Hantavirus infections: A growing global health concern

Table 1 Critical comparison of hemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome pathogenesis and clinical outcomes

Parameter	HFRS	HPS
Major viral group	Old World hantaviruses	New world hantaviruses
Main target organ	Kidney and vascular system	Lung and cardiovascular system
Key pathology	Increased vascular permeability with renal endothelial dysfunction	Pulmonary capillary leakage and myocardial depression
Dominant clinical feature	Fever, hemorrhage, thrombocytopenia, acute kidney injury	Fever, rapidly progressive pulmonary edema, shock
Mortality	Usually < 1%-12%, depending on strain	Often 30%-50%
Immune mechanism	Cytokine-mediated endothelial activation and renal inflammation	Strong inflammatory response causing pulmonary vascular leakage
Treatment response	Ribavirin may help if given early	Ribavirin benefit is limited or unclear
Main reason for difference	Longer disease evolution allows earlier antiviral intervention	Rapid cardiopulmonary phase occurs when immunopathology dominates

HFRS: Hemorrhagic fever with renal syndrome; HPS: Hantavirus pulmonary syndrome.