Hantavirus is a group of viruses that cause disorders of the lungs ( hantavirus pulmonary syndrome ) or blood vessels and kidneys ( hemorrhagic fever with renal syndrome ). This virus is carried and spread by rats and other rodents .

Hantavirus disease is classified as a zoonotic disease , because its spread starts from animals to humans. Transmission of hantavirus infection to humans generally occurs through direct contact with feces, urine, and saliva of infected rats.

Hantavirus disease is rare, but can be dangerous. The death rate for hantavirus pulmonary syndrome is about 40% and for hemorrhagic fever with renal syndrome it is about 5–15%.

Causes of Hantavirus Infection

Hantaviruses are a group of viruses that are spread by rats or other rodents. Even so, transmission of hantavirus infection between humans is very rare.

The following are a number of conditions that can cause a person to become infected with the hantavirus:

  • Touching faeces, saliva, or urine, from mice infected with the hantavirus
  • Inhaling airborne particles containing the hantavirus
  • Eating food that has been contaminated with the hantavirus
  • Experiencing injuries from the bite of a rat infected with hantavirus
  • Touching your eyes, nose or mouth without washing your hands first after contact with an object contaminated with hantavirus

hantavirus risk factors

While several factors that can increase a person's risk of being infected with hantavirus are:

  • Live in a house or area where there are lots of rats
  • Have a job that may involve frequent contact with rats or the fluids they secrete, such as the construction industry or pest control services
  • Have a hobby of camping, hiking , hunting, or doing other activities that have a high potential for contact with rats

Symptoms of Hantavirus Infection

Symptoms of the new hantavirus appear around 1–8 weeks after a person is exposed to and infected with the virus. Complaints that arise can vary, depending on the organ that is attacked.

Hantavirus infection can cause hantavirus pulmonary syndrome (HPS) and hemorrhagic fever with renal syndrome (HFRS). The following are some of the symptoms:

Hantavirus pulmonary syndrome (HPS)

In the early stages, HPS will cause symptoms in the form of:

  • Fever
  • Chilled and unwell
  • Headache
  • Nausea and vomiting
  • Abdominal pain and diarrhea
  • Muscle ache
  • Fatigue

If left for several weeks, HPS sufferers will experience the following symptoms:

  • Fever
  • Cough
  • Shortness of breath or difficulty breathing
  • Rapid heartbeat
  • Chest pain, like being tied tightly

At an advanced stage, HPS sufferers will experience swelling of the lungs or pulmonary edema which can cause shock and be fatal.

Hemorrhagic fever with renal syndrome (HFRS)

Some of the early symptoms that can appear when a person experiences HFRS are:

  • Fever
  • Severe headache
  • Pain in the back and stomach
  • Fatigue
  • Blurred vision
  • Facial redness
  • Rashes on the skin

At an advanced stage, HFRS will cause several other symptoms, namely:

  • Low blood pressure
  • Bleeding
  • Impaired blood flow ( shock )
  • Plasma leak
  • Acute kidney failure

When to see a doctor

Immediately consult a doctor if you experience the symptoms mentioned above, especially if you have recently had contact with or have been in contact with a mouse's bodily fluids. Examination and treatment need to be done immediately to prevent complications.

Get checked regularly if you are at risk of exposure to hantavirus, for example from working in a pest control office or living in an area with lots of rats.

Diagnosis of Hantavirus Infection

Diagnosis of hantavirus infection is done by asking the patient's symptoms and medical history, followed by a thorough physical examination.

To confirm the diagnosis, the doctor will carry out the following supporting examinations:

  • Blood tests , to determine the number and levels of blood cells, protein levels, electrolyte levels, and check liver and kidney function
  • Urine test , to check kidney function and see if there is blood in the urine
  • Scans, such as X-rays or chest CT scans in HPS cases, to detect lung disorders, such as pulmonary edema
  • Serological tests, to detect hantavirus antigens in the blood
  • PCR ( polymerase chain reaction ) test, to detect hantavirus in the blood

Treatment of Hantavirus Infection

There is no truly effective treatment for hantavirus infections. However, doctors can take action to relieve symptoms and prevent complications. Treatment is generally carried out in the intensive care unit of a hospital.

Some of the treatment methods that will be given are:

  • Administration of additional oxygen through breathing apparatus, including ventilators
  • Giving fluids through an IV, to restore fluid and electrolyte balance
  • Giving antiviral drugs , such as ribavirin, to treat viral infections in the early stages of HFRS
  • Administration of drugs and infusions to treat shock, including normalizing blood pressure

In cases of severe HPS, the doctor will install ECMO ( extracorporeal membrane oxygenation ). The goal is to replace damaged lung function so that all body tissues still get enough oxygen.

Meanwhile, if the patient has severe HFRS, the doctor will suggest dialysis methods to replace damaged kidney function.

The earlier treatment is carried out, the greater the patient's chance of recovery. Generally, the recovery time for HPS patients is around 2–3 weeks, while the recovery time for HFRS patients is more varied, ranging from 3 weeks to 6 months.

Hantavirus Infection Complications

If left untreated, hantavirus infection can cause various complications, such as:

  • Heart failure
  • Kidney failure
  • Severe pulmonary oedema
  • Shock
  • Dead

Prevention of Hantavirus Infection

There is no vaccine to prevent hantavirus infection. Therefore, the best way to prevent this infection is to avoid the factors that put you at greater risk for hantavirus infection. Some efforts that can be done are:

  • Make it a habit to wash your hands frequently with soap and water.
  • Keep food ingredients and tools used to process food clean.
  • Exterminate rat circulation around the house and workplace and close access for rats to enter the house. If necessary, set mouse traps.
  • Clean the house and work area with disinfectant regularly, including cleaning places where mice can nest, such as trash cans, warehouses, and rooms that are messy or rarely used.
  • Avoid contact with rats and their bodily fluids, such as saliva, urine and faeces.
  • Use personal protective equipment ( PPE ) and follow applicable standard operating procedures (SOPs) if your work frequently involves contact with rats.
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