Hantavirus infection: Frequently Asked Questions for the General Public

What is hantavirus infection?
Hantavirus infection causes three different types of illness, haemorrhagic fever with renal syndrome (HFRS) and nephropathia epidemica (NE) which both affect the kidneys, and pulmonary syndrome which affects the lungs (HPS). Hantaviruses found in Europe and Asia usually affect the kidneys while hantaviruses circulating in the Americas usually affect the lungs.

What are the symptoms of hantavirus infection?
Hantavirus infection can have no symptoms or cause mild to severe illness. Fever is the most common symptom in all three types of disease and lasts about 3-7 days. Other symptoms differ between the three types of disease. The time between being infected with hantavirus and developing symptoms is usually between one and five weeks.

Infection with hantaviruses causing HFRS and NE affect the kidneys and can last from three days to three months for complete recovery. Symptoms may begin suddenly and include:

  • fever
  • intense headache
  • abdominal pain
  • back pains
  • nausea
  • rash

Recovery from the NE form of hantavirus infection usually begins during the second week of illness. The HFRS form of hantavirus infection can last longer and cause leaking blood vessels and kidney failure. Between 1-15% of people with HFRS may die from the disease.

HPS affects the lungs and causes more severe disease. Around four out of 10 people with HPS may die from the disease. HPS has different symptoms in the early and late stages of disease. The most common early symptoms that half of people with HPS have are:

  • fever
  • tiredness
  • headache or dizziness
  • muscle aches especially in large muscles of thighs, hips, shoulders and back
  • nausea, vomiting, diarrohoea and stomach pain

The most common late symptoms that half of people with HPS have after 4-10 days illness are:

  • coughing
  • trouble breathing
  • feeling of not being able to breath as lungs fill with fluid

How is hantavirus spread?
People are infected with hantavirus when they breathe in the virus. This can happen when rodent urine or droppings of rodent nest materials are stirred up into the air. Rodents that can be infected with hantavirus include mice, rats, shrews and voles. Different rodents are infected in different countries. People can also be infected when they touch their eyes, nose or mouth after touching rodent urine, droppings, saliva or nesting materials.

Most people are infected with hantavirus through outdoor activities such as camping, working in farm buildings, or clearing out summer cabins where contact with rodents or their urine, droppings, saliva or nesting materials can occur. The best way to prevent infection with hantavirus is to avoid contact with rodents and their urine, droppings, saliva or nesting materials when travelling in affected areas. If you need to clean up rodent waste, detailed information on how to do so safely is available on the CDC US website.

So far only the Andean hantavirus found in South America has been shown to have spread from person to person on rare occasions and from very close contact. To date one case of hantavirus infection passed from mother to baby has been reported.

Hantavirus is not spread by the following:

  • regular social contact
  • usage of communal household utensils
  • caring for someone with hantavirus
  • from an infected partner during unprotected sex (without a condom)
  • from a blood transfusion

How is hantavirus infection treated?
Treatment for hantavirus consists of relieving pain, fever and any other symptoms. People with severe disease may need treatment in hospital to support their lungs or kidneys. Ribavirin is the only drug used in severe hantavirus infections in Europe. There is currently no vaccine available in Europe.

How is hantavirus infection diagnosed?
Laboratory tests are currently available to check if your blood has made antibodies to fight hantavirus infection. The National Virus Reference Laboratory performs initial hantavirus serology, with supplementary testing performed in the Rare and Imported Pathogens Laboratory in the UK. Your doctor may order other laboratory tests to rule out other conditions with similar symptoms.

Have cases of hantavirus infection been diagnosed in Ireland?
Hantavirus infection has been diagnosed in a small number of travellers returning from affected areas.

Are people in Ireland at risk of hantavirus infection?
Hantavirus can be imported into Ireland in a traveller returning from an affected area. However, as the virus is not spread through person to person contact, the virus is unlikely to spread further.

What countries are affected by hantavirus infection?
Hantavirus is widespread across most of Europe, except for Ireland, the UK, the Mediterranean coastal regions and the northernmost areas. Hantavirus is found in Northern America, including Canada and all states of the US except for Alaska and Hawaii. It is also found in Central America, South America and Eastern Asia.

What is the current travel advice?
The Department of Foreign Affairs and Trade (DFA) provides regularly updated guidance to travellers. Please consult the DFA website and click on the relevant country. It is important to check this information prior to any trips, as the situation could change rapidly.

What do I do if I’m living / working in an area where hantavirus is circulating?
Irish citizens who live in affected areas should take measures to prevent transmission. If you become ill you should contact your local health care provider who will be able to advise on your individual circumstances.

What do I do if I am travelling to an area where hantavirus is circulating?

  • All travellers going to an area affected by hantavirus should take measures to avoid contact with rodents and their urine, droppings, saliva, and nesting materials when travelling in affected areas.
  • People showing symptoms suggestive of Hantavirus infection between 1 and 5 weeks after returning from an affected area should contact their healthcare provider and mention that they have been in an affected area.

What do I do if I’m returning to Ireland from an area where hantavirus is circulating?
If you become ill when you return to Ireland, you should contact your doctor for assessment and let him/her know of your recent travel history to an affected area.

Last updated: 16 January 2019