Side-by-side comparison
| HPS | other causes of ARDS | |
|---|---|---|
| Pathway | Capillary leak from rodent-borne virus | Direct lung injury (pneumonia/aspiration) or indirect (sepsis) |
| Onset | Sudden, hours after prodrome | Variable — minutes (aspiration) to days (sepsis) |
| Patient profile | Young, previously healthy | Often elderly, comorbid, ICU patient |
| Hallmark | Profound thrombocytopenia + haemoconcentration | Variable per cause |
| Specific therapy | Supportive + ECMO | Treat underlying cause |
| CFR (ARDS subtype) | ~36% | 30–50% (population average) |
How to spot the hantavirus subtype
In a young, previously healthy adult presenting with ARDS, the clinician should ask three questions: did they have flu-like illness 4–10 days before? Have they been in rural or rodent-rich environments recently? Are platelets unusually low (often < 100 × 10⁹/L)? Two yes answers should trigger empirical hantavirus management — careful fluid restriction, early ECMO consultation, infectious-disease referral.