The dominant route. Disturbed rodent urine, droppings, or nesting material releases virus particles into the air. People inhale them when sweeping cabins, barns, or sheds that have been closed for months.

Touching contaminated surfaces, then touching nose, mouth, or eyes. Also entry through broken skin when handling rodents or cleaning droppings without gloves.

Rare but documented. A bite from an infected deer mouse, cotton rat, rice rat, or white-footed mouse can transmit the virus directly into the bloodstream.

Eating food or drinking water that has been in contact with rodent droppings, urine, or saliva. Less common but reported in rural settings with poor storage.

The Andes orthohantavirus circulating in Argentina and Chile is the only strain with confirmed human-to-human transmission, primarily through close household or healthcare contact during the prodromal phase.