Orthohantaviruses belong to emerging zoonotic pathogens of global public health importance that can cause occasional outbreaks, often associated with conflict.1–3 These viruses are also categorised as category C pathogens by the US Centers for Disease Control and Prevention, and could be used as biological weapons, with substantial biosafety and biosecurity implications.2 These viruses are transmitted to humans through permanently infected rodents in endemic areas without interhuman transmission, except for the Andes virus (ANDV), which has been proven to transmit from person to person.3,4 An anecdotal case of potential transmission through infected blood was described in a dentist who was infected after being injured with contaminated forceps during a tooth extraction of a patient with haemorrhagic fever with renal syndrome (HFRS) in Bosnia and Herzegovina.5 Two major clinical syndromes have been associated with orthohantaviruses: HFRS, which is endemic in Europe and Asia, with recent evidence of infection in Africa; and hantavirus cardiopulmonary syndrome (HCPS), which is endemic in the Americas.3,6 Due to the significant risk of interhuman transmission of ANDV, which causes severe forms of HCPS,3 it is important to have relevant data on human-to-human transmission routes. Person-to-person exposure was found in almost 16% of patients within a family (including three children, two of whom were breastfed) or labour cluster (mostly health-care workers), which is an additional strength of this study, since the authors' previous study focused only on household contacts, in which a significant risk between sexual partners was found.4 Of practical clinical and epidemiological importance is the detection of ANDV in gingival crevicular fluid and the possible transmission of infection in the context of periodontal disease and consequent inflammation. Correlation between viral load and biomarkers of severity of HCPS clinical picture (eg, peak haematocrit, lowest platelet counts) was also found in early studies with Sin Nombre virus, but also Puumala and Dobrava HFRS-causing orthohantaviruses.8,9,10 Moreover, a study by Korva and collagues9 showed significant differences between Puumala and Dobrava viral infections, in terms of viral load, specific antibodies and cytokine response dynamics, which might affect the severity of HFRS and clinical outcomes.