Logo of eidLink to Publisher's site
Emerg Infect Dis. 1997 Apr-Jun; 3(2): 95–104.
PMCID: PMC2627612

Hantaviruses: a global disease problem.


Hantaviruses are carried by numerous rodent species throughout the world. In 1993, a previously unknown group of hantaviruses emerged in the United States as the cause of an acute respiratory disease now termed hantavirus pulmonary syndrome (HPS). Before than, hantaviruses were known as the etiologic agents of hemorrhagic fever with renal syndrome, a disease that occurs almost entirely in the Eastern Hemisphere. Since the discovery of the HPS-causing hantaviruses, intense investigation of the ecology and epidemiology of hantaviruses has led to the discovery of many other novel hantaviruses. Their ubiquity and potential for causing severe human illness make these viruses an important public health concern; we reviewed the distribution, ecology, disease potential, and genetic spectrum.

Full Text

The Full Text of this article is available as a PDF (214K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Lee HW, van der Groen G. Hemorrhagic fever with renal syndrome. Prog Med Virol. 1989;36:62–102. [PubMed]
  • GAJDUSEK DC. Virus hemorrhagic fevers. Special reference to hemorrhagic fever with renal syndrome (epidemic hemorrhagic fever). J Pediatr. 1962 Jun;60:841–857. [PubMed]
  • SMADEL JE. Epidemic hemorrhagic fever. Am J Public Health Nations Health. 1953 Oct;43(10):1327–1330. [PMC free article] [PubMed]
  • Casals J, Henderson BE, Hoogstraal H, Johnson KM, Shelokov A. A review of Soviet viral hemorrhagic fevers, 1969. J Infect Dis. 1970 Nov;122(5):437–453. [PubMed]
  • Lee HW, Lee PW, Johnson KM. Isolation of the etiologic agent of Korean Hemorrhagic fever. J Infect Dis. 1978 Mar;137(3):298–308. [PubMed]
  • French GR, Foulke RS, Brand OA, Eddy GA, Lee HW, Lee PW. Korean hemorrhagic fever: propagation of the etiologic agent in a cell line of human origin. Science. 1981 Mar 6;211(4486):1046–1048. [PubMed]
  • Traub R, Wisseman CL., Jr Korean hemorrhagic fever. J Infect Dis. 1978 Aug;138(2):267–272. [PubMed]
  • Nichol ST, Spiropoulou CF, Morzunov S, Rollin PE, Ksiazek TG, Feldmann H, Sanchez A, Childs J, Zaki S, Peters CJ. Genetic identification of a hantavirus associated with an outbreak of acute respiratory illness. Science. 1993 Nov 5;262(5135):914–917. [PubMed]
  • Ksiazek TG, Peters CJ, Rollin PE, Zaki S, Nichol S, Spiropoulou C, Morzunov S, Feldmann H, Sanchez A, Khan AS, et al. Identification of a new North American hantavirus that causes acute pulmonary insufficiency. Am J Trop Med Hyg. 1995 Feb;52(2):117–123. [PubMed]
  • Schmaljohn AL, Li D, Negley DL, Bressler DS, Turell MJ, Korch GW, Ascher MS, Schmaljohn CS. Isolation and initial characterization of a newfound hantavirus from California. Virology. 1995 Feb 1;206(2):963–972. [PubMed]
  • Duchin JS, Koster FT, Peters CJ, Simpson GL, Tempest B, Zaki SR, Ksiazek TG, Rollin PE, Nichol S, Umland ET, et al. Hantavirus pulmonary syndrome: a clinical description of 17 patients with a newly recognized disease. The Hantavirus Study Group. N Engl J Med. 1994 Apr 7;330(14):949–955. [PubMed]
  • Khan AS, Spiropoulou CF, Morzunov S, Zaki SR, Kohn MA, Nawas SR, McFarland L, Nichol ST. Fatal illness associated with a new hantavirus in Louisiana. J Med Virol. 1995 Jul;46(3):281–286. [PubMed]
  • Khan AS, Gaviria M, Rollin PE, Hlady WG, Ksiazek TG, Armstrong LR, Greenman R, Ravkov E, Kolber M, Anapol H, et al. Hantavirus pulmonary syndrome in Florida: association with the newly identified Black Creek Canal virus. Am J Med. 1996 Jan;100(1):46–48. [PubMed]
