The Hantan River in South Korea was formed about 100,000 to 500,000 years ago by a volcanic eruption. Just 48 years ago, another danger would be named after this river — the Hantaan virus. It first caused an endemic hemorrhagic fever among the UN troops during the Korean War and soon after, scientific efforts localized and identified the virus. Other hantaviruses were also discovered throughout Eurasia and in 1987 — 9 years after the Hantaan virus was first isolated — the hantaviruses were classified into their unique genus.
Hantaviruses are a group of viruses of the orthohantavirus genus which are found primarily in rodents and cause severe disease in humans. It has 37 different species each carried by its own peculiar specie of rodents, with the Orthohantavirus andesense, Andes virus, implicated in the most recent outbreak.
Disease
The hantaviruses primarily cause two diseases in humans, even though its presence is asymptomatic in rodents. These are the hemorrhagic fever with renal syndrome (HFRS) and the hantavirus pulmonary syndrome (HPS). Hantaviruses in Africa, Asia and Europe predominantly cause HFRS. This has a fatality of 1-15% with symptoms usually appearing 2 weeks after initial exposure. More than 100,000 cases of this disease surprisingly occur annually with occasional epidemics littered through history. This disease has five phases. First, febrile, with fever seen here. Second, hypotensive — where there is low blood pressure which oftentimes results in sudden death. Third, low urine production, with a contrasting fourth, high urine production. And finally, recovery. Symptoms include, blood in urine (hematuria), headache, impaired vision, nausea, vomiting, blood in stool (hematochezia), red, purple or brown spots on skin (petechiae), and so much more. To call it severe could almost pass for an understatement, yet this is the one with better prognosis.
The second disease, HPS is caused by 2 viruses, with one of them notably being the Andes virus. The Andes virus is the most common cause of HPS in South America, with the Sin Nombre virus being the most common cause in North America. The prognosis of HPS? 30-60% fatality rate. Unlike HFRS, there are a few hundred cases of HPS annually with 3 phases: early, cardiopulmonary, and recovery phases. Most people die in the cardiopulmonary phase as the cells involved in blood clotting are primarily infected by the hantaviruses. The resulting symptoms are fever, headache, muscle pain, elevated heart rate, irregular heart beats and cardiogenic shock — a condition where the heart can no longer pump enough blood to sustain life leading to failure of body organs.
Recent Outbreak
A cruise ship carrying about 147 passengers and crew were traveling from Argentina to their respective locations. However, on April 11, strangely a 70-year-old man died after developing symptoms 5 days prior. His 69-year-old wife died 15 days after, at a hospital shortly after disembarking the ship. Another German woman died, again, on May 2. This had to be a pattern. It was identified to be the Andes strain of the hantaviruses, however, 30 passengers had already disembarked the ship at various parts of the world as at the confirmation of this information. There have been a total of 8 cases, with 3 already dead and several others under isolation and monitoring. This has set the world in a frenzy and one of the questions is, how did it possibly spread?
Transmission and Risk
The hantaviruses spread from rodents to humans via aerosols or droplets from their saliva, blood, urine or fecal matter. It also spreads through consumption of infected food, biting, or shed virus particles from the bodies of the rodents. Means of transmission among humans include the fecal oral route which is particularly delicate terrain for Africa especially as we are predominantly third world countries with poor hygienic practices and a high exposure to rodents. It can also spread from a pregnant mother to her unborn child and are more viable in hot environments — another vulnerability for the tropical African climate. This is quite different from the poignantly familiar COVID-19 or Ebola virus. With the recent outbreak of HPS, spread from person to person is limited. Thus, speaking on the risk, Dr. Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organization (WHO), says that “while this is a serious incident, WHO assesses the public health risk as low,” even though he admits it is possible more cases may arise due to the incubation period of the Andes virus which can take up to six weeks.
Next Steps
There is a lot of confusion as to whether or not this is going to lead to a repeat of the disarray caused by COVID-19. Even though the answer to that is ‘not likely’, we should still be equipped as it is indeed, better to be safe than sorry. First off, there is an immense vulnerability that comes with the hygienic conditions in Africa. According to WHO, 7 out of 10 people lacked basic hygiene services, not in 1995, but in 2022! For a continent that is home to several vectors of hazardous diseases, this is nothing to write home about. African governments must sit up. The issue is not lack of research or examples of functional models but lack of actual necessary improvements. Moreso, on November 1, 2025, the Nigerian Association of Resident Doctors(NARD) went on an indefinite nationwide strike, with the Joint Health Sector Unions joining in on November 15. This strike was about concerns of patient safety, the incessant issues with the working conditions, and of course, unpaid salaries. The strike was suspended after 29 whole days. Key word being suspended, because the conditions are not much different in status quo. In her April 21 editorial, UIMSA Press questioned Nigeria’s constant fall from the bare minimum of health budget allocation agreed to by the African Union. This then begs the question: “Did we really learn from the cost of our unpreparedness in the face of COVID-19 or are we one disease outbreak away from crisis?”
