Ministry of Health Guidelines Regulate Prevention to Control of Hantavirus
The Ministry of Health (Kemenkes) has guidelines for the prevention and control of Hantavirus disease as a reference for healthcare workers in detecting, preventing, and handling the zoonotic disease transmitted by rats. The guidelines were issued by the Directorate General of Disease Prevention and Control of Kemenkes in May 2023.
In the document, the government states that Hantavirus disease is still a “tip of the iceberg” phenomenon due to diagnostic limitations and minimal case reporting in Indonesia. “This disease remains a tip of the iceberg phenomenon in Indonesia because healthcare workers are still unfamiliar with it and examinations for diagnosis are limited,” the guidelines state, quoted on Tuesday, 12 May 2026.
The Ministry explains that Hantavirus disease is caused by Orthohantavirus, transmitted through its main reservoir of rats and shrews. The disease can trigger two clinical manifestations: Haemorrhagic Fever with Renal Syndrome (HFRS), commonly found in Asia and Europe, and Hantavirus Pulmonary Syndrome (HPS), found on the American continent.
The guidelines mention that globally, there are around 200,000 Hantavirus cases with a case fatality rate of 1 to 50 percent, depending on the virus type. Asian countries such as China, South Korea, Japan, Thailand, Malaysia, Singapore, and Indonesia have reported human infection cases.
The presence of Orthohantavirus in humans in Indonesia was first reported in 1991 at Maumere Port, Flores, East Nusa Tenggara. Research at that time found that 13 out of 100 examined individuals had serological evidence of Orthohantavirus. Following that finding, several other studies were conducted in various regions of Indonesia.
The Ministry states that Hantavirus disease requires special attention because it has the potential to cause outbreaks if the reservoir is not controlled.
“Various efforts need to be carried out, including surveillance, clinical management, specimen governance, risk factor control, risk communication, and community empowerment,” the guidelines state.
In the control guidelines, Kemenkes requests health facilities to strengthen epidemiological surveillance. Tracking is carried out for suspected patients in hospitals and community health centres, especially those experiencing acute fever resembling dengue, leptospirosis, typhoid, or severe respiratory tract infections.
Healthcare workers are also asked to increase vigilance because Hantavirus symptoms often overlap with other tropical diseases. The government assesses that diagnostic limitations remain the main obstacle to case detection in Indonesia.
Kemenkes directs laboratory examinations using serological ELISA methods and molecular RT-PCR testing to confirm Orthohantavirus diagnosis. The guidelines also regulate specimen governance, including safe procedures for sample collection, packaging, and shipment.
In health facilities, the government requests the implementation of infection prevention and control through the use of personal protective equipment (PPE) and medical waste management. Patient handling focuses on supportive therapy and monitoring of kidney and respiratory disorders.
At the environmental level, Kemenkes emphasises control of the main reservoir, namely rats and shrews. Recommended steps include improving sanitation, sealing rat entry points to homes and warehouses, and maintaining cleanliness of food storage areas.
The guidelines also include the use of mechanical traps, rodenticides, and biological control to suppress rat populations. Reservoir control is requested to be carried out periodically in high-risk areas.
In addition, the government requests supervision of risk factors in vulnerable groups, such as port workers, farmers, and residents in areas with poor sanitation. Kemenkes also emphasises public education on Hantavirus transmission methods and the importance of avoiding contact with rat urine or faeces.
Kemenkes is increasing vigilance against Hantavirus disease following an increase in case findings in Indonesia and reports of Hantavirus Pulmonary Syndrome (HPS) cases on the MV Hondius cruise ship reported by international health authorities. The government states that monitoring is carried out through the national surveillance system and cross-sectoral coordination.
Acting Director General of Disease Control at Kemenkes, Andi Saguni, said that to date, Indonesia has not found HPS cases. “We need to convey that up to now, no HPS cases have been found in Indonesia. The detected cases are of the HFRS type and continue to be monitored through the national surveillance system,” Andi said in a press release on Monday, 11 May 2026.
In addition to monitoring domestic cases, Kemenkes is following up on international notifications regarding one close contact of an HPS case from the MV Hondius cruise ship who was in Indonesia. The close contact has undergone examination at RSPI Sulianti Saroso, and laboratory results showed negative for Hantavirus type HPS or HFRS.