  • Hjelle B, Goade D, Torrez-Martinez N, Lang-Williams M, Kim J, Harris RL, Rawlings JA. Hantavirus pulmonary syndrome, renal insufficiency, and myositis associated with infection by Bayou hantavirus. Clin Infect Dis. 1996 Sep;23(3):495–500. [PubMed]
  • Hjelle B, Anderson B, Torrez-Martinez N, Song W, Gannon WL, Yates TL. Prevalence and geographic genetic variation of hantaviruses of New World harvest mice (Reithrodontomys): identification of a divergent genotype from a Costa Rican Reithrodontomys mexicanus. Virology. 1995 Mar 10;207(2):452–459. [PubMed]
  • Childs JE, Korch GW, Glass GE, LeDuc JW, Shah KV. Epizootiology of Hantavirus infections in Baltimore: isolation of a virus from Norway rats, and characteristics of infected rat populations. Am J Epidemiol. 1987 Jul;126(1):55–68. [PubMed]
  • Lee HW, Lee PW, Baek LJ, Song CK, Seong IW. Intraspecific transmission of Hantaan virus, etiologic agent of Korean hemorrhagic fever, in the rodent Apodemus agrarius. Am J Trop Med Hyg. 1981 Sep;30(5):1106–1112. [PubMed]
  • Chen HX, Qiu FX, Dong BJ, Ji SZ, Li YT, Wang Y, Wang HM, Zuo GF, Tao XX, Gao SY. Epidemiological studies on hemorrhagic fever with renal syndrome in China. J Infect Dis. 1986 Sep;154(3):394–398. [PubMed]
  • Niklasson B, LeDuc JW. Epidemiology of nephropathia epidemica in Sweden. J Infect Dis. 1987 Feb;155(2):269–276. [PubMed]
  • Glass GE, Childs JE, Korch GW, LeDuc JW. Association of intraspecific wounding with hantaviral infection in wild rats (Rattus norvegicus). Epidemiol Infect. 1988 Oct;101(2):459–472. [PMC free article] [PubMed]
  • Douron E, Moriniere B, Matheron S, Girard PM, Gonzalez JP, Hirsch F, McCormick JB. HFRS after a wild rodent bite in the Haute-Savoie--and risk of exposure to Hantaan-like virus in a Paris laboratory. Lancet. 1984 Mar 24;1(8378):676–677. [PubMed]
  • Armstrong LR, Zaki SR, Goldoft MJ, Todd RL, Khan AS, Khabbaz RF, Ksiazek TG, Peters CJ. Hantavirus pulmonary syndrome associated with entering or cleaning rarely used, rodent-infested structures. J Infect Dis. 1995 Oct;172(4):1166–1166. [PubMed]
  • Hjelle B, Tórrez-Martínez N, Koster FT, Jay M, Ascher MS, Brown T, Reynolds P, Ettestad P, Voorhees RE, Sarisky J, et al. Epidemiologic linkage of rodent and human hantavirus genomic sequences in case investigations of hantavirus pulmonary syndrome. J Infect Dis. 1996 Apr;173(4):781–786. [PubMed]
  • Jay M, Hjelle B, Davis R, Ascher M, Baylies HN, Reilly K, Vugia D. Occupational exposure leading to hantavirus pulmonary syndrome in a utility company employee. Clin Infect Dis. 1996 May;22(5):841–844. [PubMed]
  • Enría D, Padula P, Segura EL, Pini N, Edelstein A, Posse CR, Weissenbacher MC. Hantavirus pulmonary syndrome in Argentina. Possibility of person to person transmission. Medicina (B Aires) 1996;56(6):709–711. [PubMed]
  • Umenai T, Lee HW, Lee PW, Saito T, Toyoda T, Hongo M, Yoshinaga K, Nobunaga T, Horiuchi T, Ishida N. Korean haemorrhagic fever in staff in an animal laboratory. Lancet. 1979 Jun 23;1(8130):1314–1316. [PubMed]
  • Desmyter J, LeDuc JW, Johnson KM, Brasseur F, Deckers C, van Ypersele de Strihou C. Laboratory rat associated outbreak of haemorrhagic fever with renal syndrome due to Hantaan-like virus in Belgium. Lancet. 1983 Dec 24;2(8365-66):1445–1448. [PubMed]
  • Brummer-Korvenkontio M, Vaheri A, Hovi T, von Bonsdorff CH, Vuorimies J, Manni T, Penttinen K, Oker-Blom N, Lähdevirta J. Nephropathia epidemica: detection of antigen in bank voles and serologic diagnosis of human infection. J Infect Dis. 1980 Feb;141(2):131–134. [PubMed]
