Incidence, pathogenesis, clinical manifestations, and pharmacological management of the 2026 Andes virus outbreak

Hantavirus is considered as a fatal zoonotic pathogen that can be commonly transmitted from rodents to humans. However, the Andes virus (ANDV), a type of New World hantavirus, can also be transmitted from human to human. It is the cause of the 2026 hantavirus outbreak on a cruise ship. Hantavirus can rapidly progress to a severe respiratory distress, known as hantavirus cardiopulmonary syndrome (HCPS). Since there is no specific treatment or approved vaccine for hantavirus infection, early diagnosis and critical care support are essential. In cases of HCPS, depending on the severity of the infection, it is important to administer antipyretics, vasopressors, fluid therapy, cardiopulmonary support, extracorporeal membrane oxygenation (ECMO), mechanical ventilation, and renal replacement therapy (RRT) in a timely manner. Currently, there is no approved vaccine in the United States or Europe. However, various vaccine technologies, including inactivated, DNA, mRNA, viral vector and protein-based vaccines, are in the preclinical and clinical phases. Preventive actions, including patient isolation and physical distancing, are crucial to avoiding widespread transmission.