Where are HFRS cases registered?

HFRS is widespread worldwide, with 23,000 to 200,000 cases registered annually. HFRS cases are registered among residents of Europe (Sweden, Norway, Finland, Bulgaria, Belgium, France, and others), Asia (PRC, South Korea, and others), Africa (Egypt, Central African countries), South America (Argentina, Brazil, Colombia, and others), Canada, the USA, the Hawaiian Islands, and Alaska.

In the Republic of Belarus, the epidemiological situation regarding HFRS remains stable and controlled. Several dozen cases are registered annually among the population.

When are cases most often registered?

HFRS cases are registered throughout the year, but more often during periods of mass city dwellers' trips outside the city for recreation in nature, work on dachas and household plots in rural settlements.

Who is the source of infection?

The source of infection and natural reservoir of the HFRS pathogen are rodents: bank voles, field mice, yellow-necked mice, common voles, house mice, brown rats.

Please note!

HFRS is not transmitted from person to person; infected individuals pose no danger to others!

Where does infection with the causative agent of HFRS most often occur, and who is more likely to get sick?

Human infection most often occurs during:

• agricultural work,
• territory improvement,
• tidying up utility rooms on household plots,
• dismantling of dilapidated buildings and structures,
• visiting forests.

Cases of the disease are registered among the population of various age and gender groups. Individuals of active age (20–50 years) are more likely to get sick.

How does the virus enter the human body?

The causative agent of HFRS (hantavirus) is released into the external environment with the feces, urine, and saliva of rodents.

Human infection most often occurs by inhaling dust containing products of vital activity of infected rodents.

Virus transmission is also possible through contact with rodents or infected environmental objects (e.g., brushwood, straw, hay, construction and household waste).

Human infection is possible through the consumption of food and water contaminated with rodent excretions and not subjected to preliminary heat treatment.

How does the disease manifest?

From the moment of infection until the first signs of the disease appear, an average of 7–23 days pass (maximum – up to 46 days).

The disease begins acutely.

Fever (38–40°C), headache, insomnia, muscle pain, photophobia, general weakness, loss of appetite, sometimes nausea and vomiting appear, catarrhal phenomena (nasal congestion, dry cough, red throat) are noted, temporary vision impairment (blurred vision), redness of the face, neck, and upper torso.

By day 3–4 of the illness, the condition may worsen, with the appearance of lower back and abdominal pain, vomiting, and sometimes a rash on the skin. Kidney function is impaired, urine output sharply decreases, up to anuria (absence of urine). Patients experience thirst and dry mouth. In some cases, nosebleeds are noted, and blood appears in the urine.

Can one get HFRS again?

Re-infection with HFRS is possible, although extremely rare, as a strong lifelong immunity usually develops after the illness. Repeated cases may be caused by infection with a different serotype of the HFRS virus circulating in other regions.

What are the preventive measures for this disease?

No vaccines protecting people from HFRS have been developed.

To prevent the disease, the following recommendations should be followed:

• use respiratory and hand skin protection (gloves or mittens, mask or respirator) when working in dusty conditions (demolition of old buildings, loading hay, straw, grass, dismantling stacks of boards, logs, brushwood piles, cleaning country houses), do not eat or smoke;
• strictly observe hand hygiene, including after performing the above-mentioned work, visiting forests, and before eating, using soap and/or hand sanitizer/skin antiseptic;
• clean country houses only using the wet method, preferably with disinfectants approved for public use;
• store food and water in rodent-inaccessible places in tightly sealed containers, do not consume food damaged by rodents;

when organizing outdoor recreation for overnight stays, choose dry, non-overgrown areas free of rodents, avoid overnight stays in haystacks and straw; when consuming food, food products and ready-made meals should be stored and served using dishes;

keep household plots and yard areas clean, promptly remove last year's vegetation, household waste, and dilapidated structures;

create conditions that exclude the possibility of rodents entering residential premises and utility buildings (sealing cracks and openings in floors and walls, screening ventilation openings, etc.);

it is forbidden to touch live or dead rodents without using hand skin protection;

purchase rodents for home and school terrariums only from specialized stores;

twice a year (spring and autumn), carry out rodent extermination on the territory of dachas, gardens, and private buildings using available means and methods (using poisoned baits, mousetraps). Baits and mousetraps must be approved for domestic use and applied according to the instructions.

Additional HPS prevention measures in the winter period.

The decrease in ambient temperature during the winter period contributes to the migration of muriform rodents into residential buildings and utility structures. This must be taken into account when winterizing dachas and country houses.

When winterizing dachas and country houses, it is necessary:

• remove all garbage, fallen leaves, fallen fruits, old grass, branches of trees and shrubs after pruning from the territory of the property; do not leave all this collected in piles, as this creates favorable conditions for rodent reproduction; the best solution is to take the garbage to an authorized landfill;
• ensure that structures and premises are rodent-proof; ventilation openings should be covered with fine-mesh screens, all mouse holes and cracks should be sealed, and current repairs should be carried out if necessary;
• at dacha and household plots, including in outbuildings, place poisoned baits or mechanical traps in places inaccessible to children and pets;
• ensure that food products are not left accessible to rodents at dacha and household plots; salt, spices, cereals, flour, and soap should be stored in tightly sealed glass or tin containers; bedding, summer clothes, and dishes should be carefully packed in plastic bags.

If rodents are detected in the basements and residential premises of apartment buildings, it is necessary to contact the housing and communal services or the management company to organize deratization measures.

In addition, constant attention should be paid to the condition of indoor garbage chutes, solid municipal waste collection sites, and the timeliness of their removal. Accumulation of garbage creates favorable conditions for the life and reproduction of rodents.

Following these simple recommendations will help you maintain your health.