By Joe Edwards
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The Andes strain of hantavirus stands apart from other variants for its ability to spread between people. Health officials have been investigating a hantavirus outbreak aboard the Dutch-flagged cruise ship MV Hondius, operated by Oceanwide Expeditions, that has left three dead and at least five sickened, according to the Associated Press.
World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus said Wednesday that three patients suspected of having hantavirus had been evacuated from the ship and would receive medical care in the Netherlands.
“At this stage, the overall public health risk remains low,” Ghebreyesus said.
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Why It Matters
Health officials are closely monitoring the outbreak because the Andes strain of hantavirus is one of the few known to spread between people, unlike most variants that are linked only to rodent exposure. While authorities say the current public health risk remains low, the situation highlights how even rare viruses can raise alarms when human‑to‑human transmission is possible.
The COVID‑19 pandemic reshaped how outbreaks are handled, especially in contained settings like cruise ships, making rapid detection and isolation a priority to prevent wider spread. Public health experts say heightened vigilance reflects lessons learned from earlier delays that allowed the coronavirus to spread globally.
What is 'Old World' and 'New World' Hantavirus?
According to the Coalition for Epidemic Preparedness and Innovations (CEPI), hantaviruses are a related group of viruses found worldwide, many of which can cause disease in humans.
They are broadly divided into two categories: “Old World” hantaviruses in Africa, Asia and Europe, and “New World” hantaviruses in the Americas. While related, the two groups are associated with different illnesses—New World strains cause hantavirus cardiopulmonary pulmonary syndrome (HCPS), while Old World strains lead to hemorrhagic fever with renal syndrome (HFRS).
In the Americas, the most prominent hantaviruses associated with severe illness and death are Sin Nombre virus and Andes virus, both of which are part of the New World group. Other significant strains—including Seoul, Hantaan, Dobrava, Puumala and Saaremaa viruses—belong to the Old World subgroup, according to CEPI.
According to the WHO, between 10,000 and 100,000 hantavirus infections occur globally each year, with most cases in Asia and Europe.
East Asia—particularly China and South Korea—continues to report thousands of HFRS cases annually, though incidence has declined in recent decades, the WHO said.
In Europe, several thousand cases are recorded each year, mainly in northern and central regions. In the Americas, HCPS is much rarer, with only hundreds of cases reported annually. The U.S. has recorded fewer than 1,000 cases, while countries like Argentina, Brazil, Chile and Paraguay report small numbers each year. Despite this, HCPS has a high fatality rate of around 20-40 percent, making it a significant public health concern, according to the WHO.
What are the Symptoms of the Andes Strain of the Hantavirus?
According to the U.S. Centers for Disease Control and Prevention (CDC), HPCS typically develops one to eight weeks after exposure to an infected rodent, with early flu-like symptoms, including fatigue, fever and muscle aches—especially in large muscle groups such as the thighs, hips and back. About half of patients also experience headaches, dizziness, chills and gastrointestinal issues such as nausea, vomiting and abdominal pain.
Within four to 10 days, the disease can progress, leading to coughing and shortness of breath, sometimes accompanied by chest tightness as fluid builds up in the lungs. The condition can be severe, with around 38 percent of patients who develop respiratory symptoms dying from the disease, the CDC says.
HFRS symptoms, by contrast, usually appear within one to two weeks of exposure, though it can take up to eight weeks in rare cases, the CDC says.
It can begin abruptly with symptoms including intense headaches, fever, chills, back and abdominal pain, nausea and blurred vision. Patients may also develop facial flushing, eye redness or a rash. As the illness progresses, more serious complications can occur, including low blood pressure, lack of blood flow, internal bleeding and acute kidney failure, which can lead to dangerous fluid overload, the CDC says.
Disease severity varies by virus strain and recovery can take several weeks to months, according to the agency.
The WHO explains that human-to-human transmission of hantaviruses has been documented only with the Andes virus in the Americas. When it occurs, it has been linked to close, prolonged contact, particularly among household members or intimate partners.
Hantaviruses are primarily transmitted to humans through contact with the urine, droppings or saliva of infected rodents. Activities that bring people into close contact with rodent-contaminated environments—such as cleaning enclosed or poorly ventilated spaces, farming, forestry work or sleeping in infested buildings—can increase the risk of exposure. In less common cases, infection may also occur through rodent bites, the WHO says.
Is There a Vaccine for the Hantavirus?
There is currently no widely available vaccine to prevent hantavirus infection in the United States.
According to the CDC and the WHO, prevention focuses on avoiding contact with rodents and their urine, droppings, or saliva, rather than vaccination, because no approved vaccine exists for the strains that cause hantavirus pulmonary syndrome (HPS) in the Americas.
Some vaccines have been developed and used in parts of Asia to protect against strains linked to hemorrhagic fever with renal syndrome, but those vaccines are not approved in the U.S. and do not protect against the hantavirus strains most commonly found in North America, health authorities say.
Researchers are continuing to work on potential vaccines, and experimental candidates are in early‑stage development, but experts say any broad rollout remains years away. For now, public health officials emphasize rodent control, safe cleanup of rodent‑infested areas, and early medical care as the primary ways to reduce the risk of severe illness.
What to Know About Transmission of the Hantavirus
Unlike other strains, the Andes virus is the only hantavirus for which human-to-human transmission has been documented.
U.K. Health Security Agency guidance says that for Andes virus infection, the key complication (HCPS) has a high mortality, and it gives a specific range of approximately 35-50 percent.
By contrast, in Europe and Asia, hantaviruses are known to cause HFRS. The CDC notes Hantaan and Dobrava infections can be 5-15 percent fatal, whereas Seoul, Saaremaa, and Puumala infections are typically milder with a less than 1 percent mortality.
The CDC says that each hantavirus generally has a single primary rodent host and identifies the deer mouse as the host for Sin Nombre virus, the white-footed mouse for New York virus, the cotton rat for Black Creek Canal virus, and the rice rat for Bayou virus. A CDC Emerging Infectious Diseases article adds that the Andes virus is transmitted via aerosolized excrement of the long-tailed pygmy rice rat.
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What to Know About the Hantavirus Cruise Ship Outbreak
An international health investigation is underway after a rare hantavirus outbreak linked to the Dutch‑flagged expedition ship MV Hondius led to multiple deaths and infections across several countries.
- At least three people have died, and the World Health Organization says eight cases have been reported so far, five of them laboratory‑confirmed, all connected to the ship.
- The outbreak involves the Andes strain of hantavirus, a rare variant that can spread between people, unlike most hantaviruses that are transmitted through contact with infected rodents.
- Concerns widened after a Dutch flight attendant was hospitalized in Amsterdam with mild symptoms after coming into contact with an infected passenger who later died. The attendant is being kept in isolation while testing is completed.
- Two passengers in Singapore who had been on the cruise ship are also being isolated and tested. Health officials there said the risk to the general public remains low.
- Public health agencies in multiple countries are now tracing passengers and contacts, as some travelers left the ship or flew internationally before the outbreak was fully identified.
- The WHO has stressed that, while the cases are serious and under close monitoring, the overall public health risk is currently considered low, noting that widespread transmission has not been observed.
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