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Viral Infections and Vectors / Viral Infections and Outbreaks Research / Vector Borne Animal Diseases · Review
Reviews in Medical Virology · July 31, 2026
A consensus or society position rather than new primary data.
This narrative review consolidates current knowledge on hantavirus epidemiology, pathogenesis, diagnostics, and emerging countermeasures, emphasizing the paradigm shift from a dichotomous Old World/New World classification toward recognition of overlapping renal and pulmonary manifestations. The authors identify critical advances in structural virology enabling monoclonal antibody and vaccine development, and highlight person-to-person transmission of Andes virus as a significant epidemiological finding, while acknowledging persistent gaps in understanding determinants of transmission, long-term sequelae, and the absence of licensed broadly protective vaccines or specific antivirals.
Narrative Review. Human populations exposed to hantavirus across multiple continents; no specific patient cohort studied in this review.. Multiple continents (global scope implied).
Person-to-person transmission of Andes virus documented among household contacts and during prodromal phase with viral shedding in respiratory secretions Endothelial dysfunction driven by VEGF sensitisation, Src kinase and RhoA pathway activation, pericyte infection, and dysregulated inflammatory responses including IL-6 trans-signalling Extracorporeal membrane oxygenation (ECMO) improving survival in fulminant HCPS
Specific efficacy and safety data for emerging monoclonal antibodies and vaccine candidates not provided No reported numbers for incidence, mortality, or epidemiological burden across regions
Clinicians should recognize the broadening clinical spectrum of hantavirus infection beyond traditional Old World/New World distinctions, remain alert to person-to-person transmission of Andes virus via respiratory secretions during prodromal phases, and be aware that current management is supportive with ECMO for severe cardiopulmonary disease. However, the absence of licensed vaccines and specific antivirals underscores the need for integrated surveillance and preparedness strategies.
A narrative review synthesizing current knowledge on hantavirus epidemiology, pathogenesis, and countermeasures, with identified research gaps and recommendations for future preparedness rather than reporting original empirical findings.
As stated by the source record.
Clinicians should recognize the broadening clinical spectrum of hantavirus infection beyond traditional Old World/New World distinctions, remain alert to person-to-person transmission of Andes virus via respiratory secretions during prodromal phases, and be aware that current management is supportive with ECMO for severe cardiopulmonary disease. However, the absence of licensed vaccines and specific antivirals underscores the need for integrated surveillance and preparedness strategies.
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.
Hantaviruses are emerging zoonotic pathogens of increasing global public health significance. Their epidemiological landscape is rapidly changing due to ecological disruption, climate variability, urbanisation, and evolving human-animal interfaces. This narrative review synthesises current knowledge on hantavirus virology, epidemiology, pathogenesis, clinical management, and emerging countermeasures, with a focus on developments from the past 5 years. Traditionally classified into Old World viruses causing haemorrhagic fever with renal syndrome (HFRS) and New World viruses causing hantavirus cardiopulmonary syndrome (HCPS), this dichotomy has become increasingly blurred, with overlapping renal and pulmonary manifestations now recognized. Among the most consequential recent advances is the consolidated evidence for person-to-person transmission of Andes virus, documented among household contacts and during the prodromal phase, with viral shedding in respiratory secretions. Endothelial dysfunction remains the pathological hallmark of severe disease, driven by VEGF sensitisation, Src kinase and RhoA pathway activation, pericyte infection, and dysregulated inflammatory responses including IL-6 trans-signalling. Concurrently, environmental and ecological studies have linked climate change, rodent population dynamics, land-use modification, and urbanisation to increased human disease risk across multiple continents. Diagnostic strategies continue to rely on serology and molecular testing, while management remains predominantly supportive, with extracorporeal membrane oxygenation (ECMO) improving survival in fulminant HCPS. Importantly, recent structural virology advances have enabled the development of broadly neutralising monoclonal antibodies targeting conserved quaternary epitopes, as well as next-generation vaccine platforms including DNA, mRNA, and prefusion-stabilised glycoprotein candidates. Hantaviruses represent a paradigmatic One Health challenge at the intersection of environmental change, viral evolution, and global interconnectedness. Despite major progress in understanding transmission dynamics and endothelial pathogenesis, critical gaps remain regarding determinants of person-to-person spread, long-term post-infection sequelae, and the absence of licenced broadly protective vaccines or specific antiviral therapies. Future preparedness will require integrated surveillance frameworks combining ecological monitoring, genomic epidemiology, and clinical readiness within coordinated international public health strategies.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.