North & South America
Sin Nombre virus in the US Four Corners. Andes virus across Patagonia (Argentina/Chile). HPS endemic at low levels; Andes is the only hantavirus with documented person-to-person transmission.
Europe
Puumala virus dominant in Nordic countries. Dobrava-Belgrade in the Balkans. HFRS pattern, generally milder than Asian strains.
Asia
Hantaan and Seoul viruses in China and the Korean peninsula. Highest HFRS burden globally — about 150,000 hospitalised cases per year, the vast majority in China.
Africa & Middle East
Sporadic detection in South Africa and isolated reports across the region. Surveillance is limited; true burden likely under-reported.