Hantavirus infection

Hantavirosis is an infectious disease caused by a hantavirus (Hantaviridae family). Rodents are the natural hosts of the virus, with the type of hantavirus varying according to the species of rodent. The transmission of the virus to humans occurs mainly through inhalation of virus particles contained in contaminated feces or saliva.   

What is Hantavirosis?

  • Hantavirosis is an infectious disease caused by one of the hantaviruses of the Hantaviridae family. There are different types of hantaviruses, each with its own host, geographic distribution, virulence and a different clinical picture after infection.
  • In America, hantaviruses cause haemorrhagic fever with pulmonary hantavirus syndrome
  • In Europe, hantaviruses, which are generally less virulent than in America, cause haemorrhagic fever with a renal syndrome.
  • Hantavirus infections in Belgium, and by extension in North-West Europe and Scandinavia, are mainly caused by the Puumala virus.

Transmission

  • Humans become infected with a hantavirus by inhaling virus particles from the urine, feces or saliva of infected rodents. People also sometimes become infected through a bite. 
  • In Belgium, the bank vole (Myodes glareolus) is the main host of hantaviruses. The bank vole lives in deciduous forests, scrub, the forest edge and parks and sometimes invades homes in winter.
  • Hantaviruses are not transmitted from person to person

Clinical presentation

  • The incubation period usually fluctuates between 2 to 3 weeks, but can last from 2 days to 2 years.
  • The following symptoms may manifest themselves in the first phase and are common to all hantavirus types: high fever, headache, muscle or back pain, followed after a few days by nausea, vomiting and abdominal pain and lower back pain. 
  • After a week, the clinical picture can change and three major clinical syndromes can be distinguished, depending on where the virus was contracted, and thus depending on the type of hantavirus. 
  1. Haemorrhagic fever with severe renal insufficiency (HFRS): mainly in Europe and Asia, caused by the Puumala, Seoul and Dobrava viruses. 
  2. Nephritis (NE): occurring in (Northern) Europe and caused by the Puumala virus. 
  3. Hantavirus cardiopulmonary syndrome (HPS): this occurs mainly in North and South America and is caused by the Andes virus, Sin Nombre virus and several others. 
  • The presentation of symptoms in people with hantavirosis can range from no or few symptoms to severe symptoms. For the Puumala virus, the number of fatal cases is 0.1-0.4%. 

Prevention

Avoiding or minimising contact with rodents is the most effective way to prevent infestations. This is especially true for people who enter wooded areas for work, as well as for people who work with rodents as part of their profession.   

Diagnosis and treatment

  • The diagnosis of Hantavirosis is based on serological testing, antigen detection or on the detection of genetic material by PCR
  • There is currently no treatment for hantavirosis. The treatment is mainly symptomatic.  

Sciensano is responsible for the epidemiological surveillance of hantavirosis in Belgium. For this, we collect data via various surveillance systems. This enables us to describe the occurrence of the disease, follow trends over time and identify potential risk factors for infection.

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