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. 2022 Oct 17;226(8):1362-1371.
doi: 10.1093/infdis/jiab461.

Evidence for Human-to-Human Transmission of Hantavirus: A Systematic Review

Joao Toledo  1 , Michelle M Haby  2 , Ludovic Reveiz  3 , Leopoldo Sosa Leon  4 , Rodrigo Angerami  5 , Sylvain Aldighieri  5
Affiliations

Evidence for Human-to-Human Transmission of Hantavirus: A Systematic Review

Joao Toledo et al. J Infect Dis. .

Abstract

Background: Hantavirus is known to be transmitted from rodents to humans. However, some reports from Argentina and Chile have claimed that the hantavirus strain Andes virus (ANDV) can cause human-to-human transmission of the disease. The aim of this systematic review was to assess the evidence for human-to-human transmission of hantavirus.

Methods: We searched PubMed (inception to 28 February 2021), Cochrane Central, Embase, LILACS and SciELO (inception to 3 July 2020), and other sources. We included studies that assessed whether interpersonal contact with a person with laboratory-confirmed hantavirus infection led to human-to-human transmission. Two reviewers conducted screening, selection, data extraction, and risk of bias assessment.

Results: Twenty-two studies met the inclusion criteria. Meta-analysis was not possible due to heterogeneity. With the exception of 1 prospective cohort study of ANDV in Chile with serious risk of bias, evidence from comparative studies (strongest level of evidence available) does not support human-to-human transmission of hantavirus infection. Noncomparative studies with a critical risk of bias suggest that human-to-human transmission of ANDV may be possible.

Conclusions: The balance of the evidence does not support the claim of human-to-human transmission of ANDV. Well-designed cohort and case-control studies that control for co-exposure to rodents are needed to inform public health recommendations.

Keywords: hantavirus; hantavirus pulmonary syndrome; healthcare-associated infections; hemorrhagic fever with renal syndrome; infectious disease transmission; outbreak; systematic review.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Study selection flow diagram - human-to-human transmission of hantavirus.
See this image and copyright information in PMC

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