Why diagnosis is difficult
In the first days of illness, standard tests show almost nothing — or they show a pattern typical of a common cold. Specific hantavirus diagnostics require ordering special tests that are not routinely performed in most clinics.
Key principle: When clinical suspicion of hantavirus arises — hospitalize immediately, even before test results come back. Waiting at home is deadly.
Laboratory diagnostic methods
Detects viral RNA in blood by reverse transcription polymerase chain reaction. High sensitivity in the first 7–10 days of illness while the virus is actively replicating. Allows identification of the specific strain.
ELISA (enzyme‑linked immunosorbent assay) for antibodies against hantavirus. IgM appear as early as day 3–5 of illness and indicate acute infection. IgG rise later and persist for years. Less specific in early stages.
Rapid IgM/IgG tests — similar to COVID‑19 rapid tests. Provide results in 15–30 minutes. Used in field settings and endemic regions. Sensitivity is lower than ELISA, so positive results require PCR confirmation.
Specific for hantavirus when combined findings appear: thrombocytopenia (platelets below 150×10⁹/L), leukocytosis with atypical lymphocytes, elevated hematocrit, neutrophilia with a left shift. Not diagnostic in isolation.
Imaging diagnostics
Chest CT (HPS)
In hantavirus pulmonary syndrome, computed tomography reveals bilateral interstitial opacities and pleural effusion as early as the cardiopulmonary phase. The picture resembles pulmonary edema but without cardiac pathology — an important differential feature.
Kidney ultrasound (HFRS)
In hemorrhagic fever with renal syndrome, ultrasound shows enlarged kidneys, diffuse increased echogenicity of the parenchyma, and in severe cases — perirenal fluid. Critical for monitoring and preventing kidney capsule rupture.
Echocardiography
For HPS to assess right ventricular function and the degree of respiratory failure. Helps distinguish hantavirus shock from cardiogenic shock.
Action plan when hantavirus is suspected
Assess your exposure risk
Have you had contact with rodents (live, dead, droppings) or with a person ill with hantavirus in the past 1–6 weeks? Time spent in forests, fields, country houses — all are risk factors.
Take the online risk assessment test
Evaluation of symptoms and risk factors helps quickly gauge the probability. For moderate to high risk, seek medical attention immediately.
Call emergency services or go to an infectious disease department
Tell the doctor on duty about your suspicion of hantavirus and rodent contact. Request specific serology and PCR testing.
Do not refuse hospitalization
Even if your condition seems relatively mild — when hantavirus is suspected, inpatient monitoring is necessary. Deterioration can happen within hours.
Isolation if Andes virus is suspected
If you have returned from South America (Argentina, Chile) or have been in contact with an infected person — isolation and notification of epidemiologists are required because this strain transmits from person to person.
Where to seek help (global context)
Diagnosis of hantavirus is performed in infectious disease hospitals and reference laboratories. Key institutions in different regions include:
- Reference centers for hantavirus surveillance (e.g., CDC in the US, WHO collaborating centers)
- National verification centers (e.g., Institut Pasteur, RKI in Germany, “Vector” in Russia)
- Infectious disease hospitals in endemic areas (Bavaria, Baden‑Württemberg in Germany; Scandinavia; U.S. Southwest; Argentina, Chile; Russian Volga region, Urals, Bashkortostan)
- Local public health laboratories (state hygienic and epidemiological centers)
Highly endemic regions worldwide: Germany (particularly Swabian Alb region), Finland, Sweden, Russia (Bashkortostan, Udmurtia, Tatarstan), southwestern United States, Argentina, Chile, China, South Korea.
Check your symptoms now
Our risk assessment tool analyzes your symptoms, exposures, and risk factors — and gives a recommendation: monitor, see a doctor, or call emergency services.