Andes virus infection
| Andes virus infection | |
|---|---|
| Synonyms | ANDV infection |
| Locations the Andes virus usually occurs.[1][2] | |
| Classification and external resources | |
| Specialty | Infectious disease |
| Patient UK | Andes virus infection |
Andes virus infection, or ANDV infection,[5] is a hantavirus infection by a specific type of hantavirus.
Severity of symptoms is variable.[3] Initially there may be fever, muscle aches, and vomiting.[3] This may be followed by shortness of breath, cough, abdominal pain, and low blood pressure, a complication known as hantavirus cardiopulmonary syndrome (HCPS).[3] Worsening may occur suddenly.[3] Onset is usually 2 to 4 weeks after exposure, but can be 4 days to 8 weeks.[3]
The virus typically circulates in rodents, particularly the long-tailed pygmy rice rat.[3] It can spread to people who come into contact with infected rodents or their droppings.[3] However, infected rodents do not appear ill.[3] It is the only hantavirus that is known to spread between people, typically by close contact; though possibly airborne.[3] Spread has been documented in the healthcare environment, including affected hospital staff.[3] Diagnosis may be supported by PCR or serology testing.[3]
Prevention involves avoiding rodents in the areas of the world were the disease occurs.[3] There is no specific treatment or vaccine, with management involving supportive care.[3] In severe cases, infected individuals may be intubated and receive oxygen therapy.[4] Extracorporeal membrane oxygenation (ECMO) may be another option.[3] The risk of death among those infected is 35 to 50%.[3]
Andes virus infection is rare.[3] It primarily occurs in central Andes mountains of the Argentina and Chile.[3][1][2] Cases are most common in the spring and summer and among people who spend time in rural areas.[3] It was initially described in 1995.[3] An outbreak started as late as 2026. The infection is named for the Andes mountains, where it was first discovered.
Signs and symptoms
Initial signs can easily be mistaken for the flu. Symptoms can appear as early as 4 days and up to 6 weeks after exposure.[6][7] The only way to diagnose Andes orthohantavirus is by testing the person's blood for Andes orthohantavirus genetic material or for corresponding antibodies.[7] Individuals are typically only infectious while they are showing symptoms such as having one or more of the following:[7]
- Nausea or vomiting
- Headache
- Diarrhea
- Muscle aches
- Fever
- Coughing
- Shortness of breath
- Fluid in lungs
Complications may include kidney failure.[8]
Cause
ANDV, lineage ANDV-Sout, is the only hantavirus for which person-to-person transmission has been described; all other human hantavirus infections are transmitted exclusively from animals to humans.[9][10][11] Several ANDV strains are co-circulating in Argentina (e.g. Bermejo, Lechiguanas, Maciel, Oran and Pergamino).[12][13]
Spread
The virus can spread from humans or rodents, and there are multiple potential routes of infection including:[6][7]
- Breathing in the virus aerosols; stirred up rodent feces or urine
- Direct contact with eyes, nose, or mouth after touching infected rodent, its feces, urine, or nesting material
- Bite from infected rodent
- Although rare, through direct or close contact with an infected person
- Bodily fluids (blood, saliva, urine, or semen)
Risk is greatest among close contacts, such as sexual partners at 18%, and household contacts at 1%.[14] Though, there is concern of potential airborne spread.[3] People may also spread the disease before the onset of symptoms.[3]
Reservoir
In Argentina and Chile, the long-tailed rice rat, Oligoryzomys longicaudatus, and other species of the genus Oligoryzomys, have been documented as the reservoir for ANDV.[13][15][16]
Although it can be carried by humans and rodents, Andes orthohantavirus is most commonly found in the Oligoryzomys longicaudatus, a species of pygmy rat native to the Chile-Argentina region,[17] and in other cases, in the Abrothrix longipilis, a long-haired grass mouse.[18]
Virology

Classification
Andes orthohantavirus is a species of hantavirus, a group of enveloped, negative-sense single-stranded RNA virus, belonging to the family Hantaviridae and genus Orthohantavirus. All genera excluding hantavirus are air-borne viruses while the hantavirus is rodent-borne.[19] Transmission of the hantaviruses are through aerosol exposure to rodent bodily fluids.[20] Additionally, hantaviruses seem to cause no detectable cytopathology in vertebrate cell cultures.[20]
