Andes virus (ANDV) is the most common cause of hantavirus pulmonary syndrome (HPS) in South America. Andes virus is transmitted mainly by the long-tailed pygmy rice rat. In its natural reservoir, ANDV causes an asymptomatic, persistent infection and is spread through excretions, fighting, and grooming. Humans can become infected by inhaling aerosols that contain rodent saliva, urine, or feces, as well as through bites and scratches. In humans, infection leads to HPS, an illness characterized by an early phase of mild and moderate symptoms such as fever, headache, and fatigue, followed by sudden respiratory failure. The case fatality rate from infection is high, at about 40%.