Hemorrhagic Fever with Renal Syndrome is a viral disease caused by certain hantaviruses. It mainly affects the kidneys, but it can also cause fever, bleeding tendency, low blood pressure and shock in severe cases. It is different from Hantavirus Pulmonary Syndrome, which mainly affects the lungs and is more common in the Americas. HFRS is more commonly reported from Asia and Europe.
Cause and Transmission
HFRS is caused by hantaviruses carried by infected rodents.
Humans usually get infected when they:
- inhale dust contaminated with rodent urine, droppings or saliva
- clean rodent-infested houses, farms, warehouses or military shelters
- handle contaminated food, straw, grain or nesting material
- come in contact with infected rodents
Person-to-person transmission is not typical for HFRS.
Global Distribution
HFRS is mainly found in:
- China
- South Korea
- Russia
- parts of Europe
- Scandinavia
- Balkans
- Central and East Asia
Different hantaviruses cause different levels of severity. Some forms are mild, while others can cause serious kidney failure and death.
WHO notes that East Asia, especially China and South Korea, continues to report many cases of HFRS annually, although incidence has declined over time.
Symptoms
The disease usually begins with flu-like symptoms.
Common symptoms include:
- high fever
- headache
- back pain
- abdominal pain
- nausea and vomiting
- redness of face or eyes
- low blood pressure
- reduced urine output
- kidney dysfunction
- bleeding in severe cases
In serious cases, the patient may develop acute kidney injury and may need intensive medical care or dialysis.
Severity
HFRS can range from mild to severe.
Severity depends on:
- virus type
- patient’s health condition
- delay in diagnosis
- access to supportive care
- kidney involvement
Some hantavirus types cause mild disease, while others can have significant fatality. Severe forms are more associated with viruses such as Hantaan virus and Dobrava-Belgrade virus.
Public Health Importance
HFRS is important because it is a zoonotic disease, meaning it spreads from animals to humans. It is closely linked with rodent exposure, sanitation, land use and occupational risk.
It is relevant for:
- farmers
- soldiers
- forest workers
- warehouse workers
- grain handlers
- people living in rodent-infested houses
- disaster-affected populations
The disease shows why rodent control and safe cleaning practices are important parts of public health.
India Relevance
India does not currently have a large recognised burden of HFRS. However, the risk cannot be ignored because rodent exposure is common in rural, peri-urban, agricultural and storage settings.
For India, HFRS is relevant under:
- zoonotic disease surveillance
- One Health approach
- rodent-borne disease monitoring
- rural sanitation
- warehouse and grain-storage safety
- occupational health
India’s public-health system needs awareness because early symptoms can resemble common viral fever, dengue, leptospirosis or scrub typhus.
Prevention
Prevention mainly depends on reducing contact with rodents and contaminated dust.
Important measures include:
- control rodent infestation in homes, farms and warehouses
- store food grains in rodent-proof containers
- seal holes and gaps in buildings
- avoid dry sweeping rodent-contaminated areas
- wet contaminated areas with disinfectant before cleaning
- use gloves and masks while cleaning rodent-infested places
- improve waste management and sanitation
- protect workers in farms, forests, warehouses and military camps
Difference Between HFRS and HPS
- HFRS mainly affects the kidneys and is more common in Asia and Europe.
- HPS mainly affects the lungs and is more common in the Americas.
- Both are caused by hantaviruses.
- Both are linked with rodent exposure.
- Both require early recognition and supportive medical care.
Concerns
- Early symptoms are non-specific and may be confused with other fevers.
- Rural and occupational exposure can go unnoticed.
- Rodent control is difficult in farms, warehouses and informal settlements.
- Surveillance for hantavirus infections is limited in many countries.
- Climate change and land-use changes can affect rodent populations and disease risk.
- Lack of awareness can delay diagnosis and treatment.
Conclusion
Hemorrhagic Fever with Renal Syndrome is a rodent-borne hantavirus disease that mainly affects the kidneys. It is more common in Asia and Europe and can range from mild fever to severe kidney failure and shock.
For public health, the key focus is prevention through rodent control, safe cleaning practices, occupational protection and better zoonotic surveillance. For India, it is not a major current disease burden, but it remains relevant within the wider framework of emerging zoonotic infections and One Health preparedness.