Genome and structure
The spherical virion of the hantavirus is typically 80-120 nm long and contains the segmented single-stranded genome.[21] The tri-segmented genome includes a S (small), M (medium), and L (large) segment that code for nucleocapsid (N), glycoproteins G1 and G2, and L protein respectively.[19] The S segment of the Andes virus contains 1876 nucleotides in total, while encoding a 547 nucleotide-long N protein.[22] Upon comparison of S and M segments to other variants, the Andes virus was found to form a lineage with viruses such as ESQ H-1/96, CH H-1/96 Bayou, and Black Creek Canal viruses.[22] When expressed, the M segment generates the glycoprotein precursor (GPC) which can be cleaved into the envelope Gn and Gc proteins.[23] The L protein encoded by the L segment possesses enzymatic functions that are involved within transcription and replication.[23]
In addition to these segments, the virion also contains RdRP which are all enclosed in an envelope.[24] Unlike the other four genera in the family the hantavirion segments also contain a complementary 3'-terminal nucleotide sequence to the 5'-terminal sequence. These nucleotide sequences are AUCAUCAUCUG... at the 3′ end and UAGUAGUAUGC... at the 5′ end.[20]
Pathophysiology
The hantavirus replication takes place strictly in the cytoplasm of a host cell primarily targeting endothelial cells.[25] During early infection, Andes virus can produce a weak, innate immune response in the cell.[25] The entry and uncoating of the virus begins when the virion attaches to cell receptors on the surface of the host cell, which then brings in the virus via endocytosis.[21] By a process called pH-dependent fusion between the virion and the endosomal membrane, nucleocapsids enter the cytoplasm.[19] The virus genome contains its own RNA-dependent RNA polymerase (RdRp) which directs both transcription and replication of the viral genome. Once the nucleocapsids are released, RdRp initiates transcription by binding to the encapsidated segments.[26] While M segment mRNAs are translated by membrane-bound ribosomes, L and S segment mRNAs are translated by free ribosomes. Once transcribed, the mRNA is capped by L proteins via Cap snatching.[27] These capped RNA fragments can then be transferred to L protein, to be further trimmed in length by the endonuclease and used by the RdRp to initiate viral mRNA synthesis.[23] Replication is terminated when the plasma membrane begins to fuse with cytoplasmic vesicles and mature virions are released.[20]
Prevention
When visiting geographical locations where Andes virus has been documented, people should avoid areas of high rodent populations where the virus is more likely to be found and transmitted quickly and easily from rodent to the next.[6][28] Properly disinfecting living spaces and areas where rodents may have been present will kill the virus before it is able to be contracted. To prevent transmission from contact with infected humans, individuals, infected or not, should hand-wash frequently, abstain from kissing or sexual activity with one another, and avoid sharing spaces of close confinement for long periods of time.[6][7][28]
Treatment
There is no current treatment, cure, or vaccine available for illness caused by Andes virus. However, if patients seek medical attention quickly, early symptoms can be abated through intensive care or intubation, if necessary, for patients with severe breathing difficulties.[6][7]
Evidence does not support the use of either ribavirin or corticosteroids.[3]
Epidemiology

ANDV typically causes disease in Argentina and Chile.[29]
Argentina
In Argentina the North (Salta, Jujuy), Centro (Buenos Aires, Santa Fe Province, and Entre Ríos), Northeast (Misiones) and Patagonia (Neuquén, Río Negro, and Chubut) see cases.[3]
In Argentina, 1,350 cases of HPS have occurred up to 2016 (from various hantaviruses).[30] It is estimated (year 2014) that about 16% of these cases were due to ANDV,[31] making it the most common cause in that country.[32] At least another 34 cases of ANDV occurred in late 2018 and early 2019 in Argentina.[33]
Argentina reported 86 cases of HPS in 2025, though likely only some of these were due to the Andes virus.[34]
Chile
In Chile cases occur in Región de Los Lagos.[3]
In 2025 in Chile 44 cases occurred, probably due to ANDV.[35]
Other
Rare cases of Andes virus in the United States and Europe have occurred due to travel from Argentina or Chile.[3] In 2026 an outbreak occurred on the ship MV Hondius.
