Hantaan virus and Puumala virus (Hantaan virus: HTNV Puumala virus: PUUV)

Hantaan virus and Puumala virus are related but distinct viral pathogens within the Hantavirus genus (family Bunyaviridae). They possess a tri-segmented, negative-sense, single-stranded RNA genome and infect humans by transmission from rodent hosts through aerosolized excreta. Hantaan virus is the prototypical agent of severe hemorrhagic fever with renal syndrome (HFRS), predominantly in East Asia, and carries higher mortality (~5–15%). Puumala virus is endemic to Europe and Russia, generally causes a milder form of HFRS called nephropathia epidemica, and has a much lower case fatality (<1%). Both viruses enter host cells by binding to specific proteins/receptors (often β3 integrins) on endothelial cells, especially in the kidney and, for Hantaan virus, sometimes the lungs. There are no specific antivirals officially approved for either; ribavirin has limited evidence and is used mainly in severe outbreaks. Disease susceptibility and severity are modulated by host genetic biomarkers, especially HLA alleles and inflammatory markers. Pathogenicity is driven by viral replication, host immune response, and endothelial dysfunction, leading to capillary leakage, hemorrhage, and renal impairment.

Other names

Hantaan virus: Hantaan orthohantavirus, HTNVPuumala virus: Puumala orthohantavirus, PUUV, nephropathia epidemica virus

For ribavirin: inhibition of viral RNA-dependent RNA polymerase Supportive therapies: symptom management, not direct antiviral action