{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:25:24Z","timestamp":1791998724511,"version":"4.4.0"},"reference-count":120,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T00:00:00Z","timestamp":1745625600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health","award":["CCM 2022"],"award-info":[{"award-number":["CCM 2022"]}]},{"name":"National Institute for Infectious Diseases","award":["CCM 2022"],"award-info":[{"award-number":["CCM 2022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Orthohantavirus infection is a rodent-to-human zoonotic disease with a worldwide distribution, resulting in more than 200,000 cases per year. Human infection leads to two diseases, haemorrhagic fever with renal syndrome and hantavirus cardiopulmonary syndrome, with mortality rates ranging from 1% to 38%. Apart from the data on cases presenting obvious clinical symptoms, the true prevalence is poorly understood, especially in the occupational groups considered to be at risk of exposure. As there is currently no approved therapy or vaccine, surveillance is essential to locate the presumed site of infection following orthohantavirus outbreaks in order to control the spread of infection. To this end, the use of rapid diagnostic tools is essential to rapidly provide data on viral circulation. This review focuses mainly on the available diagnostic methods, both serological and biomolecular, and the surveillance systems used for orthohantaviruses. The information gathered could provide a valid basis for the implementation of further surveillance systems in a country lacking up-to-date data.<\/jats:p>","DOI":"10.3390\/v17050622","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T08:28:11Z","timestamp":1746174491000},"page":"622","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Orthohantaviruses: An Overview of the Current Status of Diagnostics and Surveillance"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6666-0103","authenticated-orcid":false,"given":"Maria Anele","family":"Romeo","sequence":"first","affiliation":[{"name":"Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases Lazzaro Spallanzani\u2014IRCCS, 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5273-1356","authenticated-orcid":false,"given":"Silvia","family":"Tofani","sequence":"additional","affiliation":[{"name":"Virology Unit, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana \u201cM. 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Viruses, 14.","DOI":"10.3390\/v14040682"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/B978-0-12-387022-3.00006-9","article-title":"Recent Advances in Hantavirus Molecular Biology and Disease","volume":"Volume 74","author":"Hussein","year":"2011","journal-title":"Advances in Applied Microbiology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"261","DOI":"10.3109\/1040841X.2013.783555","article-title":"Epidemiology of Hantavirus Infections in Humans: A Comprehensive, Global Overview","volume":"40","author":"Watson","year":"2014","journal-title":"Crit. Rev. Microbiol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Noack, D., Goeijenbier, M., Reusken, C.B.E.M., Koopmans, M.P.G., and Rockx, B.H.G. (2020). Orthohantavirus Pathogenesis and Cell Tropism. Front. Cell. Infect. Microbiol., 10.","DOI":"10.3389\/fcimb.2020.00399"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S0168-7069(06)16008-5","article-title":"Hantaviruses in the Old and New World","volume":"Volume 16","author":"Clement","year":"2006","journal-title":"Perspectives in Medical Virology"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Chen, R.-X., Gong, H.-Y., Wang, X., Sun, M.-H., Ji, Y.-F., Tan, S.-M., Chen, J.-M., Shao, J.-W., and Liao, M. (2023). Zoonotic Hantaviridae with Global Public Health Significance. Viruses, 15.","DOI":"10.22541\/au.168606259.94645566\/v1"},{"key":"ref_7","first-page":"22","article-title":"Etiologic and Clinical Epidemiological Features of Hemorrhagic Fever with Renal Syndrome (HFRS) in the Krasnodar Krai","volume":"21","author":"Tkachenko","year":"2016","journal-title":"Epidemiol. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1093\/infdis\/146.5.638","article-title":"Isolation of Hantaan Virus, the Etiologic Agent of Korean Hemorrhagic Fever, from Wild Urban Rats","volume":"146","author":"Lee","year":"1982","journal-title":"J. