Hantavirus preparedness at human-rodent interfaces: lessons from China's HFRS control and Andes virus transmission in...

Hantaviruses are globally distributed reservoir-associated viruses that cause haemorrhagic fever with renal syndrome (HFRS), mainly in Eurasia, and hantavirus cardiopulmonary syndrome (HCPS; also termed hantavirus pulmonary syndrome, HPS), mainly in the Americas. Most human infections arise from exposure to rodent-contaminated environments, so clustered disease may reflect shared environmental exposure rather than interpersonal transmission. This Review uses China's long-term HFRS experience as a central case study for interface-centred preparedness. China demonstrates that sustained surveillance, reservoir monitoring, risk-defined vaccination, rodent control and environmental risk reduction can substantially reduce disease burden, but declining incidence does not mean disappearance of ecological risk. Its dual HTNV and SEOV ecology further shows that one clinical syndrome can arise from distinct agricultural and peri-domestic rat-associated interfaces. Andes virus (ANDV) provides a contrasting challenge: selected outbreaks have documented limited but consequential human-to-human transmission after close or prolonged contact. The 2026 MV Hondius event illustrates how such transmission can become an international contact-tracing problem when it occurs in mobile populations. Preparedness should therefore combine long-term management of rodent-derived interfaces, rapid discrimination between common-source clusters and ANDV secondary transmission, and response systems that remain effective when exposed persons, infected animals or close contacts cross geographical borders.