Hantavirus cardiopulmonary syndrome

World Health Organization (WHO): surveillance case definition[80]​World Health Organization. Hantavirus outbreak toolbox. May 2026 [internet publication]. https://www.who.int/emergencies/outbreak-toolkit/disease-outbreak-toolboxes/hantavirus-outbreak-toolbox

Suspected case:

• A person who presents with a febrile illness (fever >101.3°F [>38.5°C] oral) with an acute respiratory distress syndrome requiring supplemental oxygen AND bilateral diffuse infiltrates developed within 72 hours of hospitalization in a previously healthy person.

• Unexplained illness resulting in death plus an autopsy exam demonstrating noncardiogenic pulmonary edema without an identifiable specific cause of death.

Confirmed case:

• A suspected case laboratory confirmed with:

  • The presence of hantavirus-specific immunoglobulin M (IgM) antibodies or a four-fold or greater increase in IgG antibody titers or hantavirus-specific IgG seroconversion

  • A positive reverse transcriptase polymerase chain reaction (RT-PCR) result for hantavirus RNA

  • Positive immunohistochemical results for hantavirus antigens

Centers for Disease Control and Prevention (CDC): hantavirus pulmonary syndrome (HPS) - 2015 case definition[69]Centers for Disease Control and Prevention. Hantavirus pulmonary syndrome (HPS) 2015 case definition. Apr 2021 [internet publication]. https://ndc.services.cdc.gov/case-definitions/hantavirus-pulmonary-syndrome-2015

Clinical description:

• An acute febrile illness (i.e., temperature greater than 101°F [38.3°C]) with a prodrome consisting of fever, chills, myalgia, headache, and gastrointestinal symptoms, and one or more of the following clinical features:

  • Bilateral diffuse interstitial edema; or

  • Clinical diagnosis of acute respiratory distress syndrome; or

  • Radiographic evidence of noncardiogenic pulmonary edema; or

  • An unexplained respiratory illness resulting in death, which includes an autopsy exam that demonstrates noncardiogenic pulmonary edema without an identifiable cause; or

  • Healthcare record with a diagnosis of HPS; or

  • Death certificate that lists HPS as a cause of death or as a significant condition contributing to death.

Laboratory criteria:

• Detection of hantavirus-specific IgM or rising titers of hantavirus-specific IgG; or

• Detection of hantavirus-specific RNA in clinical specimens; or

• Detection of hantavirus antigen by immunohistochemistry in lung biopsy or autopsy tissues.

Case classification:

• Confirmed: a clinically compatible case of HPS with laboratory evidence.