#Scenario #analysis for potential #community spread of #Andes virus (ANDV)

 

Abstract

We simulated the potential community spread of Andes virus (ANDV) following the introduction of a single infectious individual in a generic population, based on epidemiological parameters derived from a human-to-human historical outbreak. Under current available evidence, our analyses suggest that, within 4 months from the index case’s symptom onset, the expected outbreak size is unlikely to exceed 50 cases, with a high probability of epidemic extinction, particularly when > 50% cases are effectively isolated from the start of the outbreak.

Source: 

Link: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2026.31.22.2600425#abstract_content

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Why #Andes #hantavirus is not the next #SARS-CoV-2: contrasting viral shedding, #transmissibility and #genomic patterns

 

Abstract

A cruise ship-associated Andes hantavirus outbreak has raised questions usually associated with respiratory viruses, including transmissibility and pandemic risk. Although Andes virus may enter through the respiratory route, cause severe respiratory disease and under close contact spread between humans, it differs fundamentally from SARS-CoV-2. The ecology is rodent-borne, pathogenesis is vascular, diagnosis is centred on blood PCR and serology, and genetic diversity is mainly shaped by reservoir ecology and geography rather than by sustained human-to-human transmission and immune selection.

Source: 

Link: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2026.31.22.2600428?emailalert=true#abstract_content

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Use of #tocilizumab for severe #hantavirus pulmonary syndrome: a MEURI case series with contextual comparisons

 

Summary

Background

Hantavirus pulmonary syndrome is a rare zoonotic disease associated with high mortality, acute respiratory failure, shock, capillary leak, and systemic inflammation. Currently, no specific antiviral or immunomodulatory therapy has proven effective for routine clinical use. The current cruise-associated hantavirus outbreak motivated this early descriptive report from an ongoing, larger, pre–post study (ISRCTN72088243). We aimed to describe tocilizumab use under the Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI) framework.

Methods

In this descriptive case series at Hospital Zonal de Bariloche Dr Ramón Carrillo, San Carlos de Bariloche, Argentina, patients with laboratory-confirmed severe hantavirus pulmonary syndrome and requiring intensive care unit (ICU) admission or assessment were eligible to receive tocilizumab in addition to standard supportive care, in accordance with the MEURI framework. Tocilizumab was administered to patients within 24 h of ICU admission or ICU-level evaluation as a single intravenous dose of 8 mg/kg, up to a maximum of 800 mg. During this time, five eligible patients could not receive tocilizumab because timely administration was not feasible due to drug unavailability or refractory shock at diagnosis. This case series represents the first report from the larger, ongoing, pre–post study (ISRCTN72088243). The main descriptive outcome was survival to ICU discharge in patients who received tocilizumab and patients who were eligible to receive tocilizumab but did not.

Findings

Between June 1, 2024, and May 5, 2026, 13 patients with laboratory-confirmed hantavirus pulmonary syndrome were evaluated for inclusion after institutional approval of the MEURI protocol. Ten met eligibility criteria for tocilizumab; five received tocilizumab and five did not. In the five eligible non-treated patients, two were diagnosed when they were already in refractory shock, precluding timely administration, and three did not receive tocilizumab because the drug was unavailable when treatment was being considered. Four of five tocilizumab-treated patients survived to ICU discharge. The fifth treated patient died after rapid progression to refractory shock. All five eligible non-treated patients died after ICU admission.

Interpretation

These observations suggest that IL-6 inhibition warrants further evaluation within the MEURI framework or analogous expanded-access frameworks, and, when feasible, collaborative randomised studies with standardised data collection.

Funding

None.

Translations

For the Spanish translations of the abstract see Supplementary Materials section.

