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HPS Cytokine Storm Simulator

Active outbreak: Andes hantavirus (MV Hondius, April–May 2026) — 7 confirmed cases, 3 deaths across France, Germany, Netherlands, Spain, Switzerland, South Africa. WHO Level 3.

Predicted outcomeInstant estimate
RECOVERY

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Clinical Guidance — MV Hondius Andes Virus Patients

Days 1–4 · Prodrome

  • Measure CD8⁺ count, IL-6, IL-10 and platelets every day
  • Score chest X-ray infiltrate (0 = clear, 3 = severe)
  • Enter values in the triage tool at xvirus.org/hps/triage
  • If the Storm Risk Score exceeds 2.5 → transfer to HDU immediately

Days 5–9 · Treatment window

  • The virus is already clearing — antivirals will not help
  • The immune response is the threat now
  • IL-10 analogue: most effective single intervention (−40% peak lung damage)
  • Add reduced-dose corticosteroid immunosuppression
  • ECMO as bridge if lung function deteriorates

Key message

  • Both mild and fatal cases clear the virus by day 6
  • Death is caused by the immune system, not the virus
  • Outcome is determined in the 5–9 day window
  • Do not wait for respiratory failure to act