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1002\/jmv.1890380211","article-title":"Characterization of Dobrava Virus: A Hantavirus from Slovenia, Yugoslavia","volume":"38","author":"Xiao","year":"1992","journal-title":"J. Med. Virol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1093\/infdis\/141.2.131","article-title":"Nephropathia Epidemica: Detection of Antigen in Bank Voles and Serologic Diagnosis of Human Infection","volume":"141","author":"Vaheri","year":"1980","journal-title":"J. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"165","DOI":"10.4103\/ijmm.IJMM_16_429","article-title":"Globally Emerging Hantaviruses: An Overview","volume":"35","author":"Chandy","year":"2017","journal-title":"Indian J. Med. Microbiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"617","DOI":"10.3201\/eid1404.071310","article-title":"Hemorrhagic Fever with Renal Syndrome Caused by 2 Lineages of Dobrava Hantavirus, Russia1","volume":"14","author":"Klempa","year":"2008","journal-title":"Emerg. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"368","DOI":"10.26444\/aaem\/90535","article-title":"First Molecular Characterization of Dobrava-Belgrade Virus Found in Apodemus Flavicollis in Poland","volume":"25","author":"Kolodziej","year":"2018","journal-title":"Ann. Agric. Environ. Med."},{"key":"ref_14","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."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Madri\u00e8res, S., Tatard, C., Murri, S., Vulin, J., Galan, M., Piry, S., Pulido, C., Loiseau, A., Artige, E., and Benoit, L. (2020). How Bank Vole-PUUV Interactions Influence the Eco-Evolutionary Processes Driving Nephropathia Epidemica Epidemiology\u2014An Experimental and Genomic Approach. Pathogens, 9.","DOI":"10.1101\/2020.08.28.271841"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1089\/vbz.2017.2143","article-title":"Serological Survey of Hantavirus and Flavivirus Among Wild Rodents in Central Italy","volume":"17","author":"Cosseddu","year":"2017","journal-title":"Vector-Borne Zoonotic Dis."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Voutilainen, L., Kallio, E.R., Niemimaa, J., Vapalahti, O., and Henttonen, H. (2016). Temporal Dynamics of Puumala Hantavirus Infection in Cyclic Populations of Bank Voles. Sci. Rep., 6.","DOI":"10.1038\/srep21323"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Kabwe, E., Davidyuk, Y., Shamsutdinov, A., Garanina, E., Martynova, E., Kitaeva, K., Malisheni, M., Isaeva, G., Savitskaya, T., and Urbanowicz, R.A. (2020). Orthohantaviruses, Emerging Zoonotic Pathogens. Pathogens, 9.","DOI":"10.3390\/pathogens9090775"},{"key":"ref_19","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."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"489","DOI":"10.4269\/ajtmh.12-0334","article-title":"Hantavirus Fever without Pulmonary Syndrome in Panama","volume":"89","author":"Armien","year":"2013","journal-title":"Am. Soc. Trop. Med. Hyg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"438","DOI":"10.4269\/ajtmh.1998.59.438","article-title":"High Prevalence of Hantavirus Infection in Indian Communities of the Paraguayan and Argentinean Gran Chaco","volume":"59","author":"Ferrer","year":"1998","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1046\/j.1442-9993.2003.01271.x","article-title":"Myths and Facts on Ratadas: Bamboo Blooms, Rainfall Peaks and Rodent Outbreaks in South America","volume":"28","author":"Jaksic","year":"2003","journal-title":"Austral Ecol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2230","DOI":"10.1056\/NEJMoa2009040","article-title":"\u201cSuper-Spreaders\u201d and Person-to-Person Transmission of Andes Virus in Argentina","volume":"383","author":"Alonso","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.3201\/eid1507.090097","article-title":"Sensitivity of Andes Hantavirus to Antiviral Effect of Human Saliva","volume":"15","author":"Hardestam","year":"2009","journal-title":"Emerg. Infect. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1093\/infdis\/148.6.1005","article-title":"Characterization of Hantaan Virions, the Prototype Virus of Hemorrhagic Fever with Renal Syndrome","volume":"148","author":"Schmaljohn","year":"1983","journal-title":"J. Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1007\/s00705-004-0414-8","article-title":"L Protein, the RNA-Dependent RNA Polymerase of Hantaviruses","volume":"150","author":"Kukkonen","year":"2005","journal-title":"Arch. Virol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Muyangwa, M., Martynova, E.V., Khaiboullina, S.F., Morzunov, S.P., and Rizvanov, A.A. (2015). Hantaviral Proteins: Structure, Functions, and Role in Hantavirus Infection. Front. Microbiol., 6.","DOI":"10.3389\/fmicb.2015.01326"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2176","DOI":"10.1128\/JVI.06223-11","article-title":"The Andes Hantavirus NSs Protein Is Expressed from the Viral Small mRNA by a Leaky Scanning Mechanism","volume":"86","author":"Solis","year":"2012","journal-title":"J. Virol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Davidyuk, Y., Shamsutdinov, A., Kabwe, E., Ismagilova, R., Martynova, E., Belyaev, A., Shuralev, E., Trifonov, V., Savitskaya, T., and Isaeva, G. (2020). Prevalence of the Puumala Orthohantavirus Strains in the Pre-Kama Area of the Republic of Tatarstan, Russia. Pathogens, 9.","DOI":"10.3390\/pathogens9070540"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"773","DOI":"10.2174\/156652405774962317","article-title":"Jeor, S. Hantaviruses: Molecular Biology, Evolution and Pathogenesis","volume":"5","author":"Khaiboullina","year":"2005","journal-title":"Curr. Mol. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/S0042-6822(02)00070-3","article-title":"Rescue of Hantaan Virus Minigenomes","volume":"306","author":"Flick","year":"2003","journal-title":"Virology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1002\/jmv.20948","article-title":"Tula and Puumala Hantavirus NSs ORFs Are Functional and the Products Inhibit Activation of the Interferon-beta Promoter","volume":"79","author":"Kaukinen","year":"2007","journal-title":"J. Med. Virol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1006\/viro.2001.1303","article-title":"Hantaan Virus Enters Cells by Clathrin-Dependent Receptor-Mediated Endocytosis","volume":"294","author":"Jin","year":"2002","journal-title":"Virology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"8634","DOI":"10.1128\/JVI.00418-07","article-title":"Dynein-Dependent Transport of the Hantaan Virus Nucleocapsid Protein to the Endoplasmic Reticulum-Golgi Intermediate Compartment","volume":"81","author":"Ramanathan","year":"2007","journal-title":"J. Virol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/bs.aivir.2019.07.002","article-title":"Hantavirus Entry: Perspectives and Recent Advances","volume":"Volume 104","author":"Mittler","year":"2019","journal-title":"Advances in Virus Research"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"8937","DOI":"10.1128\/JVI.02720-09","article-title":"The Triplet Repeats of the Sin Nombre Hantavirus 5\u2032 Untranslated Region Are Sufficient in Cis for Nucleocapsid-Mediated Translation Initiation","volume":"84","author":"Mir","year":"2010","journal-title":"J. Virol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Meier, K., Thorkelsson, S.R., Quemin, E.R.J., and Rosenthal, M. (2023). Correction: Meier et al. Hantavirus Replication Cycle\u2014An Updated Structural Virology Perspective. Viruses 2021, 13, 1561. . Viruses, 15.","DOI":"10.3390\/v15020273"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1093\/ckj\/sfac008","article-title":"The Kidney in Hantavirus Infection\u2014Epidemiology, Virology, Pathophysiology, Clinical Presentation, Diagnosis and Management","volume":"15","author":"Koehler","year":"2022","journal-title":"Clin. Kidney J."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Ricc\u00f2, M., Ferraro, P., Peruzzi, S., Balzarini, F., and Ranzieri, S. (2021). Hantaviruses in Agricultural and Forestry Workers: Knowledge, Attitudes and Practices in Italian Physicians. Trop. Med. Infect. Dis., 6.","DOI":"10.3390\/tropicalmed6030169"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1006\/viro.1995.1020","article-title":"Complete Nucleotide Sequences of the M and S Segments of Two Hantavirus Isolates from California: Evidence for Reassortment in Nature among Viruses Related to Hantavirus Pulmonary Syndrome","volume":"206","author":"Li","year":"1995","journal-title":"Virology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1099\/vir.0.2008\/001248-0","article-title":"Accumulation of Point Mutations and Reassortment of Genomic RNA Segments Are Involved in the Microevolution of Puumala Hantavirus in a Bank Vole (Myodes Glareolus) Population","volume":"89","author":"Razzauti","year":"2008","journal-title":"J. Gen. Virol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1923","DOI":"10.1099\/vir.0.011304-0","article-title":"Analysis