Source: 

Link: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00285-9/abstract

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Breeding #pig #transport drives the dispersal of #swine #influenza A virus across #Europe

 

Abstract

Pigs serve as reservoirs of former human influenza A virus (IAV) H1N1 and H3N2 lineages and act as mixing vessels for diverse strains, facilitating the emergence of novel IAVs. Understanding the spread and evolution of swine IAVs (swIAVs) is therefore crucial to assess the risk of strains with zoonotic potential emerging. This study uses a phylogeographic framework to investigate the predictors of swIAV dispersal across Europe. All publicly available swIAV genomic sequences were retrieved and subsampled for the ten largest European pig-producing countries. Discrete phylogeographic reconstructions were conducted for H1, H3, N1, N2 encoding genes and all internal gene segments. Our analyses indicate that viral dispersal predominantly occurred from north-western to southern and eastern Europe, with frequent long-distance transitions between non-adjacent countries. We also extended the discrete phylogeographical analyses with generalized linear models to test the association between viral movement and potential predictors, such as live pig trade, pork trade, pig densities, farm sizes, or the geographic distance between key pig production zones. We find that breeding pig trade is the only consistently well-supported predictor of between-country transition events, whereas pork trade and geographic distance were not supported. This highlights that farms importing breeding pigs from multiple countries could act as hotspots for reassortment of diverse swIAV strains. Strengthening external biosecurity on farms with emphasis on quarantining breeding pigs, limiting long-distance transport, and implementing a One Health surveillance system for earlier detection of emerging strains, could help curb the rapid spread and evolution of swIAV in Europe.

Competing Interest Statement

The authors have declared no competing interest.

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.06.01.729471v1

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CEIRR #Risk #Assessment Pipeline executive reports on #H5N1 highly pathogenic avian influenza 2.3.4.4b, swine H1 1B.2, and #H9N2 low pathogenicity avian influenza B4.7.2

 

ABSTRACT

The Centers of Excellence for Influenza Research and Response (CEIRR) Risk Assessment Pipeline (RAP) integrates surveillance, phenotypic analysis, and computational modeling across six CEIRR centers to evaluate the pandemic potential of influenza A viruses. By generating coordinated data sets from wild and domestic animals and linking them to viral evolution and functional traits, CEIRR RAP supports the Centers for Disease Control and Prevention’s and the World Health Organization’s risk-assessment efforts. The RAP’s data packages thereby enable evidence-based prioritization of global influenza preparedness and response strategies.

Source: 

Link: https://journals.asm.org/doi/10.1128/jvi.00545-26

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Identification and characterization of a #SARS-CoV-2 #Mpro G23 deletion #ensitrelvir - #resistant mutant

 

ABSTRACT

Ensitrelvir is an antiviral drug that specifically targets the conserved main protease (Mpro) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, mutations in Mpro could confer resistance to antivirals, including ensitrelvir. Thus, identifying SARS-CoV-2 drug-resistant mutants and elucidating their mechanisms of resistance are critical for guiding the selection of effective antiviral therapies. Here, we utilized a recombinant luminescent attenuated SARS-CoV-2 lacking the open reading frames (ORF) 3a and 7b proteins (Δ3a7b-Nluc WT) to safely identify ensitrelvir drug-resistant mutants (DRM-E) without the need of using virulent forms of SARS-CoV-2. We isolated a DRM-E containing a Mpro G23 deletion (G23del) with high resistance (~1,000-fold) to ensitrelvir, but not to the Mpro inhibitor nirmatrelvir or to the RNA-dependent RNA polymerase (RdRp) inhibitor remdesivir. The contribution of G23del in ensitrelvir resistance was confirmed by generating a Δ3a7b-Nluc containing G23del in Mpro (Δ3a7b-Nluc G23del). Δ3a7b-Nluc G23del exhibited resistance to ensitrelvir in both cultured cells and in K18 hACE2 transgenic mice. Binding affinity revealed that the G23del mutation altered ensitrelvir, but not nirmatrelvir, binding to Mpro. Notably, while Δ3a7b-Nluc G23del was affected in viral fitness, serial passage of Δ3a7b-Nluc G23del in the absence of ensitrelvir resulted in the emergence of substitution L50F in Mpro that restored viral fitness loss caused by G23del without altering resistance to ensitrelvir. Our results demonstrate that G23del in Mpro can confer resistance to ensitrelvir. Positively, G23del in Mpro does not render SARS-CoV-2 resistant to nirmatrelvir or remdesivir, suggesting the feasibility of treating SARS-CoV-2 infections containing G23del Mpro with other approved antivirals.

