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 EspinoPhD 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. 
