Hantavirus infection in the European region: a current view of the problem

Objective. Hantavirus infection poses a significant threat to public health globally, especially in the European region, where it mainly manifests as haemorrhagic fever with renal syndrome (HFRS). This study systematises current data on the aetiology, epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment and prevention of the disease, focusing on the specific characteristics of hantavirus infection in Europe. Materials and methods. A comprehensive review of the existing literature was conducted. A search was conducted for publications in English across the following databases: PubMed, Cochrane Library, and Scopus. This study focuses on the main hantaviruses that are present in the European region, specifically the Puumala, Dobrava-Belgrade and Tula types. It provides a thorough investigation into the genetic variability of these viruses and the ecological sources from which they are transmitted. Particular emphasis is placed on epidemiological aspects in different parts of the region, the impact of environmental factors on the frequency of outbreaks, and the risks of infection associated with professional activities or exposure to natural foci. Results. One of the key challenges is the situation in Ukraine, where military operations create conditions for the spread of infection among both military personnel and the civilian population. The immunopathogenetic mechanisms of the disease are considered in detail, in particular the role of cytokines as leading factors in increasing vascular permeability and the development of acute renal failure. Variations in the clinical forms of HFRS, the stages of the disease and its severity depending on the type of virus are described. Laboratory diagnostic methods, in particular serological and molecular genetic technologies, are considered, noting the problems of their availability in combat conditions. Treatment of the disease remains largely symptomatic and pathogenetic due to the insufficient effectiveness of existing antiviral drugs. Conclusions. Hantavirus infection constitutes a significant public health problem in Europe, which is frequently underestimated and remains underdiagnosed. In the context of full-scale military operations, this problem is of particular relevance for Ukraine. The prevention of the disease is achievable through the adherence to sanitary and hygienic standards, with the objective of preventing the entry of rodents, and the implementation of extermination measures utilising personal protective equipment. The primary challenges in combating hantavirus infection pertain to the absence of effective specific therapeutic interventions and efficacious vaccine prevention measures. Concurrently, the development of efficacious vaccines remains an active area of research.