  • Lee HW, Johnson KM. Laboratory-acquired infections with Hantaan virus, the etiologic agent of Korean hemorrhagic fever. J Infect Dis. 1982 Nov;146(5):645–651. [PubMed]
  • Xiao SY, Leduc JW, Chu YK, Schmaljohn CS. Phylogenetic analyses of virus isolates in the genus Hantavirus, family Bunyaviridae. Virology. 1994 Jan;198(1):205–217. [PubMed]
  • Rawlings JA, Torrez-Martinez N, Neill SU, Moore GM, Hicks BN, Pichuantes S, Nguyen A, Bharadwaj M, Hjelle B. Cocirculation of multiple hantaviruses in Texas, with characterization of the small (S) genome of a previously undescribed virus of cotton rats (Sigmodon hispidus). Am J Trop Med Hyg. 1996 Dec;55(6):672–679. [PubMed]
  • Plyusnin A, Vapalahti O, Lankinen H, Lehväslaiho H, Apekina N, Myasnikov Y, Kallio-Kokko H, Henttonen H, Lundkvist A, Brummer-Korvenkontio M, et al. Tula virus: a newly detected hantavirus carried by European common voles. J Virol. 1994 Dec;68(12):7833–7839. [PMC free article] [PubMed]
  • Schmaljohn CS, Hasty SE, Dalrymple JM, LeDuc JW, Lee HW, von Bonsdorff CH, Brummer-Korvenkontio M, Vaheri A, Tsai TF, Regnery HL, et al. Antigenic and genetic properties of viruses linked to hemorrhagic fever with renal syndrome. Science. 1985 Mar 1;227(4690):1041–1044. [PubMed]
  • Chu YK, Rossi C, Leduc JW, Lee HW, Schmaljohn CS, Dalrymple JM. Serological relationships among viruses in the Hantavirus genus, family Bunyaviridae. Virology. 1994 Jan;198(1):196–204. [PubMed]
  • Chu YK, Jennings G, Schmaljohn A, Elgh F, Hjelle B, Lee HW, Jenison S, Ksiazek T, Peters CJ, Rollin P, et al. Cross-neutralization of hantaviruses with immune sera from experimentally infected animals and from hemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome patients. J Infect Dis. 1995 Dec;172(6):1581–1584. [PubMed]
  • Schmaljohn CS, Arikawa J, Hasty SE, Rasmussen L, Lee HW, Lee PW, Dalrymple JM. Conservation of antigenic properties and sequences encoding the envelope proteins of prototype Hantaan virus and two virus isolates from Korean haemorrhagic fever patients. J Gen Virol. 1988 Aug;69(Pt 8):1949–1955. [PubMed]
  • Nerurkar VR, Song JW, Song KJ, Nagle JW, Hjelle B, Jenison S, Yanagihara R. Genetic evidence for a hantavirus enzootic in deer mice (Peromyscus maniculatus) captured a decade before the recognition of hantavirus pulmonary syndrome. Virology. 1994 Nov 1;204(2):563–568. [PubMed]
  • Rowe JE, St Jeor SC, Riolo J, Otteson EW, Monroe MC, Henderson WW, Ksiazek TG, Rollin PE, Nichol ST. Coexistence of several novel hantaviruses in rodents indigenous to North America. Virology. 1995 Oct 20;213(1):122–130. [PubMed]
  • Li D, Schmaljohn AL, Anderson K, Schmaljohn CS. Complete nucleotide sequences of the M and S segments of two hantavirus isolates from California: evidence for reassortment in nature among viruses related to hantavirus pulmonary syndrome. Virology. 1995 Feb 1;206(2):973–983. [PubMed]
  • Spiropoulou CF, Morzunov S, Feldmann H, Sanchez A, Peters CJ, Nichol ST. Genome structure and variability of a virus causing hantavirus pulmonary syndrome. Virology. 1994 May 1;200(2):715–723. [PubMed]
  • Carey DE, Reuben R, Panicker KN, Shope RE, Myers RM. Thottapalayam virus: a presumptive arbovirus isolated from a shrew in India. Indian J Med Res. 1971 Nov;59(11):1758–1760. [PubMed]
  • Henderson WW, Monroe MC, St Jeor SC, Thayer WP, Rowe JE, Peters CJ, Nichol ST. Naturally occurring Sin Nombre virus genetic reassortants. Virology. 1995 Dec 20;214(2):602–610. [PubMed]
