Hantavirus in Europe

Europe experiences hantavirus disease primarily as Hemorrhagic Fever with Renal Syndrome (HFRS), with the milder form known as nephropathia epidemica predominating in Scandinavia and Western Europe. Puumala virus, carried by the bank vole (Myodes glareolus), is responsible for the majority of European cases and typically presents with acute kidney injury, thrombocytopenia, and a case fatality rate below 1%. In the Balkans and western Russia, Dobrava-Belgrade virus causes a more severe form of HFRS with fatality rates of 5–12%. This virus is associated with the yellow-necked mouse (Apodemus flavicollis) and the striped field mouse (Apodemus agrarius). Russia reports thousands of HFRS cases annually, concentrated in the Volga-Ural region, making it one of the highest-burden countries globally. European hantavirus epidemiology follows cyclical patterns driven by mast seeding events in beech and oak forests, which trigger bank vole population booms with a lag of approximately one year. Germany, Finland, and Sweden report marked epidemic years (notably 2005, 2010, 2012, and 2019) interspersed with low-incidence periods. Climate change is projected to alter these cycles by shifting forest ecology and rodent habitat ranges northward.