of Puumala Hantavirus in a Bank Vole Population in Northern Finland: Evidence for Co-Circulation of Two Genetic Lineages and Frequent Reassortment between Strains","volume":"90","author":"Razzauti","year":"2009","journal-title":"J. Gen. Virol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1007\/s11262-018-1590-z","article-title":"Reassortment Events in the Evolution of Hantaviruses","volume":"54","author":"Klempa","year":"2018","journal-title":"Virus Genes"},{"key":"ref_44","first-page":"52","article-title":"Nephropathia Epidemica a New Infectious Disease in Northern Scandinavia","volume":"140","author":"Myhrman","year":"1951","journal-title":"J. Intern. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.2105\/AJPH.43.10.1327","article-title":"Epidemic Hemorrhagic Fever","volume":"43","author":"Smadel","year":"1953","journal-title":"Am. J. Public Health Nations Health"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1097\/00005792-195405000-00002","article-title":"Hemorrhagic Fever: A Study of 300 Cases","volume":"33","author":"Powell","year":"1954","journal-title":"Medicine"},{"key":"ref_47","first-page":"1","article-title":"Nephropathia Epidemica in Finland. A Clinical Histological and Epidemiological Study","volume":"3","year":"1971","journal-title":"Ann. Clin. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jcv.2013.06.027","article-title":"Clinical and Molecular Epidemiological Features of Hemorrhagic Fever with Renal Syndrome in Korea over a 10-Year Period","volume":"58","author":"Noh","year":"2013","journal-title":"J. Clin. Virol."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Jiang, H., Du, H., Wang, L.M., Wang, P.Z., and Bai, X.F. (2016). Hemorrhagic Fever with Renal Syndrome: Pathogenesis and Clinical Picture. Front. Cell. Infect. Microbiol., 6.","DOI":"10.3389\/fcimb.2016.00001"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ijid.2016.01.003","article-title":"Haemorrhagic Fever with Renal Syndrome: Literature Review and Distribution Analysis in China","volume":"43","author":"Zou","year":"2016","journal-title":"Int. J. Infect. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1056\/NEJM199404073301401","article-title":"Hantavirus Pulmonary Syndrome: A Clinical Description of 17 Patients with a Newly Recognized Disease","volume":"330","author":"Duchin","year":"1994","journal-title":"N. Engl. J. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1148\/radiology.191.3.8184043","article-title":"Hantavirus Pulmonary Syndrome: Radiographic Findings in 16 Patients","volume":"191","author":"Ketai","year":"1994","journal-title":"Radiology"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1002\/jmv.25054","article-title":"Hantavirus Induced Cardiopulmonary Syndrome: A Public Health Concern","volume":"90","author":"Llah","year":"2018","journal-title":"J. Med. Virol."},{"key":"ref_54","unstructured":"CDC (1993). Outbreak of Acute Illness--Southwestern United States, 1993. MMWR Morb Mortal Wkly Rep., 42, 421\u2013424."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Leopardi, S., Drzewniokov\u00e1, P., Baggieri, M., Marchi, A., Bucci, P., Bregoli, M., De Benedictis, P., Gobbo, F., Bellinati, L., and Citterio, C. (2022). Identification of Dobrava-Belgrade Virus in Apodemus Flavicollis from North-Eastern Italy during Enhanced Mortality. Viruses, 14.","DOI":"10.3390\/v14061241"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1093\/cid\/ciz234","article-title":"Active Targeted Surveillance to Identify Sites of Emergence of Hantavirus","volume":"70","author":"Kim","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Tortosa, F., Perre, F., Tognetti, C., Lossetti, L., Carrasco, G., Guaresti, G., Iglesias, A., Espasandin, Y., and Izcovich, A. (2024). Seroprevalence of Hantavirus Infection in Non-Epidemic Settings over Four Decades: A Systematic Review and Meta-Analysis. