Bivalent Antiviral Protocol for the Neutralization of Andes Virus (ANDV) and Hantavirus Pulmonary Syndrome (HPS)

Bivalent Antiviral Protocol for the Neutralization of Andes Virus (ANDV) and Hantavirus Pulmonary Syndrome (HPS) Date: May 9, 2026 Subject: Emergency Therapeutic Intervention for Interhuman Transmission Clusters Abstract This proposal outlines a dual-phase medical intervention designed to address the high mortality rate and person-to-person transmission of the Andes virus (ANDV). By combining a recombinant Monoclonal Antibody (mAb) cocktail with a targeted RNA-dependent RNA polymerase (RdRp) inhibitor, the protocol seeks to neutralize viral entry while simultaneously halting intracellular replication. This strategy is specifically optimized for high-density environments, such as the May 2026 maritime and cruise-ship outbreaks. 1. Targeted Viral Neutralization The primary therapeutic agent consists of a Human Monoclonal Antibody (mAb) Cocktail (Targeting Gn/Gc Glycoproteins). * Mechanism of Action: The antibodies bind to the viral envelope glycoproteins, physically blocking the virus from attaching to the host’s protocadherin-1 (PCDH1) lung receptors. * Application: Intravenous administration for patients showing early-onset febrile symptoms to prevent the progression to pulmonary edema. 2. Inhibition of Viral Replication To arrest the cytokine storm associated with HPS, a small-molecule Nucleoside Analog (RdRp Inhibitor) is utilized. * Molecular Target: The viral L-protein (RNA-dependent RNA polymerase). * Pharmacodynamics: The inhibitor induces lethal mutagenesis by incorporating fraudulent nucleotides into the viral RNA strand, effectively jamming the replication machinery. * Delivery System: A specialized Nebulized Aerosol delivery to ensure the highest concentration of the inhibitor reaches the pulmonary microvasculature, the primary site of Hantavirus-induced vascular leak. 3. Prophylactic Ring Containment Given the unique human-to-human transmission capability of the Andes strain, the protocol implements a Post-Exposure Prophylaxis (PEP) model: * Tier 1 Exposure: Direct contacts of confirmed cases receive a five-day course of oral inhibitors to prevent viral shedding. * Environmental Control: Deployment of HEPA-filtered laminar flow units in isolation zones to reduce the risk of aerosolized excreta transmission. 4. Clinical Objectives and Mortality Mitigation The protocol aims to reduce the HPS case-fatality rate from the historical ~40% to <5% by addressing the three pillars of the disease: 5. Viremia: Reduced via mAb neutralization. 6. Replication: Halted via RdRp inhibition. 7. Vascular Leak: Managed via integrated JAK/STAT signaling modulation to stabilize capillary permeability. 8. Conclusion The integration of rapid-response diagnostics with bivalent antiviral therapy represents a critical shift in Hantavirus management. This architecture provides a scalable medical framework for containing future zoonotic spillovers and protecting vulnerable populations in confined transit environments. Keywords: Andes Virus (ANDV), Hantavirus Pulmonary Syndrome, RdRp Inhibitors, Monoclonal Antibodies, Viral Neutralization, 2026 Outbreak Response.