Source: 

Link: https://journals.asm.org/doi/10.1128/mbio.00584-26

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#Human #MERS-CoV #research in the #Gulf Cooperation Council Countries: A mapping scoping review of #epidemiology, #clade, and research priority gaps

 

Abstract

Middle East Respiratory Syndrome Coronavirus (MERS-CoV) continues to pose a substantial public health challenge within Gulf Cooperation Council (GCC) countries. This scoping review systematically examines geographic distribution, methodological characteristics, and thematic priorities of published research, while identifying critical evidence gaps. A total of 171 peer-reviewed studies on human MERS-CoV were included, with a marked predominance from Saudi Arabia (88.3%). Research output peaked in 2016 and 2019, followed by a decline coinciding with the COVID-19 pandemic. Cross-sectional designs were most common (43.3%), with widespread reliance on non-probability sampling (95.3%). Epidemiology and surveillance constituted the primary research focus (∼24%), with case fatality rate being the most frequently reported metric (43.9%). Limited genomic investigations were identified, with Clade B representing 71.4% of characterized strains. Overall, the evidence base reflects geographic concentration, methodological heterogeneity, and thematic limitations, underscoring the need for expanded research scope and enhanced regional collaboration.

Source: 

Link: https://www.sciencedirect.com/science/article/pii/S1876034126001449?via%3Dihub

____

Cross-border #transmission of #Ebola virus disease caused by #Bundibugyo virus into #Uganda, 2026

 

{Excerpt}

During May 17–18, 2026, WHO and the Africa Centres for Disease Control and Prevention (Africa CDC) separately determined that the outbreak of Ebola disease caused by Bundibugyo virus (BDBV) in the Democratic Republic of the Congo and Uganda constituted a Public Health Emergency of International Concern under the International Health Regulations (2005) and a Public Health Emergency of Continental Security. This occurred after more than a month of undetected but suspected transmission of an unclassified viral haemorrhagic fever in Ituri province, the Democratic Republic of the Congo. On May 15, 2026, Uganda had reported a case of imported BDBV in one of its private health facilities within the city, Kampala. A second case was identified in Kampala in a separate private health facility on the next day. This outbreak arising out of two imported cases from the Democratic Republic of the Congo represents the second recognised outbreak caused by BDBV in Uganda since its initial identification in the western part of the country in 2007.

(...)

Source: 

Link: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(26)00288-4/fulltext

____

Data #gaps of international #databases on HPAI #H5 in #wildlife in the #Americas: implications for #surveillance, research, and #conservation

 

Abstract

Global efforts to prevent and mitigate the impacts of high pathogenicity avian influenza (HPAI) H5 on domestic animals, humans, and wildlife rely on timely and transparent information that is both accurate and interpretable across countries and sectors. International epidemiological and genomic databases, such as the World Animal Health Information System (WAHIS), the Global Animal Disease Information System (EMPRES-i+), the Global Initiative on Sharing All Influenza Data (GISAID), and the National Center for Technological Bioinformation Virus Portal (NCBI) provide essential information for surveillance, research, and decision-making. To evaluate how well these resources capture recent wildlife impacts, we consolidated information from these databases and complementary public sources including government reports, scientific literature, and news articles, on wildlife mortality associated with HPAI H5 in the Americas from November 2021 to July 2024. The consolidated dataset comprised 615,883 wild birds (287 spp.) and 63,409 wild mammals (39 spp.). In comparison, WAHIS represented 16,902 wild birds (261 spp.) and 6,323 wild mammals (31 spp.) while EMPRES-i+ captured a substantially smaller portion of affected host diversity for both wild birds (105 spp.) and wild mammals (27 spp.). Genomic databases (GISAID and NCBI) represented 7,027 whole genome equivalents of H5 viruses from wild birds (175 spp.) and 371 from wild mammals (26 spp.). These discrepancies indicate that international databases, while essential, provide an incomplete picture of HPAI impacts on wildlife, with significant geographic and taxonomic asymmetries attributable to differences in surveillance capacity, reporting practices, sequencing effort, and data-sharing pathways. Studies and management strategies relying on these resources without complementary validation may therefore mistake data gaps for real-world epidemiological patterns. Strengthening data reporting standards, improving validation procedures, and integrating international databases with national reports, scientific publications, and other sources will enhance the reliability of epidemiological analyses and support more effective One Health surveillance, risk assessment, and conservation action.

