Medicines for Hantavirus

What it is

Hantaviruses are a group of viruses that are carried by rodents (such as certain mice and rats) and can, uncommonly, infect people, causing illness. Human infection is rare. People usually catch a hantavirus through contact with infected rodents or, more often, by breathing in the virus from dust contaminated with the droppings, urine, or saliva of infected rodents (for example when cleaning areas where rodents have been), or through direct contact with rodents or their droppings; it can also, less commonly, occur through a rodent bite. Hantaviruses are generally not spread from person to person (with rare exceptions for certain types). Different hantaviruses occur in different parts of the world and cause different illnesses. Broadly, hantavirus infections can cause two main types of serious illness (depending on the virus and region): a form that mainly affects the lungs and breathing (hantavirus pulmonary syndrome, occurring in the Americas), which can cause severe breathing difficulty; and a form that mainly affects the kidneys, along with other features (haemorrhagic fever with renal syndrome, occurring in parts of Europe and Asia), which can affect kidney function and cause other problems. Many infections may be mild or cause flu-like symptoms, but some can be serious. The symptoms often begin with flu-like features — such as fever, muscle aches, headache, tiredness, and sometimes tummy symptoms — and, in the more serious forms, can progress to affect breathing (with cough and shortness of breath) or the kidneys (with reduced kidney function and other effects), which can be severe. Because hantavirus infection is rare, and its early symptoms are flu-like, the diagnosis relies on considering the possibility in the context of relevant exposure (such as contact with rodents or their droppings, or relevant travel or activities) and confirming it with tests. There is no specific antiviral cure for hantavirus, so treatment is supportive — managing the symptoms and supporting the body (particularly breathing or kidney function) in hospital for the serious forms, which can be life-saving. Prevention focuses on reducing contact with rodents and their droppings and taking precautions when cleaning rodent-infested areas. The key messages are that hantaviruses are a rare group of viral infections spread mainly through contact with infected rodents or their droppings, that they can, in some cases, cause serious illness affecting the lungs or kidneys, and that prevention focuses on avoiding rodent contact and safe cleaning of rodent-infested areas.

How it is treated

Hantavirus infection is managed with supportive care (as there is no specific antiviral cure), particularly for the serious forms, and prevention focuses on reducing contact with rodents and their droppings; recognising it depends on considering relevant exposure. Because hantavirus infection is rare and its early symptoms are flu-like, the diagnosis relies on considering the possibility in someone with a relevant illness and exposure — such as contact with rodents or their droppings (for example after cleaning a rodent-infested area, or relevant occupational or recreational exposure), or relevant travel — so mentioning such exposure to the doctor is helpful; it is confirmed with blood tests. There is no specific antiviral treatment that cures hantavirus, so treatment is supportive, and, for the serious forms, this supportive care in hospital is very important and can be life-saving: for the lung form, this includes careful support of breathing and oxygen (which may include intensive care and breathing support), as the main danger is severe breathing difficulty; for the kidney form, it includes supporting the kidneys and managing fluid and the body’s balance (which may include temporary dialysis if the kidneys are significantly affected), along with managing any other effects such as bleeding problems. Careful monitoring and supportive treatment of the affected systems, in a hospital setting for serious illness, help the person through the illness while the body recovers. Many milder infections resolve with supportive care. Recovery depends on the severity and the form of the illness. Prevention is the main practical message, and focuses on reducing contact with rodents and the virus: controlling rodents and keeping homes and buildings free of them; taking precautions when cleaning areas where rodents have been (as disturbing rodent droppings, urine, or nesting materials can release the virus into the air) — for example ventilating the area first, dampening down dust rather than sweeping or vacuuming dry (which can create infectious dust), wearing protective equipment such as gloves and, where appropriate, a mask, and cleaning and disposing of materials safely; and taking care with rodent exposure during relevant activities. The reassuring messages are that hantavirus infection is rare, that many infections are mild while the serious forms are treated with supportive care that can be life-saving, and that prevention through reducing rodent contact and safe cleaning of rodent-infested areas is effective; so avoiding rodent contact, safe cleaning practices, and — for anyone unwell with relevant exposure — mentioning it to the doctor are the key points.