{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:25:23Z","timestamp":1791998723973,"version":"4.4.0"},"reference-count":41,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","ejinme.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Internal Medicine"],"published-print":{"date-parts":[[2026,7]]},"DOI":"10.1016\/j.ejim.2026.106946","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T03:52:44Z","timestamp":1779767564000},"page":"106946","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":9,"special_numbering":"C","title":["Human infection with Andes hantavirus: an update for the general physician"],"prefix":"10.1016","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5381-3537","authenticated-orcid":false,"given":"Emanuele","family":"Durante-Mangoni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iolanda","family":"Cafarella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Mercadante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Scarpulla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Durante-Mangoni","family":"Emanuele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lefort Des Ylouses","family":"Agn\u00e8s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramos-Rincon","family":"Jose Manuel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxo","family":"Fausto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samarkos","family":"Michael","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stegemann","family":"Miriam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"4","key":"10.1016\/j.ejim.2026.106946_bib0001","doi-asserted-by":"crossref","DOI":"10.1099\/jgv.0.001975","article-title":"ICTV Virus Taxonomy profile: hantaviridae 2024: this article is part of the ICTV virus taxonomy profiles collection","volume":"105","author":"Bradfute","year":"2024","journal-title":"J Gen Virol"},{"issue":"9","key":"10.1016\/j.ejim.2026.106946_bib0002","doi-asserted-by":"crossref","first-page":"e371","DOI":"10.1016\/S1473-3099(23)00128-7","article-title":"Hantavirus in humans: a review of clinical aspects and management","volume":"23","author":"Vial","year":"2023","journal-title":"Lancet Infect Dis"},{"issue":"6","key":"10.1016\/j.ejim.2026.106946_bib0003","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1111\/j.1469-0691.2009.02848.x","article-title":"Hantaviruses and climate change","volume":"15","author":"Klempa","year":"2009","journal-title":"Clin Microbiol Infect"},{"issue":"2","key":"10.1016\/j.ejim.2026.106946_bib0004","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1017\/S0950268808000940","article-title":"Hantavirus disease (nephropathia epidemica) in Belgium: effects of tree seed production and climate","volume":"137","author":"Tersago","year":"2009","journal-title":"Epidemiol Infect"},{"key":"10.1016\/j.ejim.2026.106946_bib0005","doi-asserted-by":"crossref","first-page":"399","DOI":"10.3389\/fcimb.2020.00399","article-title":"Orthohantavirus pathogenesis and cell tropism","volume":"10","author":"Noack","year":"2020","journal-title":"Front Cell Infect Microbiol."},{"issue":"1","key":"10.1016\/j.ejim.2026.106946_bib0006","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.coviro.2013.01.002","article-title":"Factors driving hantavirus emergence in Europe","volume":"3","author":"Reusken","year":"2013","journal-title":"Curr Opin Virol"},{"issue":"2","key":"10.1016\/j.ejim.2026.106946_bib0007","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1128\/CMR.00062-09","article-title":"A global perspective on hantavirus ecology, epidemiology, and disease","volume":"23","author":"Jonsson","year":"2010","journal-title":"Clin Microbiol Rev"},{"issue":"2","key":"10.1016\/j.ejim.2026.106946_bib0008","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1006\/viro.1997.8976","article-title":"Hantavirus pulmonary syndrome outbreak in Argentina: molecular evidence for person-to-person transmission of Andes virus","volume":"241","author":"Padula","year":"1998","journal-title":"Virology"},{"issue":"10","key":"10.1016\/j.ejim.2026.106946_bib0009","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.3201\/eid2010.140353","article-title":"Person-to-Person household and nosocomial transmission of andes hantavirus, Southern Chile, 2011","volume":"20","author":"Martinez-Valdebenito","year":"2014","journal-title":"Emerg Infect Dis"},{"issue":"11","key":"10.1016\/j.ejim.2026.106946_bib0010","doi-asserted-by":"crossref","first-page":"2266","DOI":"10.3390\/v15112266","article-title":"Presence and persistence of Andes Virus RNA in Human Semen","volume":"15","author":"Z\u00fcst","year":"2023","journal-title":"Viruses"},{"issue":"23","key":"10.1016\/j.ejim.2026.106946_bib0011","doi-asserted-by":"crossref","first-page":"2230","DOI":"10.1056\/NEJMoa2009040","article-title":"Super-spreaders\u201d and person-to-person transmission of Andes virus in Argentina","volume":"383","author":"Mart\u00ednez","year":"2020","journal-title":"N Engl J Med"},{"key":"10.1016\/j.ejim.2026.106946_bib0012","series-title":"Prevention measures and