Hantavirus Infections and Hemorrhagic Fever Syndromes

Hantaviruses are enveloped, negative-sense RNA viruses transmitted to humans primarily through inhalation of aerosolised excreta from infected rodents. They cause two principal clinical entities: hemorrhagic fever with renal syndrome (HFRS) in Eurasia and hantavirus pulmonary syndrome (HPS) in the Americas. HFRS presents with fever, thrombocytopenia, capillary leakage and acute kidney injury, with fatality rates varying from below 1 per cent to over 10 per cent according to viral species. HPS is characterised by rapid onset of pulmonary oedema, respiratory failure and cardiogenic shock, with mortality rates approaching 40 per cent. The geographic distribution of hantaviruses reflects the ecology of reservoir hosts—rodents, shrews and bats—and is influenced by climate, land use and environmental change. Diagnosis relies on molecular detection of viral RNA and serological assays, while management remains largely supportive. Despite extensive surveillance and control measures, the absence of broadly effective vaccines and antivirals underscores the ongoing public health challenge posed by these zoonotic pathogens.

Research from Nature Portfolio

Recent studies have provided atomic-level insight into human neutralising responses against Sin Nombre virus. A highly potent monoclonal antibody isolated from a convalescent donor was shown by crystallography to bind the membrane-distal region of the Gn glycoprotein, simultaneously blocking receptor attachment and inhibiting the fusion process. Integration of this structural data with the full tetrameric spike assembly revealed conserved epitopes that are accessible in the prefusion state. These findings establish a structural framework for rational vaccine design aimed at eliciting germline-encoded antibodies capable of broad hantavirus neutralisation and inform therapeutic antibody development against diverse orthohantaviruses.

Hantavirus Infections and Hemorrhagic Fever Syndromes publication trend

The graph below shows the total number of articles in hantavirus infections and hemorrhagic fever syndromes across all publications each year (not limited to Nature Index journals).

Technical terms

Orthohantavirus: A genus of rodent-borne, enveloped RNA viruses in the family Hantaviridae that infect humans via aerosolised rodent excreta.

Hemorrhagic fever with renal syndrome (HFRS): A disease characterised by fever, capillary leakage, thrombocytopenia and acute kidney injury following hantavirus infection.

Hantavirus pulmonary syndrome (HPS): A severe respiratory illness marked by pulmonary oedema, respiratory failure and cardiogenic shock induced by certain New World hantaviruses.

Monoclonal antibody: A laboratory-derived antibody recognising a single epitope, used for specific neutralisation of viral antigens.

Serology: The detection and measurement of antibodies in blood serum to diagnose past or current infection.

Glycoprotein complex: The viral spike composed of Gn and Gc subunits that mediates host-cell attachment and membrane fusion.

References

1. Mechanistic basis for potent neutralization of Sin Nombre hantavirus by a human monoclonal antibody. Nature Microbiology (2023).
2. External quality assessment of orthohantavirus and lymphocytic choriomeningitis virus molecular detection and serology in Europe, 2021. Eurosurveillance (2023).
3. Hemorrhagic Fever with Renal Syndrome: Pathogenesis and Clinical Picture. Frontiers in Cellular and Infection Microbiology (2016).
4. Vaccines and Therapeutics Against Hantaviruses. Frontiers in Microbiology (2020).
5. Phylogeny and Origins of Hantaviruses Harbored by Bats, Insectivores, and Rodents. PLOS Pathogens (2013).