HPS vs HFRS Syndromes — Hantavirus
Hantavirus Pulmonary Syndrome (HPS)
Also known as Hantavirus Cardiopulmonary Syndrome (HCPS). Found primarily in the Americas (North, Central, and South America). HPS is characterised by rapid onset of pulmonary edema and cardiovascular collapse.
- Case fatality rate: 20–50% depending on strain and quality of care
- Primary target: Lungs and heart
- Key mechanism: Increased capillary permeability leading to non-cardiogenic pulmonary edema
- Deadliest strains: Sin Nombre (North America, CFR ~35%), Andes (South America, CFR ~30–50%)
Haemorrhagic Fever with Renal Syndrome (HFRS)
Found across Europe and Asia. HFRS is characterised by fever, haemorrhage, and acute kidney injury. The severity varies dramatically by strain.
- Case fatality rate: 1–15% depending on strain
- Primary target: Kidneys and vascular endothelium
- Key mechanism: Capillary leak, thrombocytopenia, and renal tubular damage
Strain comparison table
| Strain | Reservoir | Region | Syndrome | CFR |
|---|---|---|---|---|
| Hantaan | Striped field mouse | China, Korea, Far East Russia | HFRS (severe) | 5–15% |
| Dobrava-Belgrade | Yellow-necked mouse | Balkans, Eastern Europe | HFRS (severe) | 5–10% |
| Seoul | Norway rat | Worldwide (urban) | HFRS (moderate) | 1–2% |
| Puumala | Bank vole | Scandinavia, Western Europe | HFRS (mild, "nephropathia epidemica") | <1% |
| Sin Nombre | Deer mouse | Western North America | HPS | 30–40% |
| Andes | Long-tailed pygmy rice rat | Chile, Argentina | HPS (+ rare H2H) | 30–50% |
| Laguna Negra | Small vesper mouse | Paraguay, Bolivia | HPS | 20–30% |
Sources
- Jonsson CB, Figueiredo LTM, Vapalahti O. A global perspective on hantavirus ecology, epidemiology, and disease. Clin Microbiol Rev 2010;23(2):412-441. DOI
- CDC. Hantavirus Pulmonary Syndrome (HPS). CDC HPS
- ECDC. Fact sheet: Hantavirus. ECDC
- Kruger DH, Figueiredo LTM, et al. Hantaviruses — globally emerging pathogens. J Clin Virol 2011;52(3):179-193.