Hantavirus: An Emerging Global Zoonotic Threat—From Molecular Basis to Clinical Management and Public Health Perspectives

Abstract

Hantavirus infection is an emerging zoonotic viral disease caused by hantaviruses of the family Hantaviridae, primarily transmitted to humans through exposure to infected rodent urine, feces, saliva, or contaminated aerosols. The disease presents mainly in two clinical forms: Hemorrhagic Fever with Renal Syndrome (HFRS), prevalent in Asia and Europe, and Hantavirus Pulmonary Syndrome (HPS)/Hantavirus Cardiopulmonary Syndrome (HCPS), predominantly reported in the Americas. The historical recognition of hantavirus began during the Korean War (1950–1953), when thousands of soldiers developed Korean hemorrhagic fever. In 1978, Ho-Wang Lee isolated the Hantaan virus from Apodemus agrarius, marking a major scientific breakthrough. Subsequent decades witnessed the identification of multiple hantavirus species, including Seoul, Puumala, Dobrava-Belgrade, Sin Nombre, and Andes viruses, each associated with distinct rodent reservoirs and clinical manifestations. A major epidemiological milestone occurred in 1993 with the outbreak of Hantavirus Pulmonary Syndrome in the Four Corners region of the United States, leading to the discovery of Sin Nombre virus. Increasing urbanization, climate change, deforestation, and closer human–rodent interactions have contributed to the global emergence of hantavirus infections in the 21st century. Advances in molecular diagnostics, including reverse transcription polymerase chain reaction (RT-PCR) and serological testing, have enhanced disease surveillance and early diagnosis. This review highlights the historical evolution, epidemiology, transmission, and growing public health significance of hantavirus infection worldwide.

Keywords: Hantavirus infection; Hemorrhagic Fever with Renal Syndrome (HFRS); Hantavirus Pulmonary