Tracking hantavirus

The outbreak of a rare but potentially deadly virus on a cruise ship is, understandably, reminding people of the early days of the COVID-19 pandemic. But international health officials and infectious disease experts are urging people to pump the brakes on the panic.

Shalika Katugaha, MD, system director of infectious disease for Baptist Health, answered common questions about hantavirus, the culprit behind three deaths and multiple illnesses linked to MV Hondius cruise ship.

What is hantavirus?

Hantavirus is a family of viruses that primarily affects rodents, like mice or rats. According to Dr. Katugaha, around 200,000 human infections occur each year worldwide. Humans are most commonly infected by inhaling airborne particles from rodent urine, feces or saliva.

While human-to-human transmission is rare, it’s suspected in the cruise ship outbreak. The strain responsible, the Andes strain, is endemic to the area of Argentina from which the ship departed, and can be passed from one person to another via close, prolonged contact.

What are the symptoms of hantavirus?

According to the Centers for Disease Control and Prevention (CDC), the virus causes two main syndromes in humans:

Hantavirus cardiopulmonary syndrome (HCPS)

Also known as hantavirus pulmonary syndrome (HPS), this condition primarily is found in the western hemisphere (including in the United States) and affects the lungs. Symptoms appear one to seven weeks after exposure and initially may include:

• Fatigue
• Fever or chills
• Muscle Aches
• Headaches
• Dizziness
• Nausea, vomiting or diarrhea

Later symptoms include:

• Cough
• Shortness of breath
• Chest tightness

Hemorrhagic fever with renal syndrome (HFRS)

Caused primarily by hantaviruses found in Europe and Asia, this syndrome affects the kidneys. Symptoms develop within two to six weeks after exposure. Initial symptoms include:

• Intense headaches
• Back and abdominal pain
• Fever or chills
• Nausea
• Blurred vision
• Flushing of the face
• Rash
• Redness of the eyes

Later symptoms may include:

• Low blood pressure
• Dangerously low blood flow
• Internal bleeding
• Acute kidney failure

“In both types of disease, hantavirus can make small blood vessels leak fluid,” Dr. Katugaha said. “This can cause low platelet counts, which can affect clotting and cause an exaggerated immune response.”

How dangerous is hantavirus?

Much of the concern about this outbreak arises from the high mortality rate of the virus. According to Dr. Katugaha, 20-40% of people who develop HCPS succumb to the disease.

“In severe cases, the lungs can fail and the heart can no longer pump effectively, and this can happen quickly,” said Dr. Katugaha. “Even with intensive care, the risk of death is high.”

According to the CDC, the mortality rate for HFRS is around 1-15%.

How is hantavirus treated?

There’s no specific treatment or cure. Patients who are diagnosed with hantavirus typically receive supportive care to manage symptoms, like fever or dehydration. In cases where a person is in respiratory distress, they may receive breathing support.

Could hantavirus be the next pandemic?

Although the cruise ship outbreak is a serious situation, Dr. Katugaha said the risk to the broader public is low.

“Hantaviruses don’t have the pandemic potential of respiratory viruses like COVID-19,” she said. “While it’s important to stay informed about global outbreaks, there is no need for alarm.”

She added, “Hantavirus differs from COVID-19 in how it spreads. Andes virus is the only hantavirus with person-to-person transmission. Unlike COVID-19 and respiratory viruses, this transmission has been linked to close, prolonged contact.”

If you’re concerned about disease outbreaks, your primary care physician can provide guidance about risk and prevention. Looking for a new doctor? Use the Find a Doctor tool or schedule an appointment online.

Source: Centers for Disease Control and Prevention