Background Hantavirus is known to be transmitted from rodents to humans. However, some reports from Argentina and Chile have claimed that the hantavirus strain Andes virus (ANDV) can cause human-to-human transmission of the disease. The aim of this systematic review was to assess the evidence for human-to-human transmission of hantavirus. Methods We searched PubMed (inception to 28 February 2021), Cochrane Central, Embase, LILACS and SciELO (inception to 3 July 2020), and other sources. We included studies that assessed whether interpersonal contact with a person with laboratory-confirmed hantavirus infection led to human-to-human transmission. Two reviewers conducted screening, selection, data extraction, and risk of bias assessment. Results Twenty-two studies met the inclusion criteria. Meta-analysis was not possible due to heterogeneity. With the exception of 1 prospective cohort study of ANDV in Chile with serious risk of bias, evidence from comparative studies (strongest level of evidence available) does not support human-to-human transmission of hantavirus infection. Noncomparative studies with a critical risk of bias suggest that human-to-human transmission of ANDV may be possible. Conclusions The balance of the evidence does not support the claim of human-to-human transmission of ANDV. Well-designed cohort and case-control studies that control for co-exposure to rodents are needed to inform public health recommendations.

中文翻译：

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汉坦病毒人际传播的证据：系统评价

背景已知汉坦病毒从啮齿动物传播给人类。然而，来自阿根廷和智利的一些报告称，汉坦病毒株安第斯病毒（ANDV）可导致该病在人与人之间传播。本系统评价的目的是评估汉坦病毒人传人的证据。方法 我们检索了 PubMed（成立至 2021 年 2 月 28 日）、Cochrane Central、Embase、LILACS 和 SciELO（成立至 2020 年 7 月 3 日）和其他来源。我们纳入了评估与实验室确诊的汉坦病毒感染者的人际接触是否会导致人际传播的研究。两名评价者进行了筛选、选择、数据提取和偏倚风险评估。结果 22 项研究符合纳入标准。由于异质性，无法进行荟萃分析。除了在智利进行的一项具有严重偏倚风险的 ANDV 前瞻性队列研究外，比较研究的证据（可用的最强证据）不支持汉坦病毒感染的人际传播。具有严重偏倚风险的非比较研究表明，ANDV 可能在人与人之间传播。结论 证据的平衡不支持 ANDV 人传人的说法。需要精心设计的队列和病例对照研究来控制与啮齿动物的共同暴露，以便为公共卫生建议提供信息。具有严重偏倚风险的非比较研究表明，ANDV 可能在人与人之间传播。结论 证据的平衡不支持 ANDV 人传人的说法。需要精心设计的队列和病例对照研究来控制与啮齿动物的共同暴露，以便为公共卫生建议提供信息。具有严重偏倚风险的非比较研究表明，ANDV 可能在人与人之间传播。结论 证据的平衡不支持 ANDV 人传人的说法。需要精心设计的队列和病例对照研究来控制与啮齿动物的共同暴露，以便为公共卫生建议提供信息。