Hantavirus in 2026: What clinicians need to know about the emerging global concern

Recent public health updates have renewed attention on hantavirus infections worldwide. Here, we examine what hantavirus is, where cases are being reported, the current evidence around transmission and risk, and the key considerations for clinicians based on guidance from international public health agencies and peer-reviewed literature.

Recent reports of hantavirus activity in South America and renewed educational updates from global public health agencies have increased awareness of hantavirus infections internationally.^1–5 Although human infections remain relatively uncommon in many regions, clinicians may increasingly encounter questions regarding transmission risk, diagnosis and management.

International agencies including the World Health Organization (WHO), the European Centre for Disease Prevention and Control (ECDC), the UK Health Security Agency (UKHSA) and the US Centers for Disease Control and Prevention (CDC) have all recently published updated guidance and educational resources relating to hantavirus surveillance, prevention and clinical recognition.^1–8

What is hantavirus?

Hantaviruses are a group of zoonotic RNA viruses primarily carried by rodents. Humans are typically infected through inhalation of aerosolized viral particles from rodent urine, saliva or droppings.^1,5,6

Different hantavirus species are associated with distinct rodent hosts and varying clinical syndromes.

Broadly, hantavirus infections are categorized into:^1,7,9

1. Hemorrhagic fever with renal syndrome (HFRS), more commonly reported in Europe and Asia
2. Hantavirus pulmonary syndrome (HPS), also known as hantavirus cardiopulmonary syndrome (HCPS), primarily reported in the Americas

Disease severity varies according to viral strain, host factors and geographic region. Some infections may be mild or asymptomatic, while others have been associated with severe respiratory or renal complications.^1,9–11

Where are hantavirus infections reported?

Hantavirus infections have been documented across Europe, Asia and the Americas, although the predominant viral strains differ geographically.^1,8–11

In Europe, Puumala virus is among the most commonly identified hantaviruses and is associated with nephropathia epidemica, a milder form of HFRS.^8,10 In Asia, Hantaan virus and Seoul virus are more frequently associated with classic HFRS presentations.^1,10

In North and South America, New World hantaviruses such as Sin Nombre virus and Andes virus are associated with HPS/HCPS, which can involve rapidly progressive pulmonary and cardiovascular complications.^6,7,9

Several studies have explored the influence of environmental and ecological factors on hantavirus activity, including rodent population dynamics, rainfall patterns and land-use change.^10,11 Public health experts note that surveillance remains important in understanding how these factors may affect regional transmission patterns.

Why has hantavirus received renewed attention?

Recent WHO Disease Outbreak News updates highlighted hantavirus activity involving Andes virus in South America.² Andes virus has previously been associated with limited person-to-person transmission in close-contact settings, distinguishing it from most other hantaviruses.⁶

The publication of updated public health guidance and increased media reporting have contributed to renewed public and clinical interest in hantavirus infections.^2–8

Experts cited by the London School of Hygiene & Tropical Medicine have emphasized that the overall risk to the general public remains low outside endemic regions, while also highlighting the importance of awareness and surveillance.⁴

How is hantavirus transmitted?

Most hantavirus infections occur following exposure to infected rodents or contaminated environments.1,5,6 Public health agencies identify common exposure settings as including:^1,5,6

• cleaning enclosed spaces contaminated with rodent waste
• agricultural or forestry work
• outdoor or rural exposure
• poorly ventilated cabins or storage spaces
• occupational exposure in endemic regions

According to the CDC, most hantaviruses are not transmitted between humans. However, Andes virus has been associated with occasional person-to-person transmission through prolonged close contact.⁶ Current evidence indicates that casual contact is not considered a major transmission route.^1,6

Differential diagnosis and diagnostic challenges

Peer-reviewed literature highlights that hantavirus infection can be difficult to recognize early because initial symptoms overlap with a range of infectious diseases.^9–11

Depending on the clinical presentation and geographic setting, differential diagnoses may include: influenza, COVID-19, leptospirosis, dengue fever, atypical bacterial pneumonia, sepsis, and other viral hemorrhagic fevers.^9–11

Clinicians should therefore consider exposure history, travel history and laboratory findings alongside clinical presentation when evaluating patients with compatible syndromes.

Laboratory findings clinicians should be aware of:

Several laboratory abnormalities have been described in hantavirus infection and may support clinical suspicion.^9–11

Reported findings include:

• thrombocytopenia
• leukocytosis
• elevated hematocrit
• elevated creatinine
• proteinuria
• elevated liver enzymes
• rapidly worsening hypoxia in HPS/HCPS

Public health guidance recommends confirmatory testing through specialist or reference laboratories where appropriate, which varies by country.^1–3

What should clinicians consider?

