severity, geography and reservoir compared
Hantaan virus vs Puumala virus
| Feature | Hantaan virus (HTNV) | Puumala virus (PUUV) |
|---|---|---|
| Syndrome | Severe HFRS | Mild HFRS (nephropathia epidemica) |
| Reservoir | Striped field mouse (Apodemus agrarius) | Bank vole (Myodes glareolus) |
| Geography | Korean peninsula, China, Far East Russia | Fennoscandia, the Baltics, Russia, Central Europe |
| CFR | ≈ 10–15% | < 0.5% |
| Hallmark severity feature | Bleeding, shock, AKI requiring dialysis | Most patients recover fully without dialysis |
| Seasonality | Autumn rural-agricultural peak | Autumn–winter, vole-cycle driven |
| Vaccine | Used in China and South Korea (inactivated) | None |
Hantaan virus (HTNV) is the prototype hantavirus — first isolated near the Hantan River in South Korea in 1976 — and remains the most clinically severe agent of Old World hantavirus disease. Puumala virus (PUUV) is the most common, but the mildest, of the European hantaviruses.
Reservoirs. HTNV is associated with the striped field mouse (Apodemus agrarius), an agricultural pest of Korean and Chinese rice-and-millet country. PUUV's reservoir is the bank vole (Myodes glareolus), a forest-edge species whose population cycles dominate northern European forests on a roughly 3–4 year rhythm.
Severity. The clinical contrast is striking. Severe HTNV-HFRS proceeds through dramatic hypotensive and oliguric phases with bleeding and acute kidney injury severe enough to require dialysis; case-fatality is 10–15%. PUUV — sometimes called nephropathia epidemica — typically presents with abrupt fever, severe headache, blurred vision, and transient acute kidney injury that almost always resolves without dialysis; case-fatality is below 0.5%.
Public-health response. China and South Korea have deployed inactivated HTNV-Seoul bivalent vaccines for decades, with substantial reductions in severe HFRS in vaccinated populations. No PUUV vaccine exists; instead, prevention focuses on rodent-proofing summer cottages, avoiding aerosolisation of dust during spring cleaning, and public-health bulletins during high-vole years.
Surveillance footprint. Despite its mildness, PUUV contributes the largest absolute case counts of any single hantavirus to European notifiable-disease registries — Finland alone reports thousands of cases per year during peak vole years. HTNV reporting is sparser per capita but disproportionately weighted toward severe outcomes.