communication strategies for hantavirus infection in Europe. [Internet]","year":"2014"},{"issue":"11","key":"10.1016\/j.ejim.2026.106946_bib0013","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1016\/j.tim.2023.05.004","article-title":"A framework for understanding and predicting orthohantavirus functional traits","volume":"31","author":"Mull","year":"2023","journal-title":"Trends Microbiol"},{"key":"10.1016\/j.ejim.2026.106946_bib0014","doi-asserted-by":"crossref","unstructured":"Pettersson L., Klingstr\u00f6m J., Hardestam J., Lundkvist \u00c5., Ahlm C., Evander M. Hantavirus RNA in Saliva from patients with hemorrhagic fever with Renal syndrome. Emerg infect dis. 2008;14(3):406\u201311. doi:10.3201\/eid1403.071242.","DOI":"10.3201\/eid1403.071242"},{"issue":"12","key":"10.1016\/j.ejim.2026.106946_bib0015","doi-asserted-by":"crossref","first-page":"1848","DOI":"10.3201\/eid1112.050501","article-title":"Person-to-Person transmission of Andes virus","volume":"11","author":"Martinez","year":"2005","journal-title":"Emerg Infect Dis"},{"issue":"3","key":"10.1016\/j.ejim.2026.106946_bib0016","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.jcv.2012.07.011","article-title":"Hantavirus infections by Puumala or Dobrava-Belgrade virus in pregnant women","volume":"55","author":"Hofmann","year":"2012","journal-title":"J Clin Virol"},{"issue":"8","key":"10.1016\/j.ejim.2026.106946_bib0017","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.3201\/eid2608.200204","article-title":"Mother-to-child transmission of Andes virus through breast milk, Chile1","volume":"26","author":"Ferr\u00e9s","year":"2020","journal-title":"Emerg Infect Dis"},{"issue":"2","key":"10.1016\/j.ejim.2026.106946_bib0018","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.epidem.2009.03.002","article-title":"Cyclic hantavirus epidemics in humans \u2014 predicted by rodent host dynamics","volume":"1","author":"Kallio","year":"2009","journal-title":"Epidemics"},{"issue":"2","key":"10.1016\/j.ejim.2026.106946_bib0019","doi-asserted-by":"crossref","DOI":"10.1103\/PhysRevE.69.021906","article-title":"Outbreaks of hantavirus induced by seasonality","volume":"69","author":"Buceta","year":"2004","journal-title":"Phys Rev E"},{"key":"10.1016\/j.ejim.2026.106946_bib0020","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.1111\/1469-0691.12291","article-title":"Hantavirus infections","volume":"21","author":"Av\u0161i\u010d-\u017dupanc","year":"2019","journal-title":"Clin Microbiol Infect"},{"issue":"12","key":"10.1016\/j.ejim.2026.106946_bib0021","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1160\/TH09-09-0640","article-title":"Hantavirus regulation of endothelial cell functions","volume":"102","author":"Mackow","year":"2009","journal-title":"Thromb Haemost"},{"issue":"12","key":"10.1016\/j.ejim.2026.106946_bib0022","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1161\/CIRCULATIONAHA.113.001870","article-title":"Increased risk of acute myocardial infarction and stroke during hemorrhagic fever with renal syndrome: a self-controlled case series study","volume":"129","author":"Connolly-Andersen","year":"2014","journal-title":"Circulation"},{"issue":"7","key":"10.1016\/j.ejim.2026.106946_bib0023","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1111\/j.1469-0691.2012.03994.x","article-title":"Clinical and laboratory findings in patients with oliguric and non-oliguric hantavirus haemorrhagic fever with renal syndrome: an analysis of 128 patients","volume":"19","author":"Tur\u010dinov","year":"2013","journal-title":"Clin Microbiol Infect"},{"issue":"3","key":"10.1016\/j.ejim.2026.106946_bib0024","doi-asserted-by":"crossref","first-page":"984","DOI":"10.3892\/etm.2021.10416","article-title":"Hanta hemorrhagic fever with renal syndrome: a pathology in whose diagnosis kidney biopsy plays a major role (Review)","volume":"22","author":"Lupu\u015foru","year":"2021","journal-title":"Exp Ther Med"},{"issue":"6","key":"10.1016\/j.ejim.2026.106946_bib0025","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0021134","article-title":"Evidence of disseminated intravascular coagulation in a hemorrhagic fever with renal syndrome\u2014scoring models and severe illness","volume":"6","author":"Sundberg","year":"2011","journal-title":"PLoS One"},{"issue":"8","key":"10.1016\/j.ejim.2026.106946_bib0026","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.3390\/v13081452","article-title":"Hantavirus research in Finland: highlights and perspectives","volume":"13","author":"Vaheri","year":"2021","journal-title":"Viruses"},{"issue":"5","key":"10.1016\/j.ejim.2026.106946_bib0027","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0197661","article-title":"Sequential assessment of clinical and laboratory parameters in patients with hemorrhagic fever with renal syndrome","volume":"13","author":"Pal","year":"2018","journal-title":"PLOS One"},{"issue":"2","key":"10.1016\/j.ejim.2026.106946_bib0028","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.antiviral.2012.05.011","article-title":"Dobrava-Belgrade