Every two to three years, large outbreaks of hantavirus disease are caused by Puumala virus, which is transmitted by bank voles and is endemic to southwestern and western Germany. In the north and east of the country, hantavirus infections are caused by the Dobrava-Belgrad virus, which is transmitted by striped field mice.

The manifestations that typically arise over the course of hantavirus disease come in several phases. The first sign is often an otherwise unexplained high fever; this may be followed by shock, renal failure, and pulmonary failure, depending on the severity of the disease. Thus, whenever persons living in high-risk areas present with fever of unknown origin or renal failure of unknown origin, physicians should consider the possibility of a hantavirus infection. Once the suspicion of hantavirus disease has been raised, special techniques can be used for precise viral diagnostic evaluation.