THE RISE AND FALL OF HANTAVIRUS IN THE LAST DECADE: A NARRATIVE REVIEW

Abstract

Hantavirus has not followed a single global rise-and-fall curve during the past decade. Instead, its epidemiology has been shaped by three overlapping patterns: sustained but declining haemorrhagic fever with renal syndrome (HFRS) in parts of Asia, cyclical nephropathia epidemica and HFRS activity in Europe, and low-incidence but high-fatality hantavirus cardiopulmonary syndrome (HCPS) in the Americas. China remains the largest contributor to global HFRS burden, but national incidence has declined substantially, even as affected counties and viral diversity remain geographically broad. In the EU/EEA, notification rates fluctuated without a clear long-term trend, with prominent peaks in 2017 and 2021 and low rates in 2020 and 2023. In the United States and much of the Americas, cases remain uncommon but clinically severe; Andes virus has sustained particular concern because it can rarely transmit between people during close or prolonged contact. The apparent ‘rise’ of hantavirus reflects ecological disturbance, climate-sensitive rodent cycles, land-use change, improved surveillance, pet-rat and occupational exposures, and highly visible travel-associated clusters. The apparent ‘fall’ reflects vaccination and rodent-control programmes in parts of Asia, better public awareness, case containment, and the natural collapse of rodent-amplified epidemic years. The next decade should move beyond passive case counting towards One Health surveillance, reservoir mapping, rapid diagnostics, safer rodent-control practices, and vaccine and therapeutic development.