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Hantavirus pulmonary syndrome

Medically reviewed by Last updated on Dec 28, 2023.


Hantavirus pulmonary syndrome is a rare infectious disease that begins with flu-like symptoms and progresses rapidly to more severe disease. It can lead to life-threatening lung and heart problems. The disease is also called hantavirus cardiopulmonary syndrome.

Several strains of the hantavirus can cause hantavirus pulmonary syndrome. They are carried by different types of rodents. The most common carrier in North America is the deer mouse. Infection is usually caused by inhaling hantaviruses that have become airborne from rodent urine, droppings or saliva.

Because treatment options are limited, the best protection against hantavirus pulmonary syndrome is to avoid contact with rodents and safely clean up rodent habitats.


The time from infection with the hantavirus to the start of illness is usually about 2 to 3 weeks. Hantavirus pulmonary syndrome advances through two distinct stages. In the first stage, which can last for several days, the most common signs and symptoms are:

Some people also experience:

As the disease progresses, it can lead to damaged lung tissues, fluid build-up in the lungs, and serious problems with lung and heart function. Signs and symptoms may include:

When to see a doctor

The signs and symptoms of hantavirus pulmonary syndrome can worsen suddenly and may quickly become life-threatening. If you have flu-like symptoms that progressively worsen over a few days, see your health care provider. Get immediate medical care if you have trouble breathing.


Rodent carriers

Hantavirus pulmonary syndrome is a human disease found only in North and South America. Each strain of the hantavirus has a preferred rodent carrier.

The deer mouse is the most common carrier of the virus in North America and Central America. In the United States, most of the infections occur in the states west of the Mississippi River.

Other carriers in North America include the rice rat and cotton rat in the Southeast and the white-footed mouse in the Northeast. Rodent carriers in South America include the rice rat and the vesper mouse.


The virus is present in the rodent's urine, feces or saliva. You can come in contact with the virus in the following ways:

Person-to-person transmission of the virus has only been recorded with a strain of the virus found in South America called the Andes virus.

Effect of the virus

When hantaviruses reach the lungs, they invade tiny blood vessels called capillaries, eventually causing them to leak. Your lungs fill with fluid (pulmonary edema), resulting in severe dysfunction of the lungs and heart.

Related disease

Another disease caused by different strains of the hantavirus is called hemorrhagic fever with renal syndrome, which causes severe kidney disease. These variants of the virus have other animal carriers in Africa, Asia and Europe.

Risk factors

In the United States, hantavirus pulmonary syndrome is most common in rural areas of the West. However, any exposure to rodent habitats can increase the risk of disease.

Common sites for exposure to rodent nests, urine and droppings include:

Activities that can increase the risk of exposure to the hantavirus include:


Hantavirus pulmonary syndrome can quickly become life-threatening. Severe disease can result in failure of the heart to deliver oxygen to the body. Each strain of the virus differs in severity. The death rate due to the strain carried by deer mice ranges from 30% to 50%.


Keeping rodents out of your home and workplace can help reduce your risk of hantavirus infection. Try these tips:

Safe cleanup procedures

Safe cleaning will help prevent the spread of viruses. Follow these steps:


Blood tests can reveal if your body has made antibodies to a hantavirus. Your doctor may order other laboratory tests to rule out other conditions with similar symptoms.


Specific treatment options for hantavirus pulmonary syndrome are limited. But the prognosis improves with early recognition, immediate hospitalization and adequate support for breathing.

Supportive therapy

People with severe cases need immediate treatment in an intensive care unit. Intubation and mechanical ventilation may be needed to support breathing and to help manage fluid in the lungs. Intubation involves placing a breathing tube through your nose or mouth into the windpipe (trachea) to help keep your airways open and functioning.

Blood oxygenation

Severe disease may require a treatment called extracorporeal membrane oxygenation (ECMO) to help ensure you retain a sufficient supply of oxygen. This involves continuously pumping your blood through a machine that removes carbon dioxide and adds oxygen. The oxygenated blood is then returned to your body.

Preparing for your appointment

You might first see your family doctor. However, when you call to set up an appointment, your doctor may recommend urgent medical care. If you're having difficulty breathing or know you have been exposed to rodents, seek emergency medical attention.

What you can do

Before your appointment, you may want to write a list of answers to the following questions:

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

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