Symptoms and diagnosis

Early symptoms (first stage)

Both HPS and HFRS start with flu-like symptoms that usually appear 1 to 8 weeks after exposure:

• Fever
• Muscle aches (especially large muscle groups)
• Fatigue
• Headache
• Dizziness
• Nausea, vomiting, diarrhea
• Abdominal pain

HPS progression (Americas)

About 4 to 10 days after early symptoms:

• Cough
• Shortness of breath
• Tightness in the chest
• Rapid progression to Acute Respiratory Distress Syndrome (ARDS)
• Case fatality rate: approximately 38%

HFRS progression (Europe/Asia)

The disease typically has five phases:

1. Febrile phase — high fever, headache, back pain, blurred vision
2. Hypotensive phase — sudden drop in blood pressure
3. Oliguric phase — reduced urine output, kidney dysfunction
4. Diuretic phase — increased urine output as kidneys recover
5. Convalescent phase — gradual recovery over weeks to months

When to seek medical help

• If you have flu-like symptoms after potential rodent exposure
• If you develop shortness of breath after initial fever
• If you have reduced urine output with fever and back pain

Diagnosis

• Blood tests (antibodies, PCR)
• Clinical history of rodent exposure
• Chest X-ray (for HPS)
• Kidney function tests (for HFRS)

Sources

• CDC - Symptoms
• WHO - Fact Sheet