Over the last few weeks, the untimely death of Betsy Arakawa, classical pianist and wife of actor Gene Hackman, has brought attention to a rare lung disease, hantavirus. Hantavirus is one of many viruses that can occur when people come in contact with animals, specifically rodents. Hantaviruses cause two syndromes, though only one is common in the United States and it is called hantavirus pulmonary syndrome (HPS). Though the symptoms can mimic many other common illnesses, like the flu, it can become fatal if not identified and treated. We spoke with Dr. Afif El-Hasan, a pediatrician and asthma care physician with Kaiser Permanente, about the dangers of hantavirus pulmonary syndrome and what we need to know to stay safe.
Q: How common is hantavirus pulmonary syndrome
It is important to understand that this is a fairly rare disease. The cases that have been found were most commonly in states west of the Mississippi River. But even in this area, it often doesn’t occur and only 864 cases have been identified between 1993 and 2022.
This may be in part because the symptoms mimic other respiratory illnesses, but it also could be because it is relatively hard to get. Though we don’t yet understand how Ms. Arakawa got the illness, there are certain situations that are more likely to put someone at risk.
Q: What is the incubation period for hantavirus? How long is it active?
Hantavirus most commonly comes from rodent droppings, urine and saliva. Though deer mice are the most common carriers’ other types of mice and rats can get it as well. So, I think it’s safe to say that in general, just assuming that droppings from any type of rodent could be dangerous and should be considered something to be treated carefully. It is believed that the virus can live up to four days depending on the environment, however you should keep any indoor space vacant for at least a week after pest control treatment. It is an airborne disease that can be spread by rodent saliva, urine or feces and may be transmitted through inhalation, a rodent bite or touching contaminated surfaces and then touching your mouth.
Since hantavirus has only been reported in a small population, we don’t definitively understand how it affects humans. But in the cases we’ve observed, we suspect the virus has anywhere between a one- and eight-week incubation period after exposure.
Q: What are the symptoms of hantavirus pulmonary syndrome?
The symptoms are similar to other viral illnesses: fever, dry cough, body aches, headaches, and diarrhea. If the virus progresses it can lead to shortness of breath and fluid in the lungs.
It can be frustrating to diagnose HPS because there are no specific tests for it. To diagnose, doctors tend to look at the history of rodent exposure with accompanying fever and fatigue. So, its similarity of symptoms and inability to test for can make it hard to detect. It’s also not there first thing that comes to a doctor’s mind.
Q: Can you treat and recover from hantavirus pulmonary syndrome?
Most mild cases can resolve by themselves, but usually supportive measures are needed and can be the key to helping a patient heal. For instance, if someone starts to develop fluid in their lungs, they may need help from a respirator or to be put in ICU for supportive care. A specific treatment protocol has not been established in the medical community.
Q: How can we protect from hantavirus?
This virus most often spreads through the air, so that should be kept in mind when you are trying to prevent infection. If someone is in an area with rodent droppings, it would be a very good idea to wet down the area to minimize airborne particles, especially if they are being disturbed when you’re trying to clean up the droppings. You can do this with household disinfections, bleach, or alcohol. It is also a good idea to ventilate the area, open windows and doors so that clean air can circulate.
Hantavirus is one of many viruses that can occur in areas where you are going to find animal waste. That is why it is always important when you’re going into an area with animal droppings or handling any kind of wild animal, especially carcasses, that you take it very seriously and protect yourself. A well-fitted N-95 mask should be worn when cleaning up the droppings to make sure that the particles that carry the virus don’t get to your lungs. Always put on gloves, protective clothing and wash up thoroughly afterwards. This is a good practice not just to protect against hantavirus but for many other illnesses associated with wild animals.
Q: When should you contact your healthcare provider?
If you start feeling short of breath or feel very ill and have a fever for more than a few days, it is always a good idea to talk to your healthcare provider. Inform your provider if you have had possible exposure to rodents or animal waste. Even if they can’t provide a specific treatment, they can help you with a plan moving forward to make sure that things don’t worsen and that you are being adequately checked on. Everyone is different and we have different levels of immunity and other illnesses that may affect your health. So having that plan and checking in with your physician is extremely important.
Blog last updated: March 24, 2025