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-20014-w"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1097\/INF.0b013e3181dfbbe5","article-title":"Nephropathia Epidemica (Puumala Virus Infection) in Austrian Children","volume":"29","author":"Aberle","year":"2010","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1007\/s00467-019-04215-9","article-title":"Clinical Course of Hantavirus-Induced Nephropathia Epidemica in Children Compared to Adults in Germany\u2014Analysis of 317 Patients","volume":"34","author":"Echterdiek","year":"2019","journal-title":"Pediatr. Nephrol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/0002-9378(94)90298-4","article-title":"Hantavirus Pulmonary Syndrome Complicating Pregnancy","volume":"171","author":"Gilson","year":"1994","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_61","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."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1865","DOI":"10.1002\/jmv.24856","article-title":"Hemorrhagic Fever with Renal Syndrome Caused by Hantaan Virus Infection in Four Pregnant Chinese Women","volume":"89","author":"Ji","year":"2017","journal-title":"J. Med. Virol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.cmi.2019.09.012","article-title":"A Newborn Infected by Andes Virus Suggests Novel Routes of Hantavirus Transmission: A Case Report","volume":"26","author":"Bellomo","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_64","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":"Angulo","year":"2020","journal-title":"Emerg. Infect. Dis."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.2147\/IDR.S454049","article-title":"Hemorrhagic Fever with Renal Syndrome Complicated by Acute Pancreatitis, High Intraocular Pressure, and Pulmonary Involvement: A Case Report","volume":"17","author":"Yang","year":"2024","journal-title":"Infect. Drug Resist."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e03813-23","DOI":"10.1128\/spectrum.03813-23","article-title":"Use of a Diagnostic Puumala Virus Real-Time RT-PCR in an Orthohantavirus Endemic Region in the Netherlands","volume":"12","author":"Geeraedts","year":"2024","journal-title":"Microbiol. Spectr."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"156340","DOI":"10.1016\/j.cyto.2023.156340","article-title":"Potential Clinical Biomarkers in Monitoring the Severity of Hantaan Virus Infection","volume":"170","author":"Zhao","year":"2023","journal-title":"Cytokine"},{"key":"ref_68","unstructured":"European Centre for Disease Prevention and Control (2018). Annual Epidemiological Report for 2016: Hantavirus Infection, European Centre for Disease Prevention and Control."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.virusres.2013.12.038","article-title":"Hantaviruses: Rediscovery and New Beginnings","volume":"187","author":"Yanagihara","year":"2014","journal-title":"Virus Res."},{"key":"ref_70","unstructured":"CDC (2024, May 23). Clinician Brief: Hantavirus Pulmonary Syndrome (HPS), Available online: https:\/\/www.cdc.gov\/hantavirus\/hcp\/clinical-overview\/hps.html."},{"key":"ref_71","unstructured":"CDC (2024, June 26). Reported Cases of Hantavirus Disease, Available online: https:\/\/www.cdc.gov\/hantavirus\/data-research\/cases\/index.html."},{"key":"ref_72","unstructured":"European Centre for Disease Prevention and Control (2023). Hantavirus Infection Annual Epidemiological Report for 2020, European Centre for Disease Prevention and Control."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"20222470","DOI":"10.1098\/rspb.2022.2470","article-title":"The Impact of Wildlife and Environmental Factors on Hantavirus Infection in the Host and Its Translation into Human Risk","volume":"290","author":"Wang","year":"2023","journal-title":"Proc. R. Soc. B"},{"key":"ref_74","unstructured":"European Centre for Disease Prevention and Control (2025, January 20). Surveillance and Updates for Hantavirus. Available online: https:\/\/www.ecdc.europa.eu\/en\/hantavirus-infection\/surveillance-and-disease-data."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1093\/milmed\/usad261","article-title":"Hantavirus Infections among Military Forces","volume":"189","author":"Mustonen","year":"2024","journal-title":"Mil. Med."},{"key":"ref_76","unstructured":"European Centre for Disease Prevention and Control (2025, January 20). Disease Information about Hantavirus. Available online: https:\/\/www.ecdc.europa.eu\/en\/hantavirus-infection\/facts."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/1440-1681.13403","article-title":"Hantavirus Diseases Pathophysiology, Their Diagnostic Strategies and Therapeutic Approaches: A Review","volume":"48","author":"Munir","year":"2021","journal-title":"Clin. Exp. Pharmacol. Physiol."