What Are Indonesia's Guidelines for Hantavirus Prevention?

TEMPO.CO, Jakarta - The Indonesian Ministry of Health has already had prevention guidelines for Hantavirus as a reference for healthcare professionals to detect, prevent, and manage the rat-borne zoonotic disease. The guidelines were published by the Ministry’s Directorate General of Disease Prevention and Control in May 2023.

In the document, the government describes Hantavirus as an 'iceberg phenomenon' due to limited diagnostic capacity and minimal case reporting in the country. "This disease remains an iceberg phenomenon in Indonesia due to the lack of knowledge among healthcare professionals and limited diagnostic examinations," the guidelines stated, as quoted on Tuesday, May 12, 2026.

The ministry explained that Hantavirus is caused by the Orthohantavirus, transmitted primarily through rats and shrews. The disease can trigger two clinical manifestations: Hemorrhagic Fever with Renal Syndrome (HFRS), commonly found in Asia and Europe, and Hantavirus Pulmonary Syndrome (HPS), prevalent in the Americas.

Global data cited in the guidelines indicate approximately 200,000 Hantavirus cases annually, with fatality rates ranging from 1 to 50 percent depending on the viral strain. Asian nations, including China, South Korea, Japan, Thailand, Malaysia, Singapore, and Indonesia, have all reported human infections.

History and Potential Epidemics

The presence of Orthohantavirus in humans in Indonesia was first reported in 1991 at Maumere Port, Flores, East Nusa Tenggara. Research at the time found that 13 out of 100 people examined showed serological evidence of the virus, prompting subsequent studies across various regions of the archipelago.

The ministry emphasized that Hantavirus requires special attention as it has the potential to cause an epidemic if reservoirs are not controlled. "Various efforts are necessary, including surveillance, clinical management, specimen governance, risk factor control, risk communication, and community empowerment," the guidelines noted.

Strengthening Surveillance and Diagnosis

In its mitigation strategy, the Ministry is calling on healthcare facilities to strengthen epidemiological surveillance. Tracking is to be conducted for suspected patients in hospitals and health centers, particularly those presenting with acute fever resembling dengue, leptospirosis, typhus, or severe respiratory infections.

Healthcare professionals are also urged to increase vigilance, as Hantavirus symptoms often overlap with other tropical diseases. The government maintains that diagnostic limitations remain a significant hurdle in detecting cases nationwide.

The Ministry has directed laboratories to utilize serological ELISA methods and molecular RT-PCR examinations to confirm Orthohantavirus diagnoses. The guidelines also regulate specimen governance, including secure procedures for sample collection, packaging, and shipment.

Clinical and Environmental Controls

Within healthcare facilities, the government has mandated the implementation of infection prevention and control through the use of personal protective equipment (PPE) and medical waste management. Patient care is focused on supportive therapy and the monitoring of renal and respiratory complications.

On the environmental front, the Ministry emphasized controlling the primary reservoirs, rats and shrews. Recommended measures include improving sanitation, sealing rat entry points to homes and warehouses, and maintaining the cleanliness of food storage areas.

The guidelines also endorse the use of mechanical traps, rodenticides, and biological controls to suppress rat populations. Periodic reservoir control is requested in high-risk areas.

Public Education and Global Monitoring

Additionally, the government is calling for the monitoring of risk factors among vulnerable groups, such as port workers, farmers, and residents in areas with poor sanitation. The Ministry of Health also emphasized the importance of public education regarding transmission and the necessity of avoiding contact with rodent excreta.

The Ministry has heightened its vigilance following an uptick in domestic findings and reports of HPS cases on the MV Hondius cruise ship by international health authorities. The government stated that monitoring is being conducted through the national surveillance system and cross-sector coordination.

Acting Director General of Disease Control at the Ministry of Health, Andi Saguni, stated that Indonesia has yet to record any HPS cases. "We wish to inform the public that there have been no HPS cases in Indonesia to date; detected cases are of the HFRS type, and we continue to monitor them through the national system," Andi said in a press release on Monday, May 11, 2026.

In addition to domestic monitoring, the Health Ministry is following up on international notifications regarding a close contact of an HPS case from the MV Hondius in Indonesia. The individual underwent examination at the Sulianti Saroso Infectious Diseases Hospital (RSPI), where laboratory results returned negative for both HPS and HFRS.

Read: Hantavirus: How It Differs from COVID

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