What is the difference between Hantavirus Pulmonary Syndrome (HPS) and Hemorrhagic Fever with Renal Syndrome (HFRS)?

Hantaviruses are a family of viruses that can cause serious illnesses, most notably Hantavirus Pulmonary Syndrome (HPS) and Hemorrhagic Fever with Renal Syndrome (HFRS) [2]. Although both are caused by hantaviruses and are primarily transmitted by rodents, they differ in their main symptoms, the organs they affect, and the geographical regions where they are commonly found [2].

Hantavirus Pulmonary Syndrome (HPS)

Hantavirus Pulmonary Syndrome is a serious and potentially fatal disease that primarily affects the lungs [2]. The viruses causing HPS are commonly found in the Western Hemisphere, including the United States [2]. Symptoms typically begin 1 to 8 weeks after exposure to infected rodents [2].

Main Symptoms of HPS:

• Early Symptoms: Include fatigue, fever, and muscle aches, especially in large muscle groups such as the thighs, hips, and back [1][2]. About half of patients may also experience headache, dizziness, chills, and abdominal problems such as nausea, vomiting, diarrhea, and abdominal pain [2].
• Late Symptoms: Appear 4 to 10 days after the initial phase of the illness and include coughing and shortness of breath [1][2]. Patients may feel tightness in the chest as the lungs fill with fluid [2].

HPS is considered a medical emergency that requires immediate care, especially if symptoms such as fever, deep muscle aches, and severe shortness of breath appear after exposure to rodents [1].

Hemorrhagic Fever with Renal Syndrome (HFRS)

Hemorrhagic Fever with Renal Syndrome is a group of clinically similar illnesses caused by hantaviruses found mainly in Europe and Asia [2]. However, the Seoul virus, a type of hantavirus that causes HFRS, can be found worldwide, including the United States [2]. HFRS primarily affects the kidneys and can sometimes be serious and fatal [2]. Symptoms usually develop within 1 to 2 weeks after exposure, and in rare cases, it may take up to 8 weeks [2].

Main Symptoms of HFRS:

• Initial Symptoms: Start suddenly and include severe headache, back and abdominal pain, fever/chills, nausea, and blurred vision [2]. People may also experience facial flushing, inflammation or redness of the eyes, or a rash [2].
• Late Symptoms: Can include low blood pressure, reduced blood flow (acute shock), internal bleeding (vascular leakage), and acute renal failure, which may cause a sharp increase in fluids [2].

The severity of the disease varies depending on the virus causing the infection; Hantaan and Dobrava virus infections cause severe symptoms with a fatality rate ranging between 5-15%, while Seoul, Saaremaa, and Puumala virus infections are milder with a fatality rate of less than 1% [2].

Diagnosis and Treatment

Diagnosing a hantavirus infection in a person within less than 72 hours is difficult [2]. If you suspect you have been exposed to a hantavirus, you should see a doctor immediately and mention any potential exposure to rodents [2]. There is no specific treatment or vaccine for hantavirus [1]. Treatment relies on supportive care, including rest, hydration, and symptom management [2]. In cases of HPS, patients may need respiratory support, such as intubation, to help them obtain oxygen [2]. In cases of HFRS, patients may need dialysis to remove toxins from the blood and maintain fluid balance when the kidneys are not functioning well [2].

Prevention

The best way to prevent hantavirus infection is by controlling rodents in and around your home [1]. You can learn more about rodent prevention and hantavirus warning signs by visiting Hantavirus Infection Prevention (Arabic).

Medical references

• Hantavirus Infections
• About Hantavirus