to the Seoul virus, with the Hantaan virus playing a more minor role.Five of the “New World” Hantaviruses cause HCPS in North America, while a few others cause disease in Central America and South America. Most New World viruses cause HCPS only; however, the Black Creek Canal virus and the Bayou virus of the southeastern United States, as well as the Andes virus of South America, have been linked to renal in the Four Corners area; the top 5 states of exposure are, in descending order, New Mexico, Colorado, Arizona, California, and Washington. National annual incidence in nonepidemic years is about 20-30 cases (see the image below); only 3 cases were reported in 2018.Hantavirus pulmonary syndrome cases by outcome. View Media Gallery The New York virus, the Black Creek Canal virus, Seoul virus, and the Bayou