Copyright © 2017 American Academy of Pediatrics. From: Hantavirus Pulmonary Syndrome Red Book® 2015, 2015 Figure Legend: Clinical course of hantavirus pulmonary syndrome (HPS). Clinical course of HPS starts with a febrile prodrome that may ultimately lead to hypotension and end-organ failure. The onset of the immune response precedes severe organ failure, which is thought to be immunopathologic in nature. Hypotension does not result in shock until the onset of respiratory failure, but this may reflect the severe physiological impact of lung edema. Courtesy of Centers for Disease Control and Prevention Date of download: 11/7/2017 Copyright © 2017 American Academy of Pediatrics. All rights reserved.