Hantavirus infections: A growing global health concern

Table 3 Diagnostic methods for hantavirus infection

Diagnostic method	Target detected	Diagnostic accuracy	Field/clinical utility	Limitations	Optimal timing of use
ELISA (IgM/IgG detection)	Anti-hantavirus antibodies	High sensitivity	Widely available, cost-effective, suitable for screening large populations	Possible cross-reactivity with other viral antigens	Acute and convalescent phases
IFA	Viral antibodies	High specificity	Reliable confirmation method; useful for sero-epidemiological studies	Labor-intensive, requires fluorescence microscopy	Acute phase confirmation
NeutralizationTest (PRNT/FRNT)	Neutralizing antibodies	Very high specificity (gold standard)	Confirms protective immunity and virus strain identification	Requires BSL-3 Laboratory, expensive, technically demanding	Research and confirmatory diagnosis
Immunochromatographic rapid tests	IgM/IgG antibodies	Moderate sensitivity	Rapid, easy to perform, suitable for field settings	Reduced accuracy and cross-reactivity issues	Early screening in endemic regions
RT-PCR	Viral RNA (S, M, L segments)	Very high sensitivity during viremia	Rapid and highly specific detection; useful for early diagnosis	Limited detection window; requires molecular laboratory	Early acute phase (viremic stage)
NGS	Whole viral genome	Very high accuracy	Enables strain identification, mutation analysis, and outbreak tracking	High cost, complex bioinformatics analysis	Research and surveillance
Microarray analysis	Multiple viral sequences	High sensitivity	Simultaneous detection of diverse pathogens	Expensive and technically complex	Advanced research settings
Virus isolation in cell culture	Live virus	Highly specific	Enables functional studies and antiviral testing	Time-consuming; requires BSL-3 containment	Research applications
IHC	Viral antigens in tissues	High specificity	Useful in post-mortem or biopsy samples	Requires skilled personnel and tissue preparation	Severe or fatal cases

ELISA: ; IFA: Indirect immunofluorescence assay; PRNT: Plaque reduction neutralization test; FRNT: Focus reduction neutralization test; RT-PCR: Reverse transcription-polymerase chain reaction; NGS: Next-generation sequencing; BSL: Biosafety level; IHC: Immunohistochemistry.