Hantavirus Infection

Hantavirus infections remain rare but clinically significant zoonotic diseases associated with high morbidity and mortality. Despite ongoing research, no FDA‑approved pharmacotherapies exist, and management is largely supportive. This review summarizes current evidence on hantavirus pathophysiology, clinical presentation, diagnostic strategies, and investigational treatments, with a focus on the potential role of ribavirin and other emerging therapies. Although early studies suggested that ribavirin may reduce mortality when administered within the first 5 days of symptom onset, subsequent trials have shown no consistent clinical benefit, and its use remains controversial. Importantly, these data apply to hemorrhagic fever with renal syndrome (HFRS), not hantavirus pulmonary syndrome (HPS), for which ribavirin has not demonstrated therapeutic benefit. Supportive care, including hemodynamic stabilization, respiratory support, and management of complications, continues to be the cornerstone of therapy. Pharmacists play a critical role in the interdisciplinary management of hantavirus infection by providing evidence‑based pharmacotherapy recommendations, guiding antimicrobial stewardship, monitoring laboratory parameters, identifying adverse drug reactions, and supporting clinical decision‑making during multidisciplinary rounds. Their expertise is essential in optimizing supportive care, ensuring safe medication use, and educating health care teams on disease recognition, prevention strategies, and discharge planning. In the absence of definitive antiviral therapy, pharmacists remain integral to improving patient outcomes through clinical vigilance, therapeutic optimization, and active participation in collaborative care models. Continued research is needed to clarify the role of antiviral agents and to develop targeted treatments for this high‑risk infection.