Quick answer
Hantavirus case fatality rates range from <0.5% (HFRS from Puumala in Europe) to 35–40% (HPS from Andes or Sin Nombre virus in the Americas). There is no single CFR for hantavirus — it is a group of diseases caused by different strains with very different mortality profiles. The 2026 MV Hondius outbreak (Andes virus) showed an observed CFR of approximately 43% (7 confirmed cases, 3 deaths), though this must be interpreted cautiously given the small sample size.
Hantavirus Case Fatality Rate (CFR) by Strain
Hantavirus mortality figures vary drastically by viral strain, geographic region and access to critical care. The table below summarises current case fatality rate (CFR) data from WHO, CDC, ECDC and peer-reviewed literature. All figures represent reported estimates and may vary by outbreak, patient population and healthcare setting.
| Disease / Strain | Region | CFR | Notes |
|---|---|---|---|
| HPS — Sin Nombre virus | USA / Canada | ~36% | Historical CDC data. ICU care improves outcomes. |
| HPS — Andes virus | Argentina / Chile | 35–40% | Includes 2026 MV Hondius outbreak data. |
| HPS — Laguna Negra | Paraguay / Bolivia | ~15–25% | Less virulent than Sin Nombre; earlier surveillance. |
| HFRS — Puumala virus | Northern Europe | <0.5% | Mild nephropathia epidemica; rarely fatal. |
| HFRS — Dobrava-Belgrade | Balkans / SE Europe | 5–12% | Variable by sub-lineage; Dobrava-Kurkino milder. |
| HFRS — Hantaan virus | China / Korea / Russia | 5–15% | Highest burden globally; hundreds of thousands annually. |
| HFRS — Seoul virus | Global (commensal rat) | <1% | Distributed worldwide via Rattus norvegicus. |
HPS vs HFRS Fatality Statistics
Hantavirus Pulmonary Syndrome (HPS) and Haemorrhagic Fever with Renal Syndrome (HFRS) are caused by different strains, affect different organs and carry very different fatality statistics. HPS strikes the cardiopulmonary system rapidly; HFRS primarily affects the kidneys with a more gradual progression.
HPS — Americas
35–40%- Affects lungs and heart
- Progresses within days
- Urgent ICU required
- Strains: Sin Nombre, Andes
- High mortality without ICU
HFRS — Europe / Asia
< 0.5 – 15%- Primarily affects kidneys
- More gradual progression (weeks)
- Can be managed without ICU (mild)
- Strains: Puumala, Hantaan, Dobrava
- Higher mortality in Asian strains
Andes Hantavirus Mortality Rate
Andes virus (Orthohantavirus andesense) is the primary cause of HPS in South America. It is the only hantavirus type known to spread person-to-person, although this appears uncommon and is usually limited to close contacts. Its case fatality rate of 35–40% is comparable to Sin Nombre virus, making it one of the deadliest hantavirus strains globally. It is endemic in Argentina, Chile and parts of Bolivia and Uruguay.
Unlike Sin Nombre, Andes virus can spread between people — though transmission appears uncommon and is typically limited to close contacts. This raises distinct clinical concerns around isolation of confirmed cases and 45-day monitoring of close contacts, and influenced the ECDC and WHO response protocols during the 2026 MV Hondius outbreak.
7
Confirmed
3
Deaths
~43%
Obs. CFR
MV Hondius · Andes virus · 2026 outbreak · Small sample — interpret cautiously
Hantavirus Mortality Rate by Age
Hantavirus does not follow a clear age-related immunity pattern. Documented cases span all age groups, including children and teenagers, and HPS severity does not differ significantly between paediatric and adult patients. The higher proportion of deaths in working-age adults (15–64) seen in CDC surveillance data reflects occupational and outdoor exposure patterns, not reduced biological susceptibility in younger individuals.
Patients over 60 with pre-existing cardiovascular or renal disease show consistently worse outcomes in both HPS and HFRS. No vaccine or age-specific immunity exists for any hantavirus strain. Age is a prognostic variable, not a protective factor. The most important modifier of outcome at any age remains speed of access to intensive care.
Hantavirus Death Rate: Key Risk Factors
Mortality is not a fixed number. Multiple clinical and contextual variables determine whether a patient survives hantavirus infection. The most modifiable — and most important — factor is speed of access to intensive care.
Time to ICU admission
Early admission (< 24 h from respiratory onset) significantly reduces mortality in HPS.
Viral load at presentation
Higher initial viral load correlates with more severe cardiopulmonary compromise.
Age
Older patients show worse outcomes in both HPS and HFRS; no age immunity exists in children.