Prognosis
It appears more lethal than some other hantaviruses having a mortality rate between 40% and 50% in South America.[6][36]
The critical phase of the disease is fairly short, if people can survive it.[4] There also appears to be limited permanent tissue damage.[4]
History
Andes virus was first identified during outbreaks in Chile and Argentina. In 1995, it was characterized in Argentina on the basis of specimens from a patient who had died from HPS complications.[9] It has been responsible for the most recorded cases in Argentina and Chile.[9][8]
Research
An animal model is available for ANDV, as it causes lethal disease in the Syrian hamster (Mesocricetus auratus) that closely models the course of disease progression in humans, including a rapid progression from first symptoms to death, which is characterized by fluid in the pleural cavity and the histopathology of the lungs and spleen.[37] Lethality of ANDV in hamsters is not true of all viruses causing HCPS; hamsters infected with Sin Nombre virus, for example, show no symptoms of disease.[37] The availability of this model allows for the study of various drugs and other treatments that may affect the treatment of all HCPS-causing hantavirus infections.[citation needed]
References
- ↑ 1.0 1.1 Andreo, V; Neteler, M; Rocchini, D; Provensal, C; Levis, S; Porcasi, X; Rizzoli, A; Lanfri, M; Scavuzzo, M; Pini, N; Enria, D; Polop, J (14 January 2014). "Estimating hantavirus risk in southern Argentina: a GIS-based approach combining human cases and host distribution". Viruses. 6 (1): 201–22. doi:10.3390/v6010201. PMC 3917439. PMID 24424500.
- ↑ 2.0 2.1 Ulloa-Morrison, R; Pavez, N; Parra, E; Lopez, R; Mondaca, R; Fernandez, P; Kraunik, D; Sanhueza, C; Bravo, S; Cornu, MG; Kattan, E (December 2024). "Critical care management of hantavirus cardiopulmonary syndrome. A narrative review". Journal of Critical Care. 84. doi:10.1016/j.jcrc.2024.154867. PMID 39024823 Check
|pmid=value (help). Unknown parameter|article-number=ignored (help) - ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 3.33 "Andes hantavirus: epidemiology, outbreaks and guidance". GOV.UK. Retrieved 11 May 2026.
- ↑ 4.0 4.1 4.2 4.3 "Clinician Brief: Hantavirus Pulmonary Syndrome (HPS)". Hantavirus. CDC. 8 May 2026. Archived from the original on 12 October 2025. Retrieved 11 May 2026. Unknown parameter
|url-status=ignored (help) - ↑ https://www.gov.uk/guidance/andes-hantavirus-epidemiology-outbreaks-and-guidance. Gov.uk. Retrieved 2026-05-19
- ↑ 6.0 6.1 6.2 6.3 6.4 6.5 "Andes Virus - an overview | ScienceDirect Topics". www.sciencedirect.com. Archived from the original on 2020-03-27. Retrieved 2019-03-07. Unknown parameter
|url-status=ignored (help) Archived 2020-03-27 at the Wayback Machine - ↑ 7.0 7.1 7.2 7.3 7.4 7.5 "Fact Sheet about Andes Virus | Hantavirus | DHCPP | CDC". www.cdc.gov. 2019-02-20. Archived from the original on 2020-03-19. Retrieved 2019-03-05. Unknown parameter
|url-status=ignored (help) Archived 2020-03-19 at the Wayback Machine - ↑ 8.0 8.1 "Andes virus". TheFreeDictionary.com. Archived from the original on 2020-03-28. Retrieved 2019-03-07. Unknown parameter
|url-status=ignored (help) Archived 2020-03-28 at the Wayback Machine - ↑ 9.0 9.1 9.2 Martinez VP, Bellomo C, San Juan J, Pinna D, Forlenza R, Elder M, Padula PJ (December 2005). "Person-to-person transmission of Andes virus". Emerging Infectious Diseases. 11 (12): 1848–53. doi:10.3201/eid1112.050501. PMC 3367635. PMID 16485469.