  • Hjelle B, Jenison S, Torrez-Martinez N, Yamada T, Nolte K, Zumwalt R, MacInnes K, Myers G. A novel hantavirus associated with an outbreak of fatal respiratory disease in the southwestern United States: evolutionary relationships to known hantaviruses. J Virol. 1994 Feb;68(2):592–596. [PMC free article] [PubMed]
  • Hjelle B, Jenison SA, Goade DE, Green WB, Feddersen RM, Scott AA. Hantaviruses: clinical, microbiologic, and epidemiologic aspects. Crit Rev Clin Lab Sci. 1995;32(5-6):469–508. [PubMed]
  • Avsic-Zupanc T, Xiao SY, Stojanovic R, Gligic A, van der Groen G, LeDuc JW. Characterization of Dobrava virus: a Hantavirus from Slovenia, Yugoslavia. J Med Virol. 1992 Oct;38(2):132–137. [PubMed]
  • Lee HW, Baek LJ, Johnson KM. Isolation of Hantaan virus, the etiologic agent of Korean hemorrhagic fever, from wild urban rats. J Infect Dis. 1982 Nov;146(5):638–644. [PubMed]
  • Elwell MR, Ward GS, Tingpalapong M, LeDuc JW. Serologic evidence of Hantaan-like virus in rodents and man in Thailand. Southeast Asian J Trop Med Public Health. 1985 Sep;16(3):349–354. [PubMed]
  • Lee PW, Amyx HL, Yanagihara R, Gajdusek DC, Goldgaber D, Gibbs CJ., Jr Partial characterization of Prospect Hill virus isolated from meadow voles in the United States. J Infect Dis. 1985 Oct;152(4):826–829. [PubMed]
  • Hörling J, Chizhikov V, Lundkvist A, Jonsson M, Ivanov L, Dekonenko A, Niklasson B, Dzagurova T, Peters CJ, Tkachenko E, et al. Khabarovsk virus: a phylogenetically and serologically distinct hantavirus isolated from Microtus fortis trapped in far-east Russia. J Gen Virol. 1996 Apr;77(Pt 4):687–694. [PubMed]
  • Elliott LH, Ksiazek TG, Rollin PE, Spiropoulou CF, Morzunov S, Monroe M, Goldsmith CS, Humphrey CD, Zaki SR, Krebs JW, et al. Isolation of the causative agent of hantavirus pulmonary syndrome. Am J Trop Med Hyg. 1994 Jul;51(1):102–108. [PubMed]
  • Song JW, Baek LJ, Gajdusek DC, Yanagihara R, Gavrilovskaya I, Luft BJ, Mackow ER, Hjelle B. Isolation of pathogenic hantavirus from white-footed mouse (Peromyscus leucopus) Lancet. 1994 Dec 10;344(8937):1637–1637. [PubMed]
  • Ravkov EV, Rollin PE, Ksiazek TG, Peters CJ, Nichol ST. Genetic and serologic analysis of Black Creek Canal virus and its association with human disease and Sigmodon hispidus infection. Virology. 1995 Jul 10;210(2):482–489. [PubMed]
  • Torrez-Martinez N, Song W, Hjelle B. Nucleotide sequence analysis of the M genomic segment of El Moro Canyon hantavirus: antigenic distinction from four corners hantavirus. Virology. 1995 Aug 1;211(1):336–338. [PubMed]
  • Morzunov SP, Feldmann H, Spiropoulou CF, Semenova VA, Rollin PE, Ksiazek TG, Peters CJ, Nichol ST. A newly recognized virus associated with a fatal case of hantavirus pulmonary syndrome in Louisiana. J Virol. 1995 Mar;69(3):1980–1983. [PMC free article] [PubMed]
  • Plyusnin A, Vapalahti O, Lundkvist A, Henttonen H, Vaheri A. Newly recognised hantavirus in Siberian lemmings. Lancet. 1996 Jun 29;347(9018):1835–1835. [PubMed]
  • López N, Padula P, Rossi C, Lázaro ME, Franze-Fernández MT. Genetic identification of a new hantavirus causing severe pulmonary syndrome in Argentina. Virology. 1996 Jun 1;220(1):223–226. [PubMed]
  • Song W, Torrez-Martinez N, Irwin W, Harrison FJ, Davis R, Ascher M, Jay M, Hjelle B. Isla Vista virus: a genetically novel hantavirus of the California vole Microtus californicus. J Gen Virol. 1995 Dec;76(Pt 12):3195–3199. [PubMed]
  • Hjelle B, Torrez-Martinez N, Koster FT. Hantavirus pulmonary syndrome-related virus from Bolivia. Lancet. 1996 Jan 6;347(8993):57–57. [PubMed]

Articles from Emerging Infectious Diseases are provided here courtesy of Centers for Disease Control and Prevention


Save items

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...