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Escadafal, C., Av\u0161i\u010d-\u017dupanc, T., Vapalahti, O., Niklasson, B., Teichmann, A., Niedrig, M., and Donoso-Mantke, O. (2012). Second External Quality Assurance Study for the Serological Diagnosis of Hantaviruses in Europe. PLoS Negl. Trop. Dis., 6.","DOI":"10.1371\/journal.pntd.0001607"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Lederer, S., Lattwein, E., Hanke, M., Sonnenberg, K., Stoecker, W., Lundkvist, \u00c5., Vaheri, A., Vapalahti, O., Chan, P.K.S., and Feldmann, H. (2013). Indirect Immunofluorescence Assay for the Simultaneous Detection of Antibodies against Clinically Important Old and New World Hantaviruses. PLoS Negl. Trop. Dis., 7.","DOI":"10.1371\/journal.pntd.0002157"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1186\/s12985-017-0799-0","article-title":"Comparison of Serological Assays to Titrate Hantaan and Seoul Hantavirus-Specific Antibodies","volume":"14","author":"Li","year":"2017","journal-title":"Virol. J."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1373\/clinchem.2007.093245","article-title":"Detection and Typing of Human Pathogenic Hantaviruses by Real-Time Reverse Transcription-PCR and Pyrosequencing","volume":"53","author":"Kramski","year":"2007","journal-title":"Clin. Chem."},{"key":"ref_82","unstructured":"Altona Diagnostics (2025, February 01). RealStar\u00ae Hantavirus-HFRS RT-PCR Kit 1.0 RUO. Available online: https:\/\/altona-diagnostics.com\/product\/realstar-hantavirus-hfrs-rt-pcr-kit-1-0-ruo\/."},{"key":"ref_83","unstructured":"Altona Diagnostics (2025, February 01). RealStar\u00ae Hantavirus-HPS RT-PCR Kit 1.0 RUO. Available online: https:\/\/altona-diagnostics.com\/product\/realstar-hantavirus-hps-rt-pcr-kit-1-0-ruo\/."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Nunes, B.T.D., De Mendon\u00e7a, M.H.R., Simith, D.D.B., Moraes, A.F., Cardoso, C.C., Prazeres, I.T.E., De Aquino, A.A., Santos, A.D.C.M., Queiroz, A.L.N., and Rodrigues, D.S.G. (2019). Development of RT-qPCR and Semi-Nested RT-PCR Assays for Molecular Diagnosis of Hantavirus Pulmonary Syndrome. PLoS Negl. Trop. Dis., 13.","DOI":"10.1371\/journal.pntd.0007884"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1128\/JCM.43.2.808-812.2005","article-title":"Identification of Genetic Evidence for Dobrava Virus Spillover in Rodents by Nested Reverse Transcription (RT)-PCR and TaqMan RT-PCR","volume":"43","author":"Weidmann","year":"2005","journal-title":"J. Clin. Microbiol."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Niskanen, S., J\u00e4\u00e4skel\u00e4inen, A., Vapalahti, O., and Sironen, T. (2019). Evaluation of Real-Time RT-PCR for Diagnostic Use in Detection of Puumala Virus. Viruses, 11.","DOI":"10.3390\/v11070661"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.jviromet.2004.10.004","article-title":"Identification of Dobrava, Hantaan, Seoul, and Puumala Viruses by One-Step Real-Time RT-PCR","volume":"124","author":"Aitichou","year":"2005","journal-title":"J. Virol. Methods"},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Pang, Z., Li, A., Li, J., Qu, J., He, C., Zhang, S., Li, C., Zhang, Q., Liang, M., and Li, D. (2014). Comprehensive Multiplex One-Step Real-Time TaqMan qRT-PCR Assays for Detection and Quantification of Hemorrhagic Fever Viruses. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0095635"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"838","DOI":"10.3201\/eid1205.051487","article-title":"Hantavirus in African Wood Mouse, Guinea","volume":"12","author":"Klempa","year":"2006","journal-title":"Emerg. Infect. Dis."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"2300054","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"},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Bagamian, K.H., Towner, J.S., Kuenzi, A.J., Douglass, R.J., Rollin, P.E., Waller, L.A., and Mills, J.N. (2012). Transmission Ecology of Sin Nombre Hantavirus in Naturally Infected North American Deermouse Populations in Outdoor Enclosures. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0047731"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s11262-024-02113-3","article-title":"Identification and Epidemiological Analysis of a Putative Novel Hantavirus in Australian Flying Foxes","volume":"61","author":"Smith","year":"2025","journal-title":"Virus Genes"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"885","DOI":"10.3201\/eid1506.081126","article-title":"Hantaviruses in Rodents and Humans, Inner Mongolia Autonomous Region, China","volume":"15","author":"Zhang","year":"2009","journal-title":"Emerg. Infect. Dis."