Zoonoses transmitted by various rodent species. These viruses are present in rodent urine and droppings. Humans contract the infection through contact with rodents or their droppings or urine, and probably through inhalation of viral particles in areas where large quantities of rodent excrement are found. Most hantaviruses do not spread from human to human, except in the case of the Anes hantavirus in Chile.

The incubation period varies from 1 to 6 weeks (with an average of 2 weeks). Symptoms of hantavirus infection begin with a sudden onset of fever, headache and muscle pain. Abdominal pain, diarrhea or vomiting may also be observed.

More specifically, the virus can affect various organs:

-         the lungs, causing a cardiopulmonary syndrome, especially in America. This is a severe, sudden-onset syndrome with respiratory and cardiac failure (30-60 % mortality).

-         the kidneys, causing hemorrhagic fever with renal syndrome, especially in Europe and Asia. Hemorrhagic fever with renal syndrome is generally divided into 5 phases: febrile, hypotensive, oliguric, polyuric and convalescent. The duration of these phases and their severity (0.4 to 10 % mortality) depend in part on the viral species involved. Macroscopic hemorrhagic manifestations are present in around 15 % of cases. 

Hantaviruses are members of the Hantaviridae family (order Elliovirales). Their genome comprises 3 single-stranded RNA molecules of negative polarity, designated S (“small”), M (‘medium’), and L (“large”), coding for nucleoprotein N, two envelope glycoproteins (Gn and Gc), and an RNA-dependent RNA polymerase, respectively. Fifty-three species are officially reported, and the number of taxa described has recently increased significantly. Nearly 140 taxa are currently recognized, and hantaviruses are present on every continent. Each viral taxon is generally associated with a single natural host species, including rodents (rats, voles, field mice), insectivores (moles, shrews) and bats (47 viral species in all), as well as fish (5 viral species) and reptiles (1 viral species).

In Europe

-        Puumala virus (Orthohantavirus puumalaense species), responsible for the largest number of cases of hemorrhagic fever with renal syndrome (clinical form known as epidemic nephropathy). Its reservoir is the bank vole (Clethrionomys glareolus, formerly known as Myodes glareolus ), which lives in forests and forest bangs. It circulates in Northern and Western Europe, with a case-fatality rate of around 0.4 %.

-        Seoul virus (Orthohantavirus seoulense species), whose main reservoir is the brown rat (Rattus norvegicus), but human cases reported in Europe are infrequent and certainly underestimated.

-        Dobrava, Kurkino and Saaremaa viruses (Orthohantavirus dobravaense species) circulate in the Balkans and Central Europe, causing severe human disease (mortality rate up to 10 %). The reservoir of the Dobrava virus is the forest-dwelling collared field mouse (Apodemus flavicollis).

-        Tula virus (Orthohantavirus tulaense species), whose reservoir is the common vole (Microtus arvalis) in the Jura mountains, Bas-Rhin and Aveyron. This rodent is present in open environments and forest edges.

Treatment is symptomatic. No specific treatment is available. The transfusion of human plasma containing antibodies to the Andes virus has greatly reduced mortality in patients infected with this virus. Infection is prevented mainly by limiting contact with rodents and their secretions and excretions.

Anesthetic implications: 

check renal and hepatic function;

References : 

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Updated: June 2025