Hantavirus Infection Guidelines

Clinical Syndromes and Severity

The Centers for Disease Control and Prevention recommends awareness of Hantaan and Dobrava viruses, which cause severe HFRS with up to 10% mortality, and Seoul virus, which causes mild HFRS with <1% mortality, and Puumala virus, which causes nephropathia epidemica (NE), a mild form with <1% mortality 1

The MMWR Recommendations and Reports suggest that workers should seek medical attention within 45 days of last potential rodent exposure if they develop febrile or respiratory illness 2
The MMWR Recommendations and Reports recommend immediate evaluation for any febrile or respiratory illness within 45 days of potential rodent exposure, and blood samples should be obtained and forwarded to state health departments for hantavirus antibody testing 2

The MMWR Recommendations and Reports advise suspecting hantavirus infection in patients with compatible symptoms and history of occupying or cleaning previously vacant cabins with rodent infestation, cleaning barns and outbuildings, disturbing rodent excreta or nests, handling mice without gloves, hiking or camping in endemic areas, or hand plowing or planting in rural settings 2
The MMWR Recommendations and Reports note that brief exposure is sufficient for infection, as little as 5 minutes in areas with infected rodents can cause disease 4

The MMWR Recommendations and Reports state that person-to-person transmission does not occur with North American hantaviruses, unlike some other viral hemorrhagic fevers 4
The MMWR Recommendations and Reports indicate that subclinical infection appears uncommon, and most infections result in clinically apparent disease 4
The MMWR Recommendations and Reports suggest that viral RNA has been detected in whole blood, lymphocyte fractions, and occasionally plasma during acute HPS 4