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1128\/jcm.35.5.1090-1096.1997","article-title":"Puumala Hantavirus Genome in Patients with Nephropathia Epidemica: Correlation of PCR Positivity with HLA Haplotype and Link to Viral Sequences in Local Rodents","volume":"35","author":"Plyusnin","year":"1997","journal-title":"J. Clin. Microbiol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0168-1702(92)90142-V","article-title":"Typing of Hantaviruses from Five Continents by Polymerase Chain Reaction","volume":"26","author":"Puthavathana","year":"1992","journal-title":"Virus Res."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1002\/jmv.20041","article-title":"Microarray Technology for Identification and Distinction of Hantaviruses","volume":"72","author":"Johansson","year":"2004","journal-title":"J. Med. Virol."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Filippone, C., Castel, G., Murri, S., Ermonval, M., Korva, M., Av\u0161i\u010d-\u017dupanc, T., Sironen, T., Vapalahati, O., McElhinney, L.M., and Ulrich, R.G. (2019). Revisiting the Genetic Diversity of Emerging Hantaviruses Circulating in Europe Using a Pan-Viral Resequencing Microarray. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-47508-7"},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Oude Munnink, B.B., M\u00fcnger, E., Nieuwenhuijse, D.F., Kohl, R., Van Der Linden, A., Schapendonk, C.M.E., Van Der Jeugd, H., Kik, M., Rijks, J.M., and Reusken, C.B.E.M. (2020). Genomic Monitoring to Understand the Emergence and Spread of Usutu Virus in the Netherlands, 2016\u20132018. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-59692-y"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1126\/science.1259657","article-title":"Genomic Surveillance Elucidates Ebola Virus Origin and Transmission during the 2014 Outbreak","volume":"345","author":"Gire","year":"2014","journal-title":"Science"},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Kim, W.-K., Cho, S., Lee, S.-H., No, J.S., Lee, G.-Y., Park, K., Lee, D., Jeong, S.T., and Song, J.-W. (2021). Genomic Epidemiology and Active Surveillance to Investigate Outbreaks of Hantaviruses. Front. Cell. Infect. Microbiol., 10.","DOI":"10.3389\/fcimb.2020.532388"},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Klein, T.A., Kim, H.-C., Chong, S.-T., Kim, J.-A., Lee, S.-Y., Kim, W.-K., Nunn, P.V., and Song, J.-W. (2015). Hantaan Virus Surveillance Targeting Small Mammals at Nightmare Range, a High Elevation Military Training Area, Gyeonggi Province, Republic of Korea. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0118483"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1093\/infdis\/173.4.781","article-title":"Epidemiologic Linkage of Rodent and Human Hantavirus Genomic Sequences in Case Investigations of Hantavirus Pulmonary Syndrome","volume":"173","author":"Hjelle","year":"1996","journal-title":"J. Infect. Dis."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"3008","DOI":"10.1128\/JCM.02573-06","article-title":"Hantavirus Disease Outbreak in Germany: Limitations of Routine Serological Diagnostics and Clustering of Virus Sequences of Human and Rodent Origin","volume":"45","author":"Schilling","year":"2007","journal-title":"J. Clin. Microbiol."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Quer, J., Colomer-Castell, S., Campos, C., Andr\u00e9s, C., Pi\u00f1ana, M., Cortese, M.F., Gonz\u00e1lez-S\u00e1nchez, A., Garcia-Cehic, D., Ib\u00e1\u00f1ez, M., and Pumarola, T. (2022). Next-Generation Sequencing for Confronting Virus Pandemics. Viruses, 14.","DOI":"10.3390\/v14030600"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1038\/nature14594","article-title":"Temporal and Spatial Analysis of the 2014\u20132015 Ebola Virus Outbreak in West Africa","volume":"524","author":"Carroll","year":"2015","journal-title":"Nature"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1056\/NEJMoa1804498","article-title":"Genomic Analysis of Lassa Virus during an Increase in Cases in Nigeria in 2018","volume":"379","author":"Siddle","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1038\/nature22400","article-title":"Genomic Epidemiology Reveals Multiple Introductions of Zika Virus into the United States","volume":"546","author":"Grubaugh","year":"2017","journal-title":"Nature"},{"key":"ref_108","doi-asserted-by":"crossref","unstructured":"No, J.S., Kim, W.