Home > Journals > Panminerva Medica > Past Issues > Panminerva Medica 2003 March;45(1) > Panminerva Medica 2003 March;45(1):43-51





A Journal on Internal Medicine

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,6




Panminerva Medica 2003 March;45(1):43-51

language: English

Hantaviruses: a tale of two hemispheres

Khan A., Khan A. S.

Special Pathogens Branch - MS A26 Centers for Disease Control and Prevention, Atlanta, USA


Infectious feb­rile neph­rop­a­thies, ­initially ­described as epi­demics ­during mil­i­tary cam­paigns in Europe and Asia at the ­turn of the 20th cen­tury, ­were even­tu­ally all uni­fied ­under the ­rubric of hemor­rhagic ­fever ­with ­renal syn­drome (­HFRS) and ­ascribed to infec­tion ­from ­rodent-­borne han­ta­vi­ruses. At the end of the cen­tury, han­ta­virus pul­mo­nary syn­drome (HPS) was ­described ­throughout the Americas as a con­se­quence of infec­tion ­with the New World han­ta­vi­ruses. The epi­dem­i­ology and clin­ical man­i­fes­ta­tions of ­these dis­eases are ­linked to the ­ecology of ­their asso­ciated ­rodent ­hosts. Murine ­rodents (Old World ­mice and ­rats) are asso­ciated ­with the ­severe ­forms of ­HFRS in Asia and the Balkans due to Hantaan, Dobrava, and Seoul ­viruses. Hantaan ­virus ­causes an esti­mated 50-100,000 infec­tions a ­year in China ­alone. Arvicoline ­rodents (­voles) are asso­ciated ­with a ­mild ­form of ­HFRS in Europe ­called neph­ro­pathia epi­demica due to Puumala ­virus. Sigmodontine ­rodents (New World ­rats and ­mice) are asso­ciated ­with approx­i­mately 200 HPS ­cases per ­year ­throughout the Americas ­caused by ­over a ­dozen ­viruses. The ­viruses are ­mainly trans­mitted as ­small-par­ticle aero­sols of ­rodent ­excreta, and the sub­se­quent infec­tions ­share car­di­o­vas­cular ­shock as a prom­i­nent fea­ture, ­although ­HFRS ­causes pre­dom­i­nantly ­renal dis­ease, ­while HPS ­causes a pre­dom­i­nantly non-car­di­o­genic pul­mo­nary ­edema — hem­or­rhage involve­ment ­varies in the syn­dromes on the ­basis of ­virus sub­types. Efforts are ­underway to ­refine pre­ven­tion strat­e­gies, under­stand the path­o­gen­esis of the ­shock, and iden­tify ther­a­peutic modal­ities.

top of page

Publication History

Cite this article as

Corresponding author e-mail