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Viral Infections and Vectors / Viral Infections and Outbreaks Research / Vector Borne Animal Diseases · Review
Biomolecules and Biomedicine · August 31, 2026
A consensus or society position rather than new primary data.
This narrative review characterizes hantavirus epidemiology in Southeastern Europe as a persistent endemic system driven by ecological and surveillance factors, with DOBV and PUUV co-circulating to cause HFRS of variable severity. The authors recommend integrated One Health surveillance across human, animal, environmental, and genomic domains to improve outbreak prediction and cross-border preparedness, but provide no new empirical evidence or formal recommendation strength assessment.
Narrative review. Southeastern European region with endemic DOBV and PUUV circulation; includes Slovenia, Croatia, and neighboring countries.. Southeastern Europe.
DOBV and PUUV co-circulate in Southeastern Europe, with DOBV causing more severe HFRS than PUUV Slovenia and Croatia exhibit the highest cumulative burden and most pronounced periods of increased HFRS activity Synchronized increases in HFRS activity occurred across multiple neighboring countries in 2008, 2012, 2014, 2017, 2019, 2021, and 2023
No quantified incidence rates, case counts, or mortality figures reported for the region or specific countries
Clinicians in Southeastern Europe should recognize regional HFRS epidemiology as driven by interconnected ecological factors with cross-border synchronization, informing suspicion and surveillance. Public health practitioners should implement coordinated One Health surveillance frameworks across borders and sectors to improve outbreak prediction and preparedness.
A narrative review synthesizing epidemiology, transmission dynamics, and public health challenges across a region, offering integrated surveillance recommendations within a One Health framework rather than reporting new empirical evidence.
As stated by the source record.
Clinicians in Southeastern Europe should recognize regional HFRS epidemiology as driven by interconnected ecological factors with cross-border synchronization, informing suspicion and surveillance. Public health practitioners should implement coordinated One Health surveillance frameworks across borders and sectors to improve outbreak prediction and preparedness.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
Human-pathogenic orthohantaviruses are significant rodent-borne zoonotic pathogens in Europe. Southeastern Europe (SEE) is a distinct endemic region where Dobrava-Belgrade virus (DOBV) and Puumala virus (PUUV) co-circulate, causing hemorrhagic fever with renal syndrome (HFRS) of varying severity. This narrative review synthesizes the epidemiology, transmission dynamics, clinical characteristics, ecological drivers, and public health challenges of hantavirus infections across SEE, identifying priorities for regional preparedness. We searched PubMed, Scopus, and Web of Science from their inception through June 2026, supplementing with reference screening. Regional epidemiological patterns were assessed descriptively using national surveillance data, European surveillance reports, published studies, and available population-based incidence estimates. Long-term surveillance reveals persistent endemic transmission with significant geographic and interannual heterogeneity. Slovenia and Croatia exhibit the highest cumulative burden and most pronounced periods of increased HFRS activity. Several years-2008, 2012, 2014, 2017, 2019, 2021, and 2023-showed partially synchronized increases across multiple neighboring countries. These patterns align with shared ecological influences, including rodent population fluctuations, mast-seeding events, and climatic variability. However, local ecology, human exposure, and differences in surveillance capacity modify their magnitude. The coexistence of generally milder PUUV-associated disease and more severe DOBV-associated HFRS further distinguishes SEE's clinical landscape. Therefore, hantavirus epidemiology in SEE is best understood as an interconnected regional ecological system. Integrated human, animal, environmental, and genomic surveillance within a coordinated One Health framework is crucial for improving outbreak prediction, cross-border preparedness, and future disease control.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.