Hantavirus Pulmonary Syndrome: What Patients and Clinicians Need to Know

Recognising the disease

Hantavirus Pulmonary Syndrome (HPS) caused by Andes virus follows a characteristic three-phase course (US CDC; ECDC RRA):

Phase 1 — Incubation

• Typical: 2–4 weeks after exposure
• Range: up to about 6 weeks
• No symptoms, but the patient may already be developing infection

Phase 2 — Prodrome (3–5 days)

• High fever
• Severe muscle aches (myalgia), especially in large muscle groups (thighs, back, shoulders)
• Headache
• Gastrointestinal symptoms: nausea, vomiting, diarrhoea, abdominal pain
• Fatigue and dizziness

This phase is easily mistaken for influenza or other viral illness — which is why exposure history (cruise contact, household contact with a known case) is critical.

Phase 3 — Cardiopulmonary phase

• Rapid-onset cough and shortness of breath
• Pulmonary oedema, often within hours of respiratory symptom onset
• Hypotension and shock
• Need for ICU admission, mechanical ventilation, frequently ECMO

Treatment

There is no specific antiviral and no licensed vaccine for HPS. Care is entirely supportive:

• Aggressive ICU monitoring at the first sign of cardiopulmonary involvement
• Cautious fluid management to avoid worsening pulmonary oedema
• Mechanical ventilation
• ECMO in centres where available — early data suggest improved survival

Who to call

This article is not medical advice. Anyone who travelled on or had close contact with someone from the MV Hondius, or who develops fever and severe muscle aches in the relevant window, should contact their national public-health authority directly.

Sources: US CDC, ECDC, WHO, peer-reviewed HPS literature.