Competing Interest Statement

The authors have declared no competing interest.

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.05.30.728949v1

____

First reported case of #Andes #hantavirus cardiopulmonary syndrome treated with a combination of #favipiravir, #ribavirin, icatibant and baricitinib

 

ABSTRACT

Objectives

To describe the first documented case of Andes virus (ANDV) hantavirus cardiopulmonary syndrome (HCPS) in Spain and the first worldwide use of a therapeutic regime including two antivirals (favipiravir and ribavirin) and two host-directed drugs (baricitinib and icatibant).

Methods

A 69-year-old Spanish man, repatriated following a multinational ANDV outbreak aboard a cruise ship, was managed in a high-level isolation unit. Diagnosis was established by RT-PCR and serology while he was still asymptomatic as part of protocol-driven screening. Under compassionate-use authorisation and written informed consent, the patient received ribavirin (initially intravenous, then switched to oral on day +4), oral favipiravir, subcutaneous icatibant, and oral baricitinib, with serial clinical, laboratory, and radiological monitoring.

Results

Hypoxaemia, bilateral B-lines, thrombocytopenia, lymphopenia, and hyponatraemia developed within 24 hours after diagnosis. The combination regimen was initiated on day 0, and baricitinib was added on day +1, coinciding with the need for high-flow nasal oxygen. Sustained clinical, laboratory, and radiological recovery occurred from day +2 onwards, without progression to invasive ventilation or vasopressors. Mild diarrhoea attributed to ribavirin led to its discontinuation on day +5, shortly after the IV-to-oral switch. Severe recurrent diarrhoea on day +8, attributed to favipiravir, prompted its withdrawal before completion of the planned 10-day course; baricitinib was completed on day +10.

Conclusions

This sentinel case of imported HCPS in non-endemic Europe was managed with, to our knowledge, the first reported combined antiviral and host-directed regimen for this syndrome and the first reported use of favipiravir in a patient with hantavirus infection. The favourable outcome supports prospective evaluation of antiviral combinations and adjunctive immunomodulation within international preparedness protocols.

Source: 

Link: https://www.clinicalmicrobiologyandinfection.org/article/S1198-743X(26)00310-1/fulltext

____

#Bundibugyo #ebolavirus #outbreak in #DRC and #Uganda: rapid #assessment from the #ESCMID Emerging Infections Subcommittee

 

Introduction

The ongoing outbreak of Ebola virus disease (EVD) caused by Bundibugyo ebolavirus (BDBV) in the Democratic Republic of the Congo (DRC) and Uganda represents a major regional public health emergency with international implications. The World Health Organization (WHO) declared the event a Public Health Emergency of International Concern (PHEIC) on 17 May 2026, while clarifying that it did not meet the criteria for a pandemic emergency [1]. This distinction reflects the revised International Health Regulations framework, which allows WHO to distinguish a PHEIC from a pandemic emergency when an event is serious and internationally relevant but does not meet the additional criteria for a pandemic emergency.

(...)

