Hantavirus: epidemiology, pathogenesis, clinical features, transmission, and therapeutic strategies

Abstract

Hantavirus is a rare but potentially fatal zoonotic infection that primarily affects the lungs and kidneys, with transmission typically occurring through infected rodents. Recent attention has focused on a 2026 outbreak aboard the MV Hondius , involving the Andes virus strain, which is uniquely capable of limited human-to-human transmission. Disease severity is largely driven by immunopathogenesis, where infection of endothelial cells triggers an exaggerated host immune response, leading to cytokine-mediated vascular leakage, pulmonary edema, and renal dysfunction. Despite improved understanding of these mechanisms, therapeutic options remain limited, with current management largely restricted to supportive care. Major challenges include the rapid progression of disease, lack of approved antivirals or broadly available vaccines, and incomplete understanding of host immune dysregulation. Future research should prioritize identifying biomarkers of disease severity and developing targeted antiviral and immunomodulatory therapies. Advancing these areas is critical for improving clinical outcomes and preparedness for emerging hantavirus outbreaks. This review summarizes the introduction, symptoms, pathogenesis, transmission, diagnostics and treatment strategies of hantavirus in simple terms, emphasizing recent developments and clinical significance.