Hanta virus (ICD-10-GM A98.5: Hemorrhagic fever with renal syndrome: hantavirus disease with renal involvement) is an RNA virus that belongs to the Bunyaviridae family. The Bunyaviridae family belongs to the list of arboviruses transmissible to humans by arthropods (arthropods).
The disease belongs to the group of viral hemorrhagic fevers and viral zoonoses (animal diseases).
Rodents are the reservoir of the pathogen. In Germany, these are mainly the red/ burnt and yellow-necked mice. In the meantime, the virus has also been detected in shrews, moles and even bats. The virus is excreted with body fluids (saliva, feces and urine).
Occurrence: Hanta viruses are distributed worldwide.
The following virus types can be distinguished:
- Hantaan group
- Hantaan virus* (HTNV) – Occurrence: Russia, China, Korea (fire mouse; Apodemus agrarius); lethality (mortality based on total number of people infected with the disease) 0.3-0.9%.
- Dobrava-Belgrade virus* (DOBV).
- Kurkinao (DOBV-Aa) – Occurrence: Central and Eastern Europe/North/Eastern Germany (fire mouse; Apodemus agrarius); lethality 0.3-0.9%.
- Dobrava (DOBV-Af) – Occurrence: Balkans (yellow-necked mouse; Apodemus flavicollis); lethality 10-12 %.
- Socchi (DOBV-Ap) – Occurrence: Russia (Crimea) (Black Sea forest mouse; Apdemus pnticus); lethality > 6 %.
- Puumala group
- Puumala virus* – Occurrence: Balkans, Central Europe, Russia, Northern/Western Europe, Southern/Western Germany (Swabian Alb; red-backed vole; Myodes glareolus); lethality <1%.
- Andes virus* * (ANDV) – Occurrence: South America (“rice rat”; Oligoryzomys longicaudatus); lethality 35 %.
- Seoul virus* – Occurrence: Asia and possibly worldwide (rat species); lethality 1-2 %.
- Sin nombre virus* * (SNV) – Occurrence: America (deer mouse; Peromyscus maniculatus); lethality 35 %.
- Tula group – only slightly pathogenic
- Tula virus* (TULV) – Occurrence: Germany (field mouse; Microtus arvalis); lethality ?
* Hemorrhagic fever with renal syndrome (HFRS) * * Hanta virus-induced (cardio-)pulmonary syndrome (HCPS).
Hanta virus is a causative agent of hemorrhagic fever with renal (affecting the kidneys) syndrome, among others.
Transmission of the pathogen (route of infection) occurs by respiratory ingestion (via the respiratory tract by inhalation) of the pathogen via dried feces or urine as dust.
Human-to-human transmission: appears to be possible only with Andes virus.
Incubation period (time from infection to onset of disease) is usually 2-4 weeks (min. 5, max. 60 days).
Sex ratio: Men are more frequently affected than women.
Frequency peak: The disease occurs predominantly between the 30th and 49th year of life. The disease is rare in those under 15 years of age.
The incidence (frequency of new cases) varies greatly each year. In 2010, it was approximately 3 cases per 100,000 inhabitants. In 2011, it was more than 80% lower. The cause is the annual fluctuation of the rodent population.
Course and prognosis: Hanta viruses preferentially damage the kidneys (interstitial nephritis) or the lungs. The course of the disease depends on the virus type (see above). Infections with indigenous virus types are often asymptomatic (without noticeable symptoms). If the kidneys are affected (HFRS), renal insufficiency (kidney weakness) requiring dialysis may develop. Typical of Hanta virus-induced (cardio-)pulmonary syndrome (HCPS) is the development of pulmonary edema (accumulation of water in the lungs). Regarding prognosis (lethality) see above under the respective virus type.
In Germany, the disease is reportable according to the Infection Protection Act (IfSG) already at suspicion.
