Criteria
World Health Organization (WHO): surveillance case definition[75]
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
World Health Organization (WHO): Andes virus (ANDV) infection case definition in the context of cruise ship outbreak[64]
Suggested case definition in the context of the MV Hondius cruise ship outbreak (current as of 11 May 2026).
Suspected case:
Anyone who shared or visited a conveyance where there has been a confirmed or probable ANDV case AND with acute (or history of) symptoms compatible with ANDV infection, including fever (100.4°F [38°C] or above), myalgia, chills, acute gastrointestinal (e.g., nausea, vomiting, diarrhea, abdominal pain) or acute respiratory (e.g., cough, shortness of breath, chest pain, difficulty breathing) symptoms.
Probable case:
A person with signs and symptoms of a suspected case that has been evaluated by a health professional AND has a known epidemiologic link with a confirmed or probable ANDV case AND for which laboratory results are not available.
Confirmed case:
A person with laboratory confirmation of ANDV through RT-PCR or serology testing.
Contact:
A person who was exposed to a confirmed or probable case of ANDV while the case was infectious, through interactions consistent with exposure to respiratory secretions, saliva, blood, or other bodily fluids, including:
Direct physical contact, including exposure to saliva or other bodily fluids (e.g., care giving, intimate contact, sharing a bed, etc.)
Close proximity exposure, defined as being within 6 foot (2 meters) for a cumulative period of more than 15 minutes (e.g., face to face interactions, shared meals or other social gatherings)
Exposure in enclosed or shared spaces (e.g., multiple days on same ship, aircraft/conveyance seating proximity, etc.)
Unprotected exposure in healthcare settings, particularly during patient care, as well as laboratory exposure
Centers for Disease Control and Prevention (CDC): hantavirus pulmonary syndrome (HPS) - 2015 case definition[62]
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.
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