Comorbidities
Cardiovascular, renal and immunosuppressive conditions worsen prognosis.
Strain virulence
Sin Nombre and Hantaan strains are consistently more lethal than Puumala or Seoul.
Healthcare access
Remote exposure locations (e.g. outdoor workers) delay diagnosis and worsen outcomes.
Extracorporeal support
ECMO has improved survival in severe HPS cases; increasingly available in referral centres.
Worldwide Hantavirus Death Statistics
Published estimates place the global burden of hantavirus disease at roughly 150,000–200,000 cases per year, with most HFRS cases reported in Asia — primarily China, Korea and Russia. The incidence of HPS is considerably lower: PAHO and CDC surveillance registers approximately 200–2,000 cases per year across the Americas, with the most complete data from Chile, Argentina and the United States.
Global data are subject to significant underreporting, particularly in regions without systematic serological surveillance. WHO acknowledges that true hantavirus incidence is likely considerably higher than recorded figures. European hantavirus deaths are relatively few given Puumala dominance; the greatest death burden comes from Asian HFRS (Hantaan virus) and HPS in the Americas.
2026 Outbreak Context: MV Hondius
The 2026 MV Hondius outbreak has generated renewed interest in hantavirus mortality statistics. WHO has confirmed 7 cases and 3 deaths linked to the cruise ship, giving an observed CFR of approximately 43% among confirmed cases. This figure must be interpreted cautiously because the sample size is small and case counts may change. ECDC, WHO and PAHO have all contacts under 45-day surveillance.
Hantavirus Mortality Rate — Frequently Asked Questions
What is the mortality rate of hantavirus?
Hantavirus mortality rates range from under 0.5% to approximately 40%, depending on the strain and disease type. Hantavirus Pulmonary Syndrome (HPS), caused by Sin Nombre or Andes virus in the Americas, carries a case fatality rate of approximately 35–40% even with intensive care. Haemorrhagic Fever with Renal Syndrome (HFRS) from Puumala virus in northern Europe has a fatality rate below 0.5%, while Hantaan virus in Asia reaches 5–15%. There is no single hantavirus mortality rate — the pathogen encompasses multiple strains with very different death rates.
What is the case fatality rate (CFR) of hantavirus?
The case fatality rate (CFR) varies widely by strain. HPS strains carry the highest CFRs: Sin Nombre ~36% (CDC historical data), Andes virus 35–40%. HFRS strains range from below 0.5% (Puumala, Seoul) to 5–15% (Hantaan) and 5–12% (Dobrava). CFR estimates may understate true mortality in regions with limited surveillance or delayed hospital access.
Which hantavirus strain has the highest death rate?
Sin Nombre virus (USA, Canada) and Andes virus (Argentina, Chile) carry the highest individual hantavirus death rates, with case fatality rates around 35–40%. Among HFRS strains, Hantaan virus causes the highest absolute death toll globally due to its enormous case burden in China and Korea, even though its per-case CFR (5–15%) is lower than HPS strains.
Is Andes hantavirus more deadly than other strains?
Andes virus has a case fatality rate of 35–40%, comparable to Sin Nombre virus, making it among the deadliest hantavirus strains. It also poses a unique risk: Andes is the only hantavirus type known to spread person-to-person, although this appears uncommon and is usually limited to close contacts. The 2026 MV Hondius outbreak — 7 confirmed cases and 3 deaths — showed an observed CFR of approximately 43%, though small sample sizes make precise estimates unreliable for individual outbreaks.
What is the difference between HPS and HFRS mortality?
HPS (Hantavirus Pulmonary Syndrome) primarily affects the lungs and cardiovascular system. It progresses rapidly within 1–5 days of symptom onset and carries a CFR of 35–40%. HFRS (Haemorrhagic Fever with Renal Syndrome) primarily damages the kidneys, progresses more gradually over days to weeks, and has a much wider CFR range: below 0.5% for mild European strains (Puumala) to 5–15% for Asian strains (Hantaan). HPS kills more quickly and more often; HFRS is usually milder but still fatal in severe cases.
Does hantavirus death rate vary by age?
Hantavirus does not spare younger patients — HPS has been documented in children and teenagers with comparable severity to adult cases. Older patients and those with pre-existing cardiovascular or renal conditions consistently show worse outcomes in both HPS and HFRS. Most reported HPS deaths in CDC surveillance fall in the 15–64 age range, but this reflects occupational and outdoor exposure patterns rather than reduced disease severity in younger groups. Age is a prognostic variable, not a protective factor.
Sources
Medical disclaimer: This page is for informational purposes only and does not replace professional medical advice. If you suspect hantavirus infection, seek emergency care immediately.