Source: 

Link: https://www.clinicalmicrobiologyandinfection.org/article/S1198-743X(26)00285-5/fulltext

____

Beyond past #Ebola #outbreaks: delayed #detection, #preparedness gaps, and the #vaccine race during the 2026 #Bundibugyo virus outbreak

 

{Summary}

The 2026 Bundibugyo Public Health Emergency of International concern

What makes the current Ebola virus (EBOV) outbreak in the Democratic Republic of the Congo (DRC), caused by the Bundibugyo virus Diseases (Orthoebolavirus), different from previous Ebola outbreaks over the past five decades? This question has gained renewed urgency following the World Health Organization’s (WHO) declaration of the outbreak as a Public Health Emergency of International Concern (PHEIC) on May 17, 20261. This declaration occurred only two days after the Ministry of Public Health, Hygiene and Social Welfare, Democratic Republic of the Congo (DRC), and the Ministry of Health of Uganda declared an outbreak of Ebola Disease following the confirmation of Bundibugyo virus disease (BVD) in both countries1–3.

(...)

Source: 

Link: https://www.ijidonline.com/article/S1201-9712(26)00478-9/fulltext

____

#Outbreak at #Sea: The MV Hondius #Hantavirus #Cluster as a Sentinel for Global #Pandemic Readiness

 

{Summary}

The South Atlantic promises crystalline isolation. But the Dutch-flagged MV Hondius—an expedition vessel carrying 147 passengers and crew from 23 nations—harbored something else entirely between the Southern Cone and Antarctica [1, 2]. An invisible passenger. Epidemiologists trace this outbreak directly to dry land, theorizing the index case inhaled aerosolized rodent excreta during a Southern Cone bird-watching excursion [1].

(...)

Source: 

Link: https://www.ijidonline.com/article/S1201-9712(26)00473-X/fulltext

____

Sex differences in #vaccine-induced #neuraminidase cross-recognition and #protection against #H5N1 in mice

 

Abstract

Despite concerns about the spread and pandemic potential of H5N1, there is no commercial H5N1 vaccine. Seasonal influenza vaccines offer some cross-protection against H5N1, but to date there has been no consideration of whether protection differs between the sexes. We investigated immune responses and protection in adult male and female C57BL/6 mice following vaccination with either inactivated H1N1 or H5N1 (LAIV backbone) virus vaccines. Vaccination induced strong homologous antibody responses, with females generating greater total IgG than males against both H1N1 and H5N1 vaccine, which was primarily mediated by greater IgG responses to neuraminidase (NA) than hemagglutinin (HA) protein. IgG cross-recognition of H1N1 also was greater among H5N1 vaccinated females and was primarily caused by greater IgG responses to N1. IgG2b and IgG2c were the primary isotypes generated in response to these vaccines, with females having greater IgG2b responses and greater binding to FcγRIV for avian and human NA than males in response to both homologous and heterologous vaccination. Antibody-dependent complement deposition was measured as an FcR-mediated non-neutralizing response against HA and NA and was robust in both sexes. Vaccinated females had greater neutralizing antibody titers than males against the homologous vaccine virus, with limited cross-neutralizing antibodies detected in either sexes. Neuraminidase inhibition titers were greater in vaccinated females than males against the heterologous virus following H1N1 vaccination and against both the vaccine and heterologous viruses following H5N1 vaccination. When H1N1 and H5N1 vaccinated mice were challenged with a lethal dose of A/Texas/37/2024 H5N1, all H5N1 vaccinated mice were protected, regardless of sex. Among H1N1 vaccinated mice, while both sexes were protected against disease, H1N1 vaccinated females cleared virus faster than their male counterparts. These findings highlight that female-biased NA-specific antibodies result in greater cross-protection and should be considered in studies of influenza vaccines.

Competing Interest Statement

The authors have declared no competing interest.

Funder Information Declared

NIH/NIAID Johns Hopkins Center of Excellence for Influenza Research and Response, 75N93021C00045

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.05.26.728011v1

____

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Increased burden of #influenza #H1N1pdm09 in older adults following the #COVID19 #pandemic

 

