Dr. Narander Kumar Singla, Principal Consultant & Unit Head- Internal Medicine, Sri Balaji Action Medical Institute, New Delhi

Hantavirus infection is a zoonotic viral disease which is mainly caused by hantaviruses, known as group of viruses mainly carried by rodents. Humans normally become infected through exposure to rodent urine, saliva, or contaminated dust particles as well. While the disease is quite uncommon, it can be severe and life threatening as well if not recognized and treated on early basis.

Global Distribution and Clinical Syndromes

As per World Health Organization, hantavirus is found globally, with unsimilar strains causing distinct clinical syndromes as well. The infections most commonly leads to Hantavirus Cardiopulmonary Syndrome, which mainly affects the lungs and the cardiovascular system. In regions like Europe and Asia, the disease often manifests as the Haemorrhagic Fever with Renal Syndrome (HFRS) affecting organs like kidney and blood vessels as well. Awareness of all these regional differences also helps clinicians to identify and manage cases in an effective way.

Mode of Transmission

Hantavirus do not spread through the casual human to human contact. Most of the infections occur after inhalation of aerosolized particles contaminated with the rodent urine, direct contact with the infected rodents, and then touching the mouth or nose. Virus can be transmitted through rodent bites very rarely. An exception is the Andes Virus, for which very limited person to person transmissions are documented in the close contact settings.

Clinical Features

Symptoms normally appear 1-8 weeks after the exposure. Early indicators of the same are usually high fever, severe body aches, pain in muscles, headache, fatigue and abdominal pain as well. As the infection increases, patients may also develop more serious kind of infections such as cough, breathlessness, and acute kidney injury. Severe cardiopulmonary involvement can also lead to respiratory system failure and even death if intensive care support is delayed.

Diagnosis

Early kind of recognition is very much critical. Diagnostic mainly relies on the clinical suspicion based on the symptoms and regional prevalence, blood test which include serology and PCR, and chest imaging for pulmonary involvement mainly. Prompt medical diagnosis is also essential since condition of patients can deteriorate fastly mainly in HCPS cases.

Treatment

In today’s time, there is no antiviral therapy which is universally approved for hantavirus infection. Management is quite supportive and may also include oxygen related therapy, mechanical ventilation for the respiratory distress, intravenous fluids with careful level of monitoring, hemodynamic support for the low blood pressure, and dialysis in the cases of renal failure. Early care of ICU has been shown to greatly improve rate of survival in several cases.

Prevention

Prevention continues to remain as the most effective strategy against the infection of hantavirus. Some of the key measures mainly include controlling the rodent populations in home and workplaces, storing food in a secure way, sealing holes and entry points for rodents, wearing gloves and masks while cleaning some contaminated areas, and avoid dry sweeping as well. Maintaining the awareness of hantavirus risk and following certain preventive strategies can also reduce the likelihood of infection.