HPS — Hantavirus Pulmonary Syndrome (Americas)
HPS is the predominant form in the American continent, caused by strains such as Sin Nombre (USA) and Andes (Argentina/Chile). The disease progresses in rapid phases and can be fatal within days if not treated in an intensive care unit.
Early phase (days 1–5)
- Fever (38–40 °C)
- Fatigue and myalgia
- Headache
- Nausea, abdominal pain
- Dizziness
Cardiopulmonary phase (days 5–10)
- Cough (dry)
- Rapid respiratory failure
- Hypoxia — oxygen saturation drops
- Pulmonary oedema
- Cardiogenic shock (severe cases)
Convalescent phase
- Gradual respiratory improvement
- Diuresis increases
- Fatigue may persist weeks
- Full recovery possible with ICU support
HFRS — Haemorrhagic Fever with Renal Syndrome (Europe/Asia)
HFRS follows a well-defined five-phase pattern. In Europe, Puumala virus causes a generally mild form called nephropathia epidemica. Asian strains (Hantaan, Dobrava) can cause severe disease with significant mortality rates.
| Phase | Key symptoms |
|---|---|
| Febrile phase (days 1–3) | Fever, headache, blurred vision · Flushing, petechiae |
| Hypotensive phase | Blood pressure drop · Tachycardia · Abdominal pain |
| Oliguric phase | Reduced urine output · Electrolyte imbalance · Possible haemorrhage |
| Diuretic phase | Rapid increase in urine output · Fluid and electrolyte loss |
| Convalescent phase | Gradual renal recovery · Weeks to months |
Warning Signs: When to Seek Urgent Care
⚠️ Seek immediate medical attention if any of the following signs appear:
- Shortness of breath or difficulty breathing
- Cough with worsening symptoms after initial fever
- Sharp drop in blood pressure
- Decreased urine output
- Confusion or altered consciousness
- Chest tightness or pain
Diagnosis
Definitive hantavirus diagnosis requires specialised laboratory tests. Preliminary clinical diagnosis is based on epidemiological exposure (contact with rodent-infested environments) combined with the characteristic clinical picture.
IgM Serology
Detection of specific IgM antibodies. Positive from the first days of symptoms.
RT-PCR
Viral RNA amplification. High sensitivity in early acute phase.
Immunohistochemistry
Antigen detection in tissue. Used mainly in autopsies.
Treatment
There is no antiviral treatment specifically approved for hantavirus. Management is intensive supportive care: high-flow oxygen or mechanical ventilation for HPS, dialysis for severe HFRS. Ribavirin has been studied but evidence of efficacy is limited. Early ICU admission is the most important prognostic factor.
✓ Important context
Hantavirus remains a rare disease. Most people exposed to rodent-infested environments never contract the disease. If you have flu-like symptoms after potential exposure, inform your doctor of the context, but do not panic — other causes are far more likely.