Hantavirus is a disease spread through contact with contaminated rodent droppings or urine. It can cause a severe respiratory disease for which there is no specific antiviral treatment.
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The recent deaths aboard a cruise ship have put hantavirus back in the public spotlight. Three passengers have died and at least four others fell ill in what the World Health Organization has called a suspected hantavirus outbreak. It follows the February 2025 death of Betsy Arakawa, wife of actor Gene Hackman, from hantavirus pulmonary syndrome at the couple’s home in Santa Fe. These cases are a reminder that while hantavirus infections in humans are relatively rare, they can be rapidly progressing and deadly.
Hantaviruses are a family of viruses found worldwide, with different strains causing various forms of disease. In the United States, the primary concern is hantavirus pulmonary syndrome (HPS), a severe respiratory illness caused by a strain called Sin Nombre virus. Although the virus has been detected in 34 states, cases are most common in the southwest, especially the Four Corners region (i.e., where Arizona, New Mexico, Colorado and Utah intersect). In Europe and Asia, hantavirus strains more often cause hemorrhagic fever with renal syndrome (HFRS), which affects the kidneys.
Hantavirus pulmonary syndrome has the potential to be a devastating illness with a 38% mortality rate. Following infection, symptoms typically appear one to eight weeks later and often resemble a flu-like illness with fatigue, fever, and muscle aches. Headaches, dizziness, chills, nausea, vomiting, and abdominal pain may also occur. Four to ten days into the illness, respiratory symptoms can worsen with coughing and shortness of breath. The disease can progress rapidly, often requiring intense supportive care and possibly intubation.
Deer mouse, Peromyscus maniculatus, a Hantavirus carrier that becomes a threat when it enters human habitation in rural and suburban areas. Image courtesy CDC/James Gathany. 1990. (Photo by Smith Collection/Gado/Getty Images).
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Hantavirus is primarily spread through contact with rodents or their nesting material. Infected animals — most commonly the deer mouse in the U.S. — shed the virus in their urine, droppings, and saliva. Human infection occurs most often through inhalation when contaminated dust or particles are disturbed and subsequently breathed in. This can happen when sweeping out a shed, cleaning a cabin that has been closed for the season, working in fields, or handling rodent nesting materials.
In rare cases, the virus can be spread through the bite of an infected rodent, or by touching contaminated surfaces and then touching the mouth or nose. The hantavirus strains in the U.S. do not spread from person to person. A notable exception is the Andes virus, found in Chile and Argentina — the same region where the latest cruise ship outbreak originated — which has demonstrated limited human-to-human transmission. Investigators are currently trying to determine whether human-to-human transmission could have occurred in the recent outbreak.
Diagnosing hantavirus is challenging, particularly early in the illness when symptoms are non-specific. Confirming the diagnosis requires laboratory testing, typically through detection of specific antibodies (IgM or IgG) in a serum sample. Unfortunately, antibodies may take several weeks to reach detectable levels, so testing during the first week after symptom onset may result in a false-negative result. The disease is often diagnosed following death using tissue collected during autopsy. Tests such as immunohistochemistry and PCR are primarily conducted at state public health laboratories or the CDC.
There is currently no specific antiviral treatment for hantavirus. Care is supportive, including supplemental oxygen, and in severe cases, mechanical ventilation or dialysis if kidney failure occurs.
Those at the greatest risk for infection include workers in construction, agriculture, pest control and janitorial services. Individuals can also be infected when cleaning out their basement, shed or cabin that has been contaminated with rodent droppings or urine.
To avoid being infected, take the following steps:
1. Avoid contact with rodents and/or rodent droppings, urine or nesting material
2. Seal cracks or gaps in your home or business to prevent rodent infestation
3. When cleaning areas (e.g., cabins, basements, sheds) with evidence of rodent nesting material or droppings, wear a mask, eye protection and gloves
4. Don’t eat or drink anything that could have been contaminated with rodent feces, urine or saliva.
Although hantavirus is a rare cause of disease in humans, infection can progress rapidly and have a devastating outcome. A basic understanding of how hantavirus spreads — and taking a few simple precautions — can significantly reduce your risk.
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