Hantavirus: For health professionals
Current situation
The Public Health Agency of Canada (PHAC) has concluded its hantavirus response and thanks domestic and international partners for their collaboration.
On May 17, 2026, PHAC confirmed one case of Andes hantavirus in Canada through laboratory testing. As of June 26, 2026, all contacts in Canada who may have been exposed to Andes hantavirus linked to the MV Hondius cruise ship have completed their self-isolation and monitoring periods. In addition, the individual who contracted Andes hantavirus has recovered.
The overall risk to the general population in Canada remains low at this time.
On this page
- Key information
- Laboratory testing
- Case classification
- Treatment
- Surveillance
- Subscribe to the Zoonoses Bulletin
Key information
Health professionals in Canada are advised to be vigilant. The recognition, reporting and prompt investigation of patients with symptoms of hantavirus infection is vital. Infection with a hantavirus is mainly associated with direct contact with rodents or their droppings and urine.
Laboratory testing
Diagnosis of hantavirus pulmonary syndrome or haemorrhagic fever with renal syndrome is confirmed by laboratory testing. Of the following diagnostic markers, 1 or more must be positive:
- presence of hantavirus-specific IgM or rising titers of IgG
- presence of hantavirus RNA by RT-PCR
- positive immunohistochemistry for hantavirus antigen
The National Microbiology Laboratory is the only laboratory in Canada that conducts diagnostic testing for hantavirus infections in people.
Case classification
The 2 main types of diseases caused by a hantavirus are:
- haemorrhagic fever with renal syndrome
- hantavirus pulmonary syndrome
Haemorrhagic fever with renal syndrome
Haemorrhagic fever with renal syndrome can be a mild, moderate or severe disease, depending upon which hantavirus you are infected with. The clinical course can be divided into 5 phases:
- prodrome (or febrile)
- hypotensive
- oliguric
- diuretic
- convalescent
The prodrome phase begins with:
- high fever
- chills
- headaches
- blurred vision
- malaise
- anorexia
These symptoms are followed by:
- abdominal or lumbar pain
- gastrointestinal symptoms
- facial flushing
- petechiae
- erythematous rash
This phase typically lasts 3 to 7 days.
The hypotensive phase lasts from several hours to many days. It is characterized by the sudden onset of hypotension, which may progress to shock and haemorrhagic manifestations.
The oliguric phase typically lasts 3 to 7 days. During this time, blood pressure may return to normal or become high, and urinary output falls quickly. Severe haemorrhage may occur. Spontaneous diuresis indicates the beginning of recovery.
Hantavirus pulmonary syndrome
Hantavirus pulmonary syndrome has 4 clinical phases:
- prodrome
- cardiopulmonary
- diuresis
- convalescence
The prodrome phase typically lasts 3 to 6 days and is characterized by fever, myalgia and malaise. Other symptoms include:
- headache
- dizziness
- abdominal pain
- gastrointestinal symptoms
This is followed by the rapidly progressive cardiopulmonary phase, which is characterized by:
- non-cardiogenic pulmonary edema
- hypoxemia and cough
- pleural effusion
- gastrointestinal symptoms
- tachypnea and tachycardia
- myocardial depression
- cardiogenic shock
Hypotension and oligouria may also occur during this phase.
The diuresis phase involves rapid clearance of pulmonary edema and resolution of fever and shock.
Treatment
Treatment with antiviral ribavirin improves the outcome of haemorrhagic fever with renal syndrome. But this has not been investigated for hantavirus pulmonary syndrome. Treatment is provided to improve a patient's symptoms. Treatment options include:
- supportive care
- help to maintain oxygen levels
- help to prevent dehydration (loss of body fluids)
Furthermore, an extracorporeal CO2 elimination system should be considered for hantavirus pulmonary syndrome patients. This is to prevent life-threatening pulmonary edema and cardiogenic shock.
Surveillance
The Government is responsible for providing Canadians with essential information on hantaviruses and diseases caused by the viruses. The National Microbiology Laboratory is the only laboratory in Canada that:
- conducts diagnostic testing for hantavirus infections in humans
- analyzes trends in hantavirus pulmonary syndrome cases in Canada
- carries out field investigations into hantavirus infection cases across Canada
As of May 1, 2026, the National Microbiology Laboratory has confirmed 168 cases of hantavirus infection in Canada, since the start of active surveillance in 1994.
Canada works closely with its national and international partners. Together, they monitor diseases caused by hantaviruses in Canada and the U.S. We will continue to assess the risks of hantaviruses and associated diseases in North America on an ongoing basis.
About 200 cases of hantavirus pulmonary syndrome occur each year, primarily in North and South America.
Between 150,000 and 200,000 cases of haemorrhagic fever with renal syndrome due to a hantavirus infection occur each year worldwide. Most of these occur in China, where the average case fatality rate is from 1% to 12%.
Subscribe to the Zoonoses Bulletin
The Zoonoses Bulletin is an email subscription list that provides regular updates from the Public Health Agency of Canada on zoonotic diseases and related public health issues. Topics may include:
- hantavirus
- avian influenza
- tick and mosquito-borne diseases
- other infectious diseases that can spread between animals and people
Related links
- Hantavirus pathogen safety data sheet
- National case definition: Hantavirus pulmonary syndrome
- Hantaan orthohantavirus: Infectious substances pathogen safety data sheet
- Rapid risk assessment: Hantavirus (Andes virus) outbreak on international cruise ship
- Interim guidance: Public health management of contacts of Andes virus cases from MV Hondius cruise ship (May 26, 2026)
- Notice: Interim recommendations for infection prevention and control of Andes hantavirus in healthcare settings (June 2026)