- ↑ Toro J, Vega JD, Khan AS, Mills JN, Padula P, Terry W, Yadón Z, Valderrama R, Ellis BA, Pavletic C, Cerda R, Zaki S, Shieh WJ, Meyer R, Tapia M, Mansilla C, Baro M, Vergara JA, Concha M, Calderon G, Enria D, Peters CJ, Ksiazek TG, et al. (October–December 1998). "An outbreak of hantavirus pulmonary syndrome, Chile, 1997". Emerging Infectious Diseases. 4 (4): 687–94. doi:10.3201/eid0404.980425. PMC 2640255. PMID 9866751.
- ↑ Wells RM, Sosa Estani S, Yadon ZE, Enria D, Padula P, Pini N, Gonzalez Della Valle M, Mills JN, Peters CJ (October 1998). "Seroprevalence of antibodies to hantavirus in health care workers and other residents of southern Argentina". Clinical Infectious Diseases. 27 (4): 895–6. doi:10.1086/517161. PMID 9798052.
- ↑ Padula PJ, Colavecchia SB, Martínez VP, Gonzalez Della Valle MO, Edelstein A, Miguel SD, Russi J, Riquelme JM, Colucci N, Almirón M, Rabinovich RD (August 2000). "Genetic diversity, distribution, and serological features of hantavirus infection in five countries in South America". J Clin Microbiol. 38 (8): 3029–3035. doi:10.1128/JCM.38.8.3029-3035.2000. PMC 87178. PMID 10921972.
- ↑ 13.0 13.1 Levis S, Morzunov SP, Rowe JE, Enria D, Pini N, Calderon G, Sabattini M, St Jeor SC (March 1998). "Genetic diversity and epidemiology of hantaviruses in Argentina". The Journal of Infectious Diseases. 177 (3): 529–38. doi:10.1086/514221. PMID 9498428.
- ↑ Ferres, M; Vial, P; Marco, C; Yanez, L; Godoy, P; Castillo, C; Hjelle, B; Delgado, I; Lee, SJ; Mertz, GJ; Andes Virus Household Contacts Study, Group (1 June 2007). "Prospective evaluation of household contacts of persons with hantavirus cardiopulmonary syndrome in chile". The Journal of Infectious Diseases. 195 (11): 1563–71. doi:10.1086/516786. PMID 17471425.
- ↑ Wells RM, Sosa Estani S, Yadon ZE, Enria D, Padula P, Pini N, Mills JN, Peters CJ, Segura EL (April–June 1997). "An unusual hantavirus outbreak in southern Argentina: person-to-person transmission? Hantavirus Pulmonary Syndrome Study Group for Patagonia". Emerging Infectious Diseases. 3 (2): 171–4. doi:10.3201/eid0302.970210. PMC 2627608. PMID 9204298.
- ↑ Cantoni G, Padula P, Calderón G, Mills J, Herrero E, Sandoval P, Martinez V, Pini N, Larrieu E (October 2001). "Seasonal variation in prevalence of antibody to hantaviruses in rodents from southern Argentina". Tropical Medicine & International Health. 6 (10): 811–6. doi:10.1046/j.1365-3156.2001.00788.x. PMID 11679129.
- ↑ "Hantavirus | virus". Encyclopædia Britannica. Archived from the original on 2019-07-25. Retrieved 2019-03-07. Unknown parameter
|url-status=ignored (help) Archived 2019-07-25 at the Wayback Machine - ↑ Medina RA, Torres-Perez F, Galeno H, Navarrete M, Vial PA, Palma RE, et al. (March 2009). "Ecology, genetic diversity, and phylogeographic structure of andes virus in humans and rodents in Chile". Journal of Virology. 83 (6): 2446–59. doi:10.1128/JVI.01057-08. PMC 2648280. PMID 19116256.
