Korean haemorrhagic fever

Korean haemorrhagic fever is caused by Hantaan virus, and was first noted during the Korean war in the 1950s. The virus is found in field rodents and voles as well as laboratory rats

• in 1978, the etiologic agent of Korean Hemerologic fever was isolated from small infected field rodent Apodemus agrarius near Hantan river in South Korea
• virus was named as Hantaan virus, after the name of the river Hantan

Hantaviruses target endothelial cells

• can affect diverse organ systems; increased vascular permeability is central to pathogenesis (1)
• main clinical syndromes associated with hantaviruses are haemorrhagic fever with renal syndrome (HFRS), which is endemic in Europe and Asia, and hantavirus cardiopulmonary syndrome (HCPS), which is endemic in the Americas
  • HCPS
    • typically presents with a short febrile prodrome of 3-5 days (2)
      • early symptoms include fever, myalgias, headache, chills, dizziness, non-productive cough, nausea, vomiting, and other gastrointestinal symptoms
        • malaise, diarrhea, and lightheadedness are reported by about 50% of patients, with less frequent reports of arthralgias, back pain, and abdominal pain
• is diagnosed on the basis of a positive serological test and the confirmation of viral antigen in the tissue of infected patient or the presence of viral RNA sequences in patient’s blood or tissue, along with a compatible history of the disease (2)
  
  

Many factors influence their epidemiology and transmission, such as climate, environment, social development, ecology of rodent hosts, and human behaviour in endemic regions

• transmission to humans occurs by exposure to infected rodents in endemic areas
• Andes hantavirus is unique in that it can be transmitted from person to person (1)

Management:

• supportive care
• is no treatment for hantavirus infection at present

Measures to prevent hantavirus infection (3):

• the most efficacious way to prevent hantavirus infection is to keep wild rodents, especially mice, out of homes, cabins, vehicles, sheds, or other enclosed spaces
• pet rodents may need to be tested for hantavirus and should be kept away from wild rodents
• when cleaning areas that contain rodent urine, droppings, saliva, or nesting materials, always wear plastic or rubber gloves
  • potentially infested spaces should be aired out and a disinfectant or bleach solution should be used to wet the area before cleaning with a sponge or mop
    • avoid sweeping to prevent air contamination with virus particles

Reference:

1. Vial PA et al. Hantavirus in humans: a review of clinical aspects and management. Lancet Infectious Diseases April 24th 2023
2. Mir MA. Hantaviruses. Clin Lab Med. 2010 Mar;30(1):67-91. doi: 10.1016/j.cll.2010.01.004. PMID: 20513542; PMCID: PMC2880890.
3. Abdoler EA, Malani PN. What Is Hantavirus? JAMA. 2025;334(1):98.