Abstract

Of the two influenza A virus (IAV) subtypes circulating endemically in humans, A/H3N2 and A/H1N1pdm09, A/H3N2 has historically been the dominant driver of disease burden in older adults. Based on an analysis of publicly available global surveillance data from 2015 to 2025 (>300,000 subtyped, age-stratified infections), we report a substantially increased contribution of A/H1N1pdm09 to influenza morbidity in older adults since approximately 2022. Birth cohort-stratified analyses suggest elevated A/H1N1pdm09 burden among individuals born before 1955-1959, consistent with erosion of pre-existing immunity originally generated by exposure to historical A/H1N1 strains. Pooled estimates across datasets and analytical approaches indicate the increase in A/H1N1pdm09 burden rises with earlier birth year, ranging from 1.22-fold (95% CI 1.08-1.37) for the 1955-1959 birth cohort to 3.10-fold (95% CI 2.58-3.72) for the 1930-1934 cohort. These findings point to a substantial rise in the overall influenza burden among the most vulnerable age groups, with implications for vaccine policy, clinical management, and public health planning.

Competing Interest Statement

C.A.R. has received consulting fees from CSL Seqirus, Moderna, Pfizer, GSK, and Sanofi for advisory services unrelated to this work.

Source: 

Link: https://www.medrxiv.org/content/10.64898/2026.05.20.26353664v1

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#Hantavirus #infections: an emerging zoonotic #threat in the context of #ecological change

 

{Extract}

Dear Editor,

Hantaviruses, belonging to the family Hantaviridae, are increasingly recognized as significant zoonotic pathogens responsible for severe human diseases, including hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). Although traditionally considered geographically confined, recent epidemiological data indicate a gradual expansion in the incidence and geographic distribution of hantavirus infections, raising concerns regarding their re-emergence as a global public health threat [1,2]. 

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Source: 

Link: https://www.sciencedirect.com/science/article/pii/S2052297526000673?via%3Dihub

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BNT162b2 #LP81 early #vaccine #effectiveness against #COVID19 emergency department, urgent care, and outpatient visits

 

Abstract

COVID-19 continues to cause substantial illness, particularly among older adults and individuals with underlying conditions. Updated vaccines are designed to better protect against the strains of the virus that are currently circulating. However, real-world evidence on the effectiveness of updated vaccines remains limited. Here we show the early vaccine effectiveness (VE) of the BNT162b2 LP.8.1-adapted COVID-19 vaccine against mild-to-moderate COVID-19 outcomes. We used a test-negative case-control design to estimate early VE of the BNT162b2 LP.8.1-adapted vaccine against COVID-19 emergency department/urgent care (ED/UC) and outpatient visits. Adult patients from the US Veterans Affairs Healthcare System with an acute respiratory infection (ARI) who underwent SARS-CoV-2 testing from September 10 to November 30, 2025, were included. VE was estimated using multivariable logistic regression adjusted for patient demographics and clinical characteristics. Among 34,455 ARI episodes, 10.7% were COVID-19 cases. A total of 1.2% of cases and 2.6% of controls received the BNT162b2 LP.8.1 vaccine, with a median time since vaccination of 29 days (interquartile range 20-–41). BNT162b2 LP.8.1 vaccine was effective during the early 2025–2026 respiratory virus season. VE was 57% (95% confidence interval [CI] 39–70%) against ED/UC visits and 54% (95% CI 15–75%) against outpatient visits. These findings inform shared decision-making in clinical practice and support the continued importance of COVID-19 vaccination in populations for whom it is recommended.

Source: 

Link: https://www.nature.com/articles/s41467-026-73798-3

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#Andes virus, #hantavirus infections, and the unresolved question of #transfusion #transmission

 

{Summary}

The May 2026 multinational outbreak of Andes virus infection linked to cruise ship travel has appropriately focused public health attention on case identification, quarantine, contact tracing, and prevention of secondary transmission. Although the US Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have emphasized that the general public risk remains low, the outbreak is relevant to transfusion medicine because Andes virus (Orthohantavirus andesense, also known as Andes hantavirus) occupies an unusual position among hantaviruses. Hantaviruses are enveloped, negative-sense RNA viruses in the family Hantaviridae that are maintained primarily in rodent and other small mammal reservoirs. 

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Source: 

Link: https://www.trasci.com/article/S1473-0502(26)00087-X/abstract

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