Hantavirus

Hantaviruses are a group of viruses that are carried by rodents. The virus is found in their urine and feces, but it does not make the animal sick. In the United States, the deer mouse is the main carrier of the virus.

Humans can get sick with this virus if they breathe in contaminated dust from mice nests or droppings. It can spread if you touch mouse droppings or nest material and then touch your face. You may come in contact with dust or droppings when cleaning homes, sheds, or enclosed areas that have been empty for a long time.

In most cases, hantavirus does not seem to spread from person to person. The exemption is the Andes virus, a specific type of hantavirus spread from person to person through close contact, but this remains rare.

Symptoms vary depending on what type of hantavirus illness you have.

Hantavirus pulmonary syndrome (HPS)

HPS affects the lungs. Symptoms occur 1 to 7 weeks after being exposed to the virus.

Early symptoms of HPS are similar to the flu and include: 

• Fatigue
• Fever
• Muscle aches

Other early symptoms may include:

• Headaches
• Chills
• Dizziness
• Gastrointestinal symptoms including nausea, vomiting, diarrhea, and abdominal pain 

After about 4 to 5 days, it becomes hard to breathe. The disease gets worse quickly. Symptoms include:

• Dry cough
• Shortness of breath
• Chest tightness due to lungs filling with fluid

Hemorrhagic fever with renal syndrome (HFRS)

HFRS affects the kidneys. Symptoms may occur 1 to 2 weeks after exposure. Rarely, symptoms may show up as long as 7 weeks after exposure to the virus. Symptoms may include:

• Severe headache
• Back pain
• Abdominal pain
• Fever
• Chills
• Nausea
• Blurred vision

Other early symptoms may include a flushed face, red eyes, and rash.

As the illness continues, more serious symptoms may occur:

• Low blood pressure
• Shock
• Internal bleeding
• Acute kidney failure

Your health care provider will perform a physical exam. This may reveal:

• Abnormal lung sounds due to inflammation or infection
• Kidney failure
• Low blood pressure (hypotension)
• Low blood oxygen levels, which cause the skin to turn a blue color (cyanosis)

The following tests may be done:

• Blood tests to check for signs of hantavirus (presence of antibodies to the virus or the virus itself)
• Complete blood count (CBC) with white blood cell differential
• Comprehensive metabolic panel (includes kidney and liver function tests)
• Urinalysis
• X-ray of the chest
• CT scan of the chest

People with hantavirus are admitted to the hospital, often to the intensive care unit (ICU).

Treatments include:

• Oxygen
• Breathing tube or breathing machine (mechanical ventilation) in severe cases
• Special machines to add oxygen to the blood
• Other supportive care to treat symptoms

There are no antivirals or other medicines that work against hantavirus.

Hantavirus is a serious infection that can get worse quickly. With HPS, lung failure can occur and may lead to death. Even with aggressive treatment, 38% of people with HPS who get respiratory symptoms die from the illness. Early treatment improves the chances of recovery and survival in people with HPS.

Ther severity of HFRS depends on which form of the virus caused the illness. Some forms cause severe symptoms leading to death in about 5% to 15% of people. Other forms cause more moderate symptoms with few deaths.

In people who survive the illness, it may take weeks to months to completely recover. 

Complications of hantavirus may include:

• Kidney failure
• Heart and lung failure

These complications can lead to death.

Contact your provider if you develop flu-like symptoms after you come in contact with rodent droppings or rodent urine, or dust that is contaminated with these substances.

Avoid exposure to rodent urine and droppings.

• Drink only disinfected water.
• When camping, sleep on a ground cover and pad.
• Keep your home clean. Clear out potential nesting sites and clean your kitchen using the precautions listed below.

If you must work in an area where contact with rodent urine or feces is possible, follow these recommendations from the Centers for Disease Control and Prevention (CDC):

• When opening an unused cabin, shed, or other building, open all the doors and windows, leave the building, and allow the space to air out for 30 minutes.
• Return to the building and spray the surfaces, carpet, and other areas with a disinfectant. Leave the building for another 30 minutes.
• Spray mouse nests and droppings with a 10% solution of chlorine bleach or similar disinfectant. Allow it to sit for 30 minutes. Using rubber gloves, place the materials in plastic bags. Seal the bags and throw them in the trash or an incinerator. Dispose of gloves and cleaning materials in the same way.
• Wash all potentially contaminated hard surfaces with a bleach or disinfectant solution. Avoid vacuuming until the area has been thoroughly decontaminated. Then, vacuum the first few times with enough ventilation. Surgical masks may provide some protection.
• If you have a heavy infestation of rodents, call a pest control company. They have special cleanup equipment and methods.

Hantavirus pulmonary syndrome; Hemorrhagic fever with renal syndrome

Bausch DG, Kaiser L. Viral hemorrhagic fevers. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 351.

Centers for Disease Control and Prevention website. Hantavirus. www.cdc.gov/hantavirus/index.html. Updated May 13, 2024. Accessed May 20, 2026.

Malenfant JH, Staples JE, Kofman AD. Bunyavirus infections: hantavirus syndromes, La Crosse encephalitis, Rift Valley fever, Crimean-Congo hemorrhagic fever, and others. In: Blaser MJ, Cohen JI, Holland SM, et al, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 10th ed. Philadelphia, PA: Elsevier; 2026:chap 173.

World Health Organization website. Hantavirus. www.who.int/health-topics/hantavirus#tab=tab_1. Accessed May 20, 2026. 

Updated by: Jatin M. Vyas, MD, PhD, Roy and Diana Vagelos Professor in Medicine, Columbia University Vagelos College of Physicians and Surgeons, Division of Infectious Diseases, Department of Medicine, New York, NY. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.