How worried should we be about the hantavirus epidemic?

Read: ~12 minutes | Category: Health & Prevention

Lately, the word "hantavirus" has been popping up in the news and on social media more and more often. People are asking: is it dangerous? Is it contagious like COVID-19? Should we panic? The answer is neither "yes, get ready for the apocalypse" nor "don't worry at all". The truth is more nuanced - and that's exactly why it's important to know.

Hantavirus is a family of viruses transmitted by rodents - mice, rats and squirrels. It was first discovered in Korea in the early 1950s, when American soldiers fell ill en masse at the Hantan River - hence its name.

There are two main syndromes associated with hantavirus:

• Hemorrhagic fever with renal syndrome (HTBS) - occurs primarily in Europe and Asia. It affects the kidneys and can cause serious but rarely fatal disease.
• Hantavirus pulmonary syndrome (HPS) - typical of the Americas. Rarer but significantly more deadly - mortality rates reach 30-40%.

In Bulgaria and most of Europe, CTVS is predominantly carried by the yellow-backed wood mouse (Apodemus flavicollis) and the common field mouse.

How do you get infected? Causes and risk factors

Here comes one of the most important things to know: hantavirus is NOT transmitted from person to person (except for one rare strain, Andes virus in South America). This makes it fundamentally different from influenza or COVID-19.

The virus is transmitted by:

• Breathing contaminated aerosols - when cleaning abandoned rooms, barns or warehouses, you inhale dust containing dried urine, feces or saliva of an infected mouse. This is the most common route of infection.
• Direct contact - touching or being bitten by an infected rodent.
• Ingestion - consuming food or water contaminated with rodent excrement.

Who is at higher risk?

• People working in agriculture, forestry and livestock
• Hikers and scouts sleeping outdoors or in unprotected shelters
• People cleaning abandoned buildings, basements or attics
• Hunters and anglers with extended stays in nature
• Military and rescue personnel working in the field

Important: living in the city without direct contact with rodents carries extremely low risk.

Symptoms - how do you recognise the disease?

The incubation period is between 1 and 8 weeks (usually 2-4 weeks) after exposure to the virus. Symptoms of CTVS (the European form) go through several phases:

Phase 1 - Acute onset (days 1-5)

• Sudden high fever (38-40°C)
• Severe headache and low back pain
• Muscle aches and general fatigue
• Redness of face, neck and chest
• Sometimes - nausea and vomiting

Phase 2 - Renal involvement (days 5-11)

• Decreased urine output or complete absence
• Swelling around the eyes
• Increased blood pressure
• Laboratory abnormalities in renal parameters

Phase 3 - Recovery

With timely treatment, most patients fully recover within 2-6 weeks. Mortality in the European form is relatively low - less than 1%.

Caution: Symptoms are easily confused with influenza. If you have had contact with rodents or have spent time in nature and develop these complaints, be sure to notify the doctor.

How contagious is hantavirus?

Directly speaking - it is not contagious between humans. Unlike flu, measles or COVID-19, you can't catch hantavirus from a sick neighbor on the subway, from coughing or shaking hands.

The World Health Organization (WHO) stresses that cases of person-to-person transmission have only been recorded for the Andes virus strain in Argentina and Chile - and only in very close contact. All other known strains are transmitted exclusively by rodents.

This is a key distinction when assessing risk: hantavirus cannot cause a pandemic of the type of COVID-19. It is an endemic problem in specific regions and populations.

Diagnosis and treatment

Diagnosis is made by a blood test for antibodies to hantavirus. Because the symptoms resemble many other diseases, it is important to tell the doctor about possible contact with rodents.

There is currently no approved antiviral therapy specifically for hantavirus. Treatment is supportive:

• Hospitalization for more severe cases
• Maintenance of water-salt balance
• Dialysis to support kidney function if needed
• Monitoring vital signs

Ribavirin (an antiviral drug) has shown some effectiveness with early administration, but is not standard therapy everywhere.

How to protect yourself? Practical Tips

The good news is that prevention is relatively simple:

Vaccine - does it exist?

Hantavirus vaccines approved for local use exist in China and South Korea. In Europe and Bulgaria a vaccine is not yet available to the general public. Research is ongoing and international pharmaceutical companies are working to develop a universal vaccine.

Should we panic?

Short answer: no. But we should be informed and careful.

Hantavirus is a serious disease that has been around for decades. Cases in Europe periodically increase in years with higher rodent populations - usually after a mild winter or fruit-rich autumn. This is a natural natural cycle, not a sign of a new pandemic.

Understanding the real risk is more valuable than panic. If you work or spend time in nature - be careful, follow prevention measures and consult a doctor if symptoms are suspicious. If you live in the city and have no contact with rodents - the risk to you is minimal.

Important: This article is for informational purposes. Always consult a doctor for health complaints.