How is hantavirus diagnosed?

Hantavirus is diagnosed using a combination of laboratory tests and clinical criteria. The gold standard for Hantavirus Pulmonary Syndrome (HPS) is serology: IgM and IgG ELISA antibody tests that become positive within days of symptom onset. RT-PCR (reverse-transcription polymerase chain reaction) can detect viral RNA in blood during the early febrile phase before antibodies develop, and was used to confirm Andes virus in the MV Hondius cluster cases. Supportive CBC findings include thrombocytopenia (platelets often below 150,000/µL), immunoblasts (activated lymphocytes), hemoconcentration (rising hematocrit), and left-shifted neutrophilia. Chest X-ray and CT show bilateral interstitial infiltrates as HPS progresses to pulmonary edema. Diagnosis typically combines a compatible clinical picture, recent rodent exposure or travel to an endemic area, and confirmatory serology or PCR. Standard influenza or COVID-19 tests will NOT detect hantavirus — physicians must order specific hantavirus serology panels, available through most state and national reference laboratories in the US, EU, Argentina, and Chile.