Hantavirus infections: A growing global health concern

Abstract

Hantaviruses are increasingly regarded as an important emerging risk to global health, with an estimated annual impact on more than 200000 people worldwide. These pathogens are single-stranded RNA viruses belonging to the family Hantaviridae and are known to cause two major clinical syndromes in humans: Hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). The so-called old world hantaviruses, which are associated with HFRS, are predominantly distributed across Asia, Europe, and parts of Africa. In contrast, new world hantaviruses, responsible for HPS, are largely confined to North and South America. Each year, approximately 150000-200000 HFRS cases require hospitalization globally, with the greatest burden occurring in developing regions. The mortality rate of HFRS ranges from below 1% to about 12%, depending on the infecting strain. Both disease forms are characterized by increased capillary permeability, leading to clinical features such as hypotension, thrombocytopenia, and leukocytosis. While HFRS has a broader geographic distribution, HPS carries a higher risk of death.. Moreover, the detection of new viral strains and the steady rise in reported cases have intensified global concern. Enhancing surveillance systems and expanding laboratory diagnostic capacity are therefore essential for effective monitoring and control of hantavirus diseases.

Keywords: Hantavirus infection; Hantaviridae; Hemorrhagic fever with renal syndrome; Hantavirus pulmonary syndrome; Global health threat; Leukocytosis

Core Tip: Hantavirus infections represent an expanding global zoonotic threat characterized by high mortality rates and limited therapeutic options. This article provides an updated and integrated overview of hantavirus biology, epidemiology, clinical manifestations, diagnostic strategies, and emerging therapeutic approaches. Particular emphasis is placed on recent advances in molecular virology, RNA-based antiviral technologies, monoclonal antibody therapy, and next-generation vaccine platforms, including mRNA and DNA vaccines. By combining classical clinical perspectives with contemporary translational research, this review identifies key gaps in current knowledge and proposes future directions for surveillance, therapeutic development, and global preparedness.