Epidemiological intelligence in response to hantavirus: evidence-based risk analysis and infodemic management

The recent hantavirus outbreak aboard the cruise ship MV Hondius has reignited, both in public opinion and within the medical community, the official perception of risk associated with global health crises.However, this phenomenon must be analyzed with scientific rigor, using the tools of epidemiological intelligence to strengthen an appropriate perception of risk, support evidence-based communication strategies, and proactively manage the infodemic. 1,2 Emerging and re-emerging zoonotic diseases are, for the most part, a direct reflection of ecosystem degradation, human mobility, anthropogenic pressure on wildlife interfaces, and climate change.Hantaviruses belong to a family of viral agents that have been widely studied for decades; however, their present behavior requires us to reconsider global containment strategies and the robustness of local response systems.At present, more than 20 hantavirus variants associated with different reservoirs and geographic regions worldwide are recognized.Far from behaving as a clinically homogeneous entity, these pathogens are clearly divided into two major groups according to their phylogenetic evolution, geographic distribution, and the systemic syndrome they cause in humans: 1 Old world hantavirusesPredominant in Europe and Asia, these are the etiological agents of Hemorrhagic Fever with Renal Syndrome.Their clinical spectrum ranges from mild forms, such as nephropathia epidemica caused by Puumala virus, to severe clinical presentations with acute renal involvement and severe hemorrhage, associated with Hantaan and Dobrava-Belgrade viruses.Their case-fatality rate ranges from 1% to 12%.