- ↑ 19.0 19.1 19.2 "Virology | Hantavirus | DHCPP | CDC". www.cdc.gov. 2019-02-26. Archived from the original on 2017-11-23. Retrieved 2019-03-07. Unknown parameter
|url-status=ignored (help) Archived 2017-11-23 at the Wayback Machine - ↑ 20.0 20.1 20.2 20.3 International Committee on Taxonomy of Viruses (ICTV) (2019). "Bunyaviridae". International Committee on Taxonomy of Viruses. Archived from the original on 2022-08-19. Retrieved 2023-01-30. Unknown parameter
|url-status=ignored (help) Archived 2022-08-19 at the Wayback Machine - ↑ 21.0 21.1 Muyangwa M, Martynova EV, Khaiboullina SF, Morzunov SP, Rizvanov AA (November 2015). "Hantaviral Proteins: Structure, Functions, and Role in Hantavirus Infection". Frontiers in Microbiology. 6: 1326. doi:10.3389/fmicb.2015.01326. PMC 4661284. PMID 26640463.
- ↑ 22.0 22.1 López N, Padula P, Rossi C, Miguel S, Edelstein A, Ramírez E, Franze-Fernández MT (July 1997). "Genetic characterization and phylogeny of Andes virus and variants from Argentina and Chile". Virus Research. 50 (1): 77–84. doi:10.1016/S0168-1702(97)00053-1. PMID 9255937.
- ↑ 23.0 23.1 23.2 Heinemann P, Schmidt-Chanasit J, Günther S (June 2013). "The N terminus of Andes virus L protein suppresses mRNA and protein expression in mammalian cells". Journal of Virology. 87 (12): 6975–85. doi:10.1128/JVI.00043-13. PMC 3676134. PMID 23576516.
- ↑ Hepojoki J, Strandin T, Lankinen H, Vaheri A (August 2012). "Hantavirus structure--molecular interactions behind the scene". The Journal of General Virology. 93 (Pt 8): 1631–44. doi:10.1099/vir.0.042218-0. PMID 22622328.
- ↑ 25.0 25.1 Wang Z, Mir MA (February 2015). "Andes virus nucleocapsid protein interrupts protein kinase R dimerization to counteract host interference in viral protein synthesis". Journal of Virology. 89 (3): 1628–39. doi:10.1128/JVI.02347-14. PMC 4300761. PMID 25410857.
- ↑ Muranyi W, Bahr U, Zeier M, van der Woude FJ (December 2005). "Hantavirus infection". Journal of the American Society of Nephrology. 16 (12): 3669–79. doi:10.1681/ASN.2005050561. PMID 16267154.
- ↑ "ViralZone page". viralzone.expasy.org. Archived from the original on 2019-03-08. Retrieved 2019-03-07. Unknown parameter
|url-status=ignored (help) Archived 2019-03-08 at the Wayback Machine - ↑ 28.0 28.1 "Andes Virus (Hantavirus) in Argentina - Watch - Level 1, Practice Usual Precautions - Travel Health Notices | Travelers' Health | CDC". wwwnc.cdc.gov. Archived from the original on 2019-03-07. Retrieved 2019-03-07. Unknown parameter
|url-status=ignored (help) Archived 2019-03-07 at the Wayback Machine - ↑ Jacob AT, Ziegler BM, Farha SM, Vivian LR, Zilinski CA, Armstrong AR, Burdette AJ, Beachboard DC, Stobart CC (9 November 2023). "Sin Nombre Virus and the Emergence of Other Hantaviruses: A Review of the Biology, Ecology, and Disease of a Zoonotic Pathogen". Biology (Basel). 12 (11): 1143. doi:10.3390/biology12111413. PMC 10669331 Check
|pmc=value (help). PMID 37998012 Check|pmid=value (help). - ↑ Afzal S, Ali L, Batool A, Afzal M, Kanwal N, Hassan M, Safdar M, Ahmad A, Yang J (12 October 2023). "Hantavirus: an overview and advancements in therapeutic approaches for infection". Front Microbiol. 14. doi:10.3389/fmicb.2023.1233433. PMC 10601933 Check
|pmc=value (help). PMID 37901807 Check|pmid=value (help). Unknown parameter|article-number=ignored (help) - ↑ Andreo, Veronica; Neteler, Markus; Rocchini, Duccio; Provensal, Cecilia; Levis, Silvana; Porcasi, Ximena; Rizzoli, Annapaola; Lanfri, Mario; Scavuzzo, Marcelo; Pini, Noemi; Enria, Delia; Polop, Jaime (14 January 2014). "Estimating Hantavirus Risk in Southern Argentina: A GIS-Based Approach Combining Human Cases and Host Distribution". Viruses. 6 (1): 201–222. doi:10.3390/v6010201. PMC 3917439. PMID 24424500.