International guidance recommends that clinicians consider hantavirus infection in patients presenting with compatible symptoms and relevant exposure histories.^1–3,5

Situations where consideration may be appropriate include: recent travel to endemic areas, known rodent exposure, severe unexplained respiratory illness, and acute febrile illness with renal involvement or thrombocytopenia.^1,2,7,8

WHO and CDC guidance emphasize the importance of obtaining detailed travel, occupational and environmental exposure histories, particularly in patients with severe or rapidly progressive illness.^1,2,5

Infection prevention and healthcare considerations

For most hantaviruses, standard infection prevention precautions are considered appropriate in healthcare settings.^1,3 However, additional precautions may be considered if Andes virus infection is suspected because limited person-to-person transmission has previously been reported.^2,6

The WHO outbreak toolbox³ highlights the importance of:

1. appropriate specimen handling
2. environmental cleaning
3. multidisciplinary coordination
4. timely communication with public health authorities

Healthcare professionals involved in laboratory handling or environmental decontamination should follow local biosafety guidance and public health recommendations.^1,3

Clinical management

There are currently no widely approved specific antiviral therapies for most hantavirus infections.1 Management recommendations from WHO and CDC guidance primarily focus on supportive care and early recognition of severe disease.^1,5

Patients with significant respiratory involvement may require supplemental oxygen, hemodynamic support, and intensive care management.^1,5,7 Early escalation of care may be important in patients with rapidly progressive respiratory compromise.

Prevention and public health messaging

Current prevention strategies focus primarily on reducing exposure to rodents and contaminated environments. Public health agencies also emphasize the importance of balanced public communication that supports awareness without causing unnecessary concern.^4,8

Research and future directions

Ongoing research continues to explore several aspects of hantavirus infection, including vaccine development, antiviral therapies, improved molecular diagnostics, ecological surveillance, and One Health approaches to zoonotic disease monitoring.^9–11

Several peer-reviewed reviews have also highlighted the importance of continued international surveillance and interdisciplinary collaboration in understanding emerging zoonotic infections.

Conclusion

Recent public health updates have increased awareness of hantavirus infections globally, particularly following reported outbreaks in the Americas. Although infections remain uncommon in many settings, international agencies continue to emphasize the importance of surveillance, exposure assessment and clinician awareness.

For healthcare professionals, current guidance focuses on recognizing compatible clinical presentations, obtaining appropriate exposure histories and following public health recommendations for testing, reporting and supportive management.

References

1. World Health Organization. WHO hantavirus fact sheet. 2026. Available at: https://www.who.int/news-room/fact-sheets/detail/hantavirus (accessed May 12, 2026).
2. World Health Organization. WHO Disease Outbreak News: Hantavirus. 2026. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON600 (accessed May 12, 2026).
3. World Health Organization. WHO hantavirus outbreak toolbox. 2026. Available at: https://www.who.int/emergencies/outbreak-toolkit/disease-outbreak-toolboxes/hantavirus-outbreak-toolbox (accessed May 12, 2026).
4. London School of Hygiene & Tropical Medicine. Should I be worried about hantavirus? 2026. Available at: https://www.lshtm.ac.uk/newsevents/news/2026/rapid-reaction-should-i-be-worried-about-hantavirus (accessed May 12, 2026).
5. UK Health Security Agency. What is hantavirus, how is it transmitted and what are the symptoms? 2026. Available at: https://ukhsa.blog.gov.uk/2026/05/05/what-is-hantavirus-how-is-it-transmitted-and-what-are-the-symptoms/ (accessed May 12, 2026).
6. Centers for Disease Control and Prevention. CDC Andes virus overview. 2026. Available at: https://www.cdc.gov/hantavirus/about/andesvirus.html (accessed May 12, 2026).
7. Centers for Disease Control and Prevention. Hantavirus situation summary. 2026. Available at: https://www.cdc.gov/hantavirus/situation-summary/index.html (accessed May 12, 2026).
8. European Centre for Disease Prevention and Control. ECDC hantavirus questions and answers. 2026. Available at: https://www.ecdc.europa.eu/en/infectious-disease-topics/hantavirus-infection/surveillance-and-updates/questions-answers-outbreak (accessed May 12, 2026).
9. Vaheri A, Strandin T, Hepojoki J, et al. Uncovering the mysteries of hantavirus infections. Nat Rev Microbiol. 2013;11:539–50.
10. Jonsson CB, Figueiredo LTM, Vapalahti O. A global perspective on hantavirus ecology, epidemiology and disease. Clin Microbiol Rev. 2010;23:412–41.
11. MacNeil A, Nichol ST, Spiropoulou CF. Hantavirus pulmonary syndrome. Virus Res. 2011;162:138–47.
12. The BMJ. Hantavirus: what clinicians need to know. BMJ. 2026;393:s877.
13. World Organisation for Animal Health. WOAH hantaviruses infection document. 2022. Available at: https://www.woah.org/app/uploads/2022/02/hantaviruses-infection-with.pdf (accessed May 12, 2026).

Related content

Strengthening global infectious disease control: Insights from ISID

Rebuilding vaccine confidence after COVID-19: Practical guidance for clinicians

Unravelling HIV persistence: How tissue immunology and single-cell multi-omics are redefining the reservoir