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Diagnosis and Treatment of Hantavirus Infection


Diagnosis of Hantavirus Pulmonary Syndrome is most frequently made based on appropriate clinical signs and positive serology.  A CBC that shows significant bandemia, thrombocytopenia and presence of atypical lymphocytes in a person with pulmonary edema is highly suggestive of Hantavirus infection. (25)  Diagnosis is more difficult early in the disease, because flu-like symptoms are consistent with many fevers of viral origin.  Diagnosis can also be made by demonstrating viral antigen in body fluids or tissues.

Methods available for detection of Hantavirus antigens and host antibody response

Antigen detection -  Isolation of whole virus from humans has not yet been achieved (25)

  • ELISA - detection of antigen in urine or serum
  • Immunohistochemistry (IHC) - biopsy specimens
  • Reverse Transcriptase PCR - only for research purposes due to frequency of cross-contamination

Serology - presence of Hantavirus-specific IgM, or a four-fold or greater increase in IgG titers between acute and convalescing sera (25)
  • Antibody capture ELISA
  • Single Radial Hemolysis (SRH)
  • Haemagglutination Inhibition (HAI)

Hantavirus Immunohistochemistry - courtesy of hsc.unm.edu
Histologic section of lung from a patient that died of HPS.  Immunohistochemistry has been used to demonstrate viral antigen (red-brown) in the alveolar capillary walls. 


There is no specific treatment for Hantavirus infection, so health professionals can only provide supportive care such as fluid administration and frequent monitoring.  Patients in severe respiratory distress are intubated and put on a oxygen via a ventilator.  Early treatment appears to result in a better outcome, so persons experiencing muscle pain, fever and difficulty breathing, especially if they have had prior rodent exposure, should seek medical attention immediately.  People that do not seek treatment until they are in full-blown respiratory distress tend to have a poorer prognosis. (12, 25)