanced for people with impaired kidneys.
Is hantavirus treatment right for me?
If you have a hantavirus infection, treatment is necessary to manage your symptoms and prevent complications. Without early diagnosis and treatment, you have a higher risk of severe illness and death.
How long does it take to recover after treatment for hantavirus illness?
Your recovery time depends on your specific case. In general, it can take anywhere from a few weeks to several months to recover from hantavirus illness.