virus: phylogeny, epidemiology, disease","volume":"95","author":"Papa","year":"2012","journal-title":"Antiviral Res"},{"issue":"8","key":"10.1016\/j.ejim.2026.106946_bib0029","doi-asserted-by":"crossref","first-page":"e358","DOI":"10.1111\/1469-0691.12218","article-title":"Viral load and immune response dynamics in patients with haemorrhagic fever with renal syndrome","volume":"19","author":"Korva","year":"2013","journal-title":"Clin Microbiol Infect"},{"issue":"1","key":"10.1016\/j.ejim.2026.106946_bib0030","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/S0928-0197(97)10019-8","article-title":"Evaluation of Puumala virus IgG and IgM enzyme immunoassays based on recombinant baculovirus-expressed nucleocapsid protein for early nephropathia epidemica diagnosis","volume":"10","author":"Kallio-Kokko","year":"1998","journal-title":"Clin Diagn Virol"},{"issue":"40","key":"10.1016\/j.ejim.2026.106946_bib0031","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.2023.28.40.2300054","article-title":"External quality assessment of orthohantavirus and lymphocytic choriomeningitis virus molecular detection and serology in Europe, 2021","volume":"28","author":"Erdin","year":"2023","journal-title":"Eurosurveillance"},{"issue":"4","key":"10.1016\/j.ejim.2026.106946_bib0032","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1002\/rmv.581","article-title":"How to diagnose hantavirus infections and detect them in rodents and insectivores","volume":"18","author":"Vaheri","year":"2008","journal-title":"Rev Med Virol"},{"key":"10.1016\/j.ejim.2026.106946_bib0033","doi-asserted-by":"crossref","first-page":"2989","DOI":"10.3389\/fmicb.2019.02989","article-title":"Vaccines and therapeutics against hantaviruses","volume":"10","author":"Liu","year":"2020","journal-title":"Front Microbiol"},{"key":"10.1016\/j.ejim.2026.106946_bib0034","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.antiviral.2014.08.007","article-title":"Pathophysiology of a severe case of Puumala hantavirus infection successfully treated with bradykinin receptor antagonist icatibant","volume":"111","author":"Vaheri","year":"2014","journal-title":"Antiviral Res"},{"issue":"6","key":"10.1016\/j.ejim.2026.106946_bib0035","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1080\/23744235.2023.2200563","article-title":"Icatibant in viral infections","volume":"55","author":"Mustonen","year":"2023","journal-title":"Infect Dis"},{"key":"10.1016\/j.ejim.2026.106946_bib0036","series-title":"Oceanwide Expeditions","article-title":"Operator statement on MV Hondius Voyage and onboard measures [Internet]","year":"2026"},{"key":"10.1016\/j.ejim.2026.106946_bib0037","unstructured":"World Health Organization. Hantavirus cluster linked to cruise ship travel, multi-country. Disease outbreak News (DON599) [Internet]. World Health Organization; 2026 May. Available from: https:\/\/www.who.int\/emergencies\/disease-outbreak-news\/item\/2026-DON599."},{"key":"10.1016\/j.ejim.2026.106946_bib0038","unstructured":"World Health Organization. WHO\u2019s response to hantavirus cases linked to a cruise ship [Internet]. World Health Organization; 2026 May. Available from: https:\/\/www.who.int\/news\/item\/07-05-2026-who-s-response-to-hantavirus-cases-linked-to-a-cruise-ship."},{"key":"10.1016\/j.ejim.2026.106946_bib0039","series-title":"Centers for disease control and prevention","article-title":"2026 Multi-country hantavirus cluster linked to cruise ship. Health alert network (HAN00528) [Internet]","year":"2026"},{"key":"10.1016\/j.ejim.2026.106946_bib0040","series-title":"Stockholm: ECDC","article-title":"Hantavirus-associated cluster of illness on a cruise ship. Threat assessment brief [Internet]","year":"2026"},{"key":"10.1016\/j.ejim.2026.106946_bib0041","unstructured":"UK Health Security Agency. Contact tracing statement regarding MV Hondius passengers [Internet]. UK Health Security Agency; 2026 May. Available from: https:\/\/www.gov.uk\/government\/organisations\/uk-health-security-agency."}],"container-title":["European Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0953620526002517?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0953620526002517?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T08:45:40Z","timestamp":1782895540000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0953620526002517"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":41,"alternative-id":["S0953620526002517"],"URL":"https:\/\/doi.org\/10.1016\/j.ejim.2026.106946","relation":{},"ISSN":["0953-6205"],"issn-type":[{"value":"0953-6205","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Human infection with Andes hantavirus: an update for the general physician","name":"articletitle","label":"Article Title"},{"value":"European Journal of Internal Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ejim.2026.106946","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier B.V. on behalf of European Federation of Internal Medicine.","name":"copyright","label":"Copyright"}],"article-number":"106946"}}