[Controversies on Hantavirus]

Over the past decades, significant progress has been made on our understanding of the possible mechanisms involved in hantavirus transmission in the southern hemisphere and how to address and treat hantavirus infections. Hantavirus infections have been subject to controversies concerning its prevention, case management and treatment. Some possibly related to the fact that it is a rare disease and there is lack of comprehensive data regarding treatment options. Besides, the possible person-to-person transmission of some genotypes (only proven in certain regions of Argentina and Chile) has proven to be a challenge for infection control. In addition, the dynamic scenario regarding emerging infectious diseases in the region has produced changes in the possible differential diagnoses to be considered. This review intends to summarize the current available scientific evidence on some of the remaining controversies regarding hantavirus infections in Argentina and South America. It is a narrative literature of published evidence reviewed by a group of experts with the unique experience of having faced outbreaks in this region with interhuman transmission. It discusses respiratory precautions adapted to different genotypes/areas, possible transmission through breastfeeding, predictors of severity in laboratory tests, the use of corticosteroids, plasma and ribavirin for treatment, and finally differential diagnoses in Argentina. While most of these aspects of hantavirus infection are still complex to conclude, it is essential to raise awareness in these severe infections of the available scientific evidence in order to prevent and improve the quality of care, optimizing patient outcomes.