Hantavirus infections

Area of Science:

• Virology
• Infectious Diseases
• Public Health

Background:

• Hantavirus infection recognition has improved, yet outbreaks are increasing in magnitude and frequency worldwide.
• Novel hantaviruses are continually identified in insectivore hosts, expanding known geographical distributions and discovering new species, particularly in Africa.
• Human hantavirus infections manifest as haemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS), caused by Old World and New World viruses, respectively.

Purpose of the Study:

• To review the current understanding of hantavirus infections, including emerging threats and clinical presentations.
• To discuss the pathogenesis of HFRS and HCPS, highlighting key mechanisms like increased vascular permeability and thrombocytopenia.
• To emphasize the importance of public awareness and preventative measures due to the lack of approved vaccines and treatments in key regions.

Main Methods:

• Literature review of hantavirus epidemiology, clinical syndromes, and pathogenesis.
• Analysis of varying disease severity and mortality rates associated with different hantavirus species.
• Examination of contributing factors to pathogenesis, including immune response, platelet function, endothelial barrier integrity, and genetic predisposition.

Main Results:

• Hantavirus outbreaks are escalating globally, with new viral species and hosts being identified.
• HFRS severity varies by causative agent, with Hantaan, Amur, and Dobrava viruses causing severe disease (5-15% mortality), while Seoul, Puumala, and Saaremaa viruses cause milder forms (<1% mortality).
• Pathogenesis involves increased vascular permeability, acute thrombocytopenia, immune responses, platelet dysfunction, endothelial barrier deregulation, and potentially HLA-related genetic predisposition.

Conclusions:

• Hantavirus infections pose a growing global health challenge with increasing outbreaks and newly identified viruses.
• Understanding the complex pathogenesis involving vascular and immune systems is key to managing HFRS and HCPS.
• In the absence of specific treatments or vaccines in the USA and Europe, public awareness and precautionary measures are paramount for risk mitigation.