Emerging Risk of Hantavirus Outbreaks in South America and Probabilistic Spillover to Europe via Human Migration

• Fabiano de Abreu Agrela Rodrigues

  Post-PhD in Neurosciences, specialist in Genomics Heraclitus Research and Analysis Center (CPAH), Department of Neurosciences and Genomics, Brazil & Portugal

  Autor

• MSc. Adriel Pereira da Silva Weber

  MSc in Neuropsychology, Physicist, Specialist in People and Project Management Heraclitus Research and Analysis Center (CPAH), Department of Physics, Brazil & Portugal

  Autor

Hantaviruses are diseases carried by rodents that can cause serious illness in humans, including hantavirus cardiopulmonary syndrome (HCPS) in the Americas and hemorrhagic fever with renal syndrome (HFRS) in parts of Europe and Asia. Brazil and Argentina are major hotspots for HCPS, with several different hantavirus genotypes in circulation and repeated local outbreaks. With growing migration and travel from South America to Europe, particularly to Spain and Portugal, there is increasing concern that hantavirus infections may be imported and go unrecognized in European countries where South American genotypes are not usually found. In this article, we present an expanded narrative review and a conceptual risk assessment that brings together epidemiological data from South America, reports from Europe, and a simplified probabilistic model that takes into account migration volumes, estimated incidence, and the likelihood of detecting cases. Our analysis indicates that, even with conservative assumptions, the expected number of imported hantavirus infections into the Iberian Peninsula over several years is not negligible. This is especially worrisome in the case of Andes virus, which has shown limited persontoperson transmission. We examine both the biological and statistical aspects of transmission, differences in risk among migrant subgroups, and what this means for clinical practice and surveillance in Europe. We propose that hantavirus should be explicitly considered in the differential diagnosis of acute febrile illnesses with respiratory or renal involvement in European regions with substantial South American immigration, and we recommend targeted awareness efforts, improved diagnostic readiness, and the development of more detailed quantitative risk models.

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