Hantavirus: Why Does This Rare Virus Continue to Concern Intensive Care Specialists?

By Ana Espino | Published on June 03, 2026 | 4 min read


Little known to the general public, hantavirus is nevertheless responsible for one of the most feared viral infections in intensive care medicine. It is mainly transmitted through the inhalation of contaminated particles from the excreta of infected rodents and can cause a severe Hantavirus Cardiopulmonary Syndrome (HCPS) characterized by acute respiratory distress, shock, and multiorgan failure. In South America, the Andes virus (ANDV) is of particular concern because, unlike other hantaviruses, it can be transmitted from person to person.

Despite significant advances in understanding the disease over recent decades, treatment options remain limited. No specific antiviral therapy has demonstrated sufficient efficacy to be routinely recommended, and management relies primarily on supportive care. The rapid progression of the infection, combined with its high mortality rate, presents a major challenge for healthcare teams.

In response to these issues, researchers from Argentina, Chile, and Spain conducted a narrative literature review to summarize current knowledge on the epidemiology, diagnosis, prevention measures, and management of hantavirus cardiopulmonary syndrome in the era of globalization.

Behind the Scenes of a Virus Capable of Destabilizing the Body Within Hours

The authors reviewed the most recent data on hantavirus infection, with a particular focus on the Andes virus, the leading cause of severe cases in South America.

The review highlights that the disease typically begins with a flu-like phase characterized by fever, headache, and muscle aches. However, this often misleading stage can rapidly progress to severe cardiopulmonary deterioration, marked by pulmonary edema, severe respiratory failure, and shock requiring admission to intensive care.

The authors emphasize the importance of early diagnosis. Several biological markers appear particularly suggestive of the disease, including:

• Severe thrombocytopenia
• Hemoconcentration
• Neutrophilia
• Presence of immunoblasts in peripheral blood
• Elevated lactate dehydrogenase (LDH) levels

Diagnosis is then confirmed through serological testing or RT-PCR.

The review also highlights a major characteristic of the Andes virus: its proven ability to spread between humans in Argentina and Chile. This feature necessitates enhanced isolation measures in certain regions of South America and raises important concerns regarding hospital infection prevention.

Management Still Relies Primarily on Supportive Care

The findings show that treatment remains largely symptomatic. Key management strategies include:

• Careful fluid management
• Use of vasopressors
• Protective mechanical ventilation

The authors note that corticosteroids have not shown sufficient benefit to justify routine use, and ribavirin does not appear effective during the cardiopulmonary phase of the disease.

Conversely, several approaches are generating increasing interest. Convalescent plasma has shown promise in several studies, while extracorporeal membrane oxygenation (ECMO) is becoming an important life-saving option for the most critically ill patients. In specialized centers, ECMO has produced encouraging survival rates among patients whose prognosis was initially considered extremely poor.

What If the Future Depends More on Intensive Care Than on Antivirals?

This review confirms that hantavirus infection remains a formidable medical emergency, characterized by rapid progression and persistently high mortality. It also underscores the ongoing challenges posed by the lack of effective antiviral treatments and the critical need for extremely early diagnosis.

The authors emphasize that the progress achieved in recent years is largely attributable to improvements in intensive care management, optimization of ventilation strategies, and access to advanced technologies such as ECMO. Epidemiological surveillance and preventive measures also remain essential, particularly in areas where person-to-person transmission of the Andes virus has been documented.

However, several questions remain unanswered. The exact role of convalescent plasma, the potential benefit of certain immunomodulatory strategies, and the most effective isolation protocols continue to be debated. Likewise, the absence of a vaccine and the growing risk of emerging zoonotic diseases in an increasingly globalized world reinforce the need for continued research.

Ultimately, a better understanding of the pathophysiological mechanisms underlying hantavirus infection may pave the way for targeted therapies. Until then, early case recognition, rapid transfer to specialized centers, and high-quality organ-supportive care remain the best tools for improving patient outcomes.



About the author – Ana Espino
PhD in Immunology, specialized in Virology  
As a scientific writer, Ana is passionate about bridging the gap between research and real-world impact. With expertise in immunology, virology, oncology, and clinical studies, she makes complex science clear and accessible. Her mission: to accelerate knowledge sharing and empower evidence-based decisions.