Hantavirus infections in a changing world: epidemiology, pathogenesis, and one health challenges.

Hantavirus infections are zoonotic diseases of global relevance, characterised by significant morbidity and mortality and complex ecological dynamics. Transmitted primarily through rodent reservoirs, hantaviruses cause two major clinical syndromes: haemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). Despite being historically confined to specific geographic regions, recent environmental changes, increased human animal interaction, and global mobility have contributed to evolving epidemiological patterns. This review summarises current knowledge on hantavirus transmission, global epidemiology, pathophysiological mechanisms, clinical manifestations, and therapeutic approaches. Particular attention is given to the emerging global epidemiology of Seoul virus (SEOV), an urban-associated hantavirus linked to brown rats and pet rodents. In addition, it explores emerging challenges related to vaccine development, surveillance, and the integration of One Health strategies in the prevention and control of hantavirus infections. Strengthening multidisciplinary approaches and improving early detection remain critical to mitigating the global impact of these infections.