HFRS epidemiology by continent
Hantavirus in Asia vs Europe
| Feature | Asia | Europe |
|---|---|---|
| Dominant pathogens | Hantaan, Seoul | Puumala, Dobrava-Belgrade, Tula |
| Severity profile | Often severe (HTNV CFR 10–15%) | Usually mild (PUUV CFR < 0.5%) |
| Highest-incidence countries | China, South Korea, Russia (Far East) | Finland, Sweden, Russia (European), Germany, the Balkans |
| Annual case counts | Tens of thousands across China and Korea | Thousands in Finland alone during peak years |
| Vaccines used | Yes — inactivated HTNV+SEOV in China and South Korea | No |
| Driver of year-to-year variation | Apodemus / Rattus density, agricultural cycles | Bank vole population cycles (3–4 year rhythm) |
Eurasian hantavirus disease is HFRS, but the continent splits into two very different epidemiological pictures. East Asia is dominated by severe Hantaan-virus disease and the urban Seoul virus. Europe is dominated by mild Puumala-virus nephropathia epidemica, with severe Dobrava-Belgrade pockets in the Balkans.
Asia. China and South Korea have together reported tens of thousands of HFRS cases per year for decades, with HTNV the principal pathogen and SEOV a substantial secondary contributor in urban and port settings. Severity is the clinical headline: severe HFRS produces shock, AKI requiring dialysis, and case-fatality of 10–15% even with modern care. Both China and South Korea have deployed inactivated bivalent HTNV+SEOV vaccines for occupational and high-risk populations, with substantial public-health benefit.
Europe. The Puumala-virus story is one of vole cycles. Bank vole (Myodes glareolus) populations in Fennoscandia and Central Europe boom and crash on a roughly 3–4 year rhythm; PUUV case counts track those cycles closely. Finland alone has reported thousands of cases in peak years. The good news is that PUUV-HFRS is almost always mild — case-fatality below 0.5%, with most patients recovering fully without dialysis. The exception is the Balkans, where Dobrava-Belgrade virus produces severe disease with case-fatality comparable to Hantaan.
Why the contrast? Reservoir genus. Asia's HFRS is driven by Apodemus mice and Rattus rats; Europe's by Myodes voles. The viral lineages differ in pathogenicity, and the rodent ecology differs in human-contact intensity.
Use the live map to track HFRS reporting across both regions.