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Hantavirus in Dentistry: Occupational Exposure Considerations and a Proposed Tiered Infection Prevention and Control
Parsa Vafaei1, Morteza Banakar2,3, Mostafa Alam4
1Faculty of Dentistry, Azad University of Isfahan (Khorasgan Branch), Isfahan, Iran.
Objective:
The aim of this study is to synthesize evidence on hantavirus transmission and occupational exposure pathways relevant to dentistry, and to propose an evidence-informed tiered infection prevention and control (IPC) framework that distinguishes established from theoretical risk.
Material And Methods:
The initial narrative search covered database inception through May 15, 2026 in MEDLINE/PubMed, Embase, Web of Science, Scopus, Google Scholar, and WHO/CDC/ECDC/OSHA sources, followed by a targeted PubMed/MEDLINE and public-health guidance update through August 18, 2026. Approximately 1450 records were identified. After duplicate removal, 1070 records were subjected to title/abstract screening, 215 full-text records were assessed for eligibility, and 45 sources were included in the final synthesis, comprising 34 peer-reviewed publications and 11 gray-literature or public-health guidance sources.
Results:
Environmental exposure to infected-rodent contamination is the established occupational pathway. Limited person-to-person transmission is documented for the Andes virus (ANDV), but no dental transmission has been reported. ANDV RNA and culture-based infectivity have been demonstrated in some oral/respiratory fluids; however, dental-aerosol transmission has not been shown. Dental-specific occupational risk therefore remains unquantified.
Conclusions:
No dental transmission has been documented, and patient-related risk remains uncertain. Standard precautions and rodent control are foundational; suspected or confirmed ANDV warrants transmission-based precautions and airborne precautions for aerosol-generating procedures according to current guidance. The proposed dental tiers are evidence-informed, author-derived, and unvalidated.
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