Diagnosing and Treating Hantavirus Infection

Diagnosis starts with the clinical picture and a history of possible exposure — recent contact with rodents or rodent-infested spaces. It's confirmed through laboratory testing that detects hantavirus nucleic acid, viral proteins, or hantavirus-specific IgM and IgG antibodies in blood.

Supporting lab findings include a low platelet count (thrombocytopenia) and elevated creatinine in both diseases, plus protein in the urine (proteinuria) in HFRS.

There is no antiviral drug proven broadly effective against hantavirus infection. Ribavirin and favipiravir have been studied and show only limited efficacy.

A vaccine against Hantaan-type viruses, Hantavax, has been licensed in South Korea since 1990 and is used there for HFRS-causing viruses. No vaccine is widely available for the hantaviruses that cause HPS in the Americas.

Because there's no cure, treatment focuses on intensive supportive care that keeps a patient alive while their body fights the infection. For HPS, that can mean continuous cardiac monitoring and respiratory support — up to mechanical ventilation, extracorporeal membrane oxygenation (ECMO), or hemofiltration.

For HFRS, supportive treatment centers on intravenous fluids, electrolyte management, platelet transfusions, and hemodialysis if acute kidney injury develops.

HPS in particular can deteriorate suddenly — death often occurs two to ten days after symptoms begin, during the cardiopulmonary phase. Getting to a hospital equipped for intensive care as soon as symptoms appear, especially after a known or suspected rodent exposure, meaningfully improves the odds of survival.