- ↑ Avšič-Županc, T.; Saksida, A.; Korva, M. (April 2019). "Hantavirus infections". Clinical Microbiology and Infection. 21: e6–e16. doi:10.1111/1469-0691.12291. PMID 24750436.
- ↑ Martínez, Valeria P.; Di Paola, Nicholas; Alonso, Daniel O.; Pérez-Sautu, Unai; Bellomo, Carla M.; Iglesias, Ayelén A.; Coelho, Rocio M.; López, Beatriz; Periolo, Natalia; Larson, Peter A.; Nagle, Elyse R.; Chitty, Joseph A.; Pratt, Catherine B.; Díaz, Jorge; Cisterna, Daniel; Campos, Josefina; Sharma, Heema; Dighero-Kemp, Bonnie; Biondo, Emiliano; Lewis, Lorena; Anselmo, Constanza; Olivera, Camila P.; Pontoriero, Fernanda; Lavarra, Enzo; Kuhn, Jens H.; Strella, Teresa; Edelstein, Alexis; Burgos, Miriam I.; Kaler, Mario; Rubinstein, Adolfo; Kugelman, Jeffrey R.; Sanchez-Lockhart, Mariano; Perandones, Claudia; Palacios, Gustavo (3 December 2020). ""Super-Spreaders" and Person-to-Person Transmission of Andes Virus in Argentina". New England Journal of Medicine. 383 (23): 2230–2241. doi:10.1056/NEJMoa2009040. PMID 33264545 Check
|pmid=value (help). - ↑ "Statement from the International Hantavirus Society and members of the international hantavirus research and clinical community regarding Andes virus transmission and the current outbreak investigation". Archived from the original on 13 May 2026. Retrieved 13 May 2026. Unknown parameter
|url-status=ignored (help) - ↑ "MINSAL refuerza alerta epidemiológica por Hantavirus ante aumento de casos fatales en el país". SaludPM - Salud Municipal Puerto Montt. 2 February 2026. Retrieved 11 May 2026.
- ↑ Ermonval M, Baychelier F, Tordo N (August 2016). "What Do We Know about How Hantaviruses Interact with Their Different Hosts?". Viruses. 8 (8): 223. doi:10.3390/v8080223. PMC 4997585. PMID 27529272.
- ↑ 37.0 37.1 Hooper JW, Larsen T, Custer DM, Schmaljohn CS (October 2001). "A lethal disease model for hantavirus pulmonary syndrome". Virology. 289 (1): 6–14. doi:10.1006/viro.2001.1133. PMID 11601912.
Further reading
- Guerrant, Richard L.; Walker, David H.; Weller, Peter F. (27 May 2011). Tropical Infectious Diseases: Principles, Pathogens and Practice E-Book: Tropical Infectious Diseases: Principles, Pathogens and Practice E-Book. Elsevier Health Sciences. p. 474. ISBN 978-1-4377-3777-6. Retrieved 13 May 2026. Search this book on

- Kasper, Dennis L.; Fauci, Anthony S. (4 June 2010). Harrison's Infectious Diseases. McGraw Hill Professional. p. 982. ISBN 978-0-07-170294-2. Retrieved 13 May 2026. Search this book on

External links
| Wikimedia Commons has media related to Hantavirus. |
- CDC's Hantavirus Technical Information Index page Archived 2012-01-18 at the Wayback Machine
- Viralzone: Hantavirus Archived 2010-06-13 at the Wayback Machine
- Virus Pathogen Database and Analysis Resource (ViPR): Hantaviridae Archived 2019-09-12 at the Wayback Machine
- Occurrences and deaths in North and South America
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