-K., Cho, S., Lee, S.-H., Kim, J.-A., Lee, D., Song, D.H., Gu, S.H., Jeong, S.T., and Wiley, M.R. (2019). Comparison of Targeted Next-Generation Sequencing for Whole-Genome Sequencing of Hantaan Orthohantavirus in Apodemus Agrarius Lung Tissues. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-53043-2"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"e00188-18","DOI":"10.1128\/genomeA.00188-18","article-title":"Complete Genome Sequences of a Hantavirus Isolate from New York","volume":"6","author":"McMullan","year":"2018","journal-title":"Genome Announc."},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Cho, S., Kim, W.-K., No, J.S., Lee, S.-H., Jung, J., Yi, Y., Park, H.C., Lee, G.-Y., Park, K., and Kim, J.-A. (2021). Urinary Genome Detection and Tracking of Hantaan Virus from Hemorrhagic Fever with Renal Syndrome Patients Using Multiplex PCR-Based next-Generation Sequencing. PLoS Negl. Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009707"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"105525","DOI":"10.1016\/j.meegid.2023.105525","article-title":"Genetic Variants Associated with Hantavirus Infection in a Reservoir Host Are Related to Regulation of Inflammation and Immune Surveillance","volume":"116","author":"Settlecowski","year":"2023","journal-title":"Infect. Genet. Evol."},{"key":"ref_112","doi-asserted-by":"crossref","unstructured":"Taylor, M.K., Williams, E.P., Wongsurawat, T., Jenjaroenpun, P., Nookaew, I., and Jonsson, C.B. (2020). Amplicon-Based, Next-Generation Sequencing Approaches to Characterize Single Nucleotide Polymorphisms of Orthohantavirus Species. Front. Cell. Infect. Microbiol., 10.","DOI":"10.3389\/fcimb.2020.565591"},{"key":"ref_113","doi-asserted-by":"crossref","unstructured":"Park, K., Lee, S.-H., Kim, J., Lee, J., Lee, G.-Y., Cho, S., Lee, S.H., Park, K., No, J.S., and Budhathoki, S. (2021). Multiplex PCR-Based Nanopore Sequencing and Epidemiological Surveillance of Hantaan Orthohantavirus in Apodemus Agrarius, Republic of Korea. Viruses, 13.","DOI":"10.3390\/v13050847"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"3414","DOI":"10.1128\/JCM.39.9.3414-3416.2001","article-title":"Hemorrhagic Fever with Renal Syndrome: Diagnostic Problems with a Known Disease","volume":"39","author":"Wichmann","year":"2001","journal-title":"J. Clin. Microbiol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"657","DOI":"10.3201\/eid0807.010277","article-title":"First Human Isolate of Hantavirus (Andes Virus) in the Americas","volume":"8","author":"Galeno","year":"2002","journal-title":"Emerg. Infect. Dis."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.jcv.2014.08.033","article-title":"Hantaviruses\u2014Globally Emerging Pathogens","volume":"64","author":"Kruger","year":"2015","journal-title":"J. Clin. Virol."},{"key":"ref_117","unstructured":"(2024, October 01). Hantavirus Outbreak Toolbox. Available online: https:\/\/www.who.int\/emergencies\/outbreak-toolkit\/disease-outbreak-toolboxes\/hantavirus-outbreak-toolbox."},{"key":"ref_118","unstructured":"(2024, March 13). PAHO Strengthens Capacities for Hantavirus and Arenavirus Surveillance in the Americas. Available online: https:\/\/www.paho.org\/en\/news\/13-3-2024-paho-strengthens-capacities-hantavirus-and-arenavirus-surveillance-americas#:~:text=This%20international%20collaboration%20will%20not,fight%20against%20emerging%20and%20re%2D."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.3201\/eid1912.131217","article-title":"Twenty-Year Summary of Surveillance for Human Hantavirus Infections, United States","volume":"19","author":"Knust","year":"2013","journal-title":"Emerg. Infect. Dis."},{"key":"ref_120","unstructured":"(2022, February 01). Hantaviruses (Infection with). Available online: https:\/\/www.woah.org\/app\/uploads\/2022\/02\/hantaviruses-infection-with.pdf."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/5\/622\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:22:15Z","timestamp":1760030535000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/5\/622"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,26]]},"references-count":120,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["v17050622"],"URL":"https:\/\/doi.org\/10.3390\/v17050622","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,26]]}}}