Hantavirus is Associated With Open Developed Areas and Arid Climates, Highlighting Increased Risk in the Western United States.

In the United States, hantaviruses can cause hantavirus pulmonary syndrome (HPS) in humans, an acute respiratory illness with a high mortality rate. Most people contract HPS from exposure to infected rodent excrement. The interannual dynamics of hantavirus transmission are tied to both environmental and human-related factors, including changes in annual climate conditions, rodent populations, and the built environment in which humans are more likely to be exposed. Similar environmental conditions and socioeconomic factors also likely determine the long-term risk of hantavirus exposure. Here, we use ecological niche models and human cases of HPS in the U.S. from 1993 to 2022 to assess hantavirus risk using four socioeconomic variables, 17 land use variables, one variable of rodent richness, and seven climate variables to determine both the geographical locations of highest exposure risk and leading environmental predictors. We found that areas with higher relative risk tend to be where it is drier, higher social vulnerability, increased rodent richness, and more open to low levels of development-this largely mapped to the western U.S. We found evidence that fringe ecosystems may be important areas of hantavirus transmission, similar to other emerging diseases. Increased rodent richness was associated with increased hantavirus risk, warranting further investigation into how the abundance and community composition of rodents could impact long-term risk. These risk maps can help public health officials develop plans for mitigating hantavirus, especially for the most susceptible populations. They can also be used to further investigate regions estimated to be at high risk for hantavirus where disease cases have not been as common but may be underreported.