Hantavirus vs Influenza (Flu)
Hantavirus and influenza both start with non-specific flu-like symptoms. The clinical divergence is dramatic: by day 5–10 after symptom onset, hantavirus patients in the HPS-causing serotypes are in profound cardiopulmonary failure with thrombocytopenia and haemoconcentration; influenza patients are typically improving. The exposure history is critical: rural rodent contact, recent travel to endemic areas, or cleaning of rodent-infested structures should raise suspicion for hantavirus.
| Hantavirus (HPS, ANDV/SNV) | Seasonal influenza (A/B) | |
|---|---|---|
| Initial symptoms | Fever, severe myalgia (thighs/back), headache, GI upset | Fever, myalgia, headache, sore throat, cough |
| Incubation | 1–8 weeks (very long) | 1–4 days |
| Lethal phase | Cardiopulmonary collapse 4–10 days after symptom onset | Pneumonia, occasional bacterial co-infection |
| Case-fatality | 30–50% (ANDV), ~38% (SNV) | 0.1% (typical season) |
| Transmission | Rodent aerosol; ANDV person-to-person | Respiratory droplet, person-to-person |
| Treatment | Supportive ICU care, ECMO; no licensed antiviral | Oseltamivir, baloxavir, supportive |
| Vaccine | Hantavax only (Hantaan, South Korea) | Annual updated vaccines |
| Lab clue | Thrombocytopenia + left shift + immunoblasts | Lymphopenia, normal platelets |