Hantavirus Infections: Emerging Epidemiological and Therapeutic Challenges, Epidemiology, Pathogenesis, Diagnosis and Management

Objective: To systematically review the epidemiology, pathogenesis, diagnosis, clinical manifestations, and management approaches of hantavirus infections with emphasis on their emerging public health threat. Data Sources: A comprehensive literature review was conducted using electronic databases including PubMed, Scopus, Google Scholar, and WHO/CDC publications. Articles published from 2000 to 2025 were reviewed using the following keywords: "Hantavirus," "HPS," "HFRS," "epidemiology," "pathogenesis," "diagnosis," and "management." Study Selection: Relevant preclinical, clinical, and review articles published in English were selected based on their relevance to hantavirus epidemiology, virology, clinical presentation, diagnosis, and management. Studies lacking scientific validation or sufficient data were excluded. Summary of Content: Hantaviruses are zoonotic RNA viruses transmitted by rodents that cause two serious clinical syndromes: hemorrhagic fever with renal syndrome (HFRS), predominantly in Europe and Asia, and hantavirus pulmonary syndrome (HPS), predominantly in the Americas. Both syndromes are characterized by increased vascular permeability attributable to immune-mediated endothelial dysfunction, resulting in capillary leak syndrome. Serological tests (ELISA) and molecular methods (RT-PCR) are the cornerstones of laboratory diagnosis. Clinical presentation ranges from mild febrile illness to life-threatening respiratory failure and shock. Intensive supportive care remains the primary mode of management, with ribavirin demonstrating benefit primarily in HFRS patients. Prevention strategies emphasize rodent control and personal protective measures. Conclusion: Hantavirus infections remain significant emerging zoonotic diseases with high mortality rates. Enhanced disease surveillance, improved laboratory diagnostics, integrated rodent control programmes, and accelerated development of effective vaccines and antiviral therapies are essential to mitigate the global disease burden.