A multi-country cluster of hantavirus disease has been reported aboard a Dutch-flagged cruise ship, the MV Hondius, which departed Ushuaia, Argentina, on 1 April 2026 and travelled across the South Atlantic, with stops including Antarctica, South Georgia, Saint Helena, and Ascension Island. As of 6 May 2026, the vessel is on its way to Canary Islands and carried 146 passengers and crew from 23 nationalities.
CASES:
- Onset: 6 – 1 May 2026
- Dx (lab confirmation in South Africa): 2 May (case 2)
- Symptoms: Fever, GI symptoms, rapid progression to pneumonia, ARDS, and shock.
- Total: 8 cases (5 laboratory-confirmed, 3 suspected)
- Current status: 3 fatalities; 1 critically ill in ICU; 4 with mild-to-moderate symptoms
- 1 confirmed case hospitalized in Zurich (mild)
- 2 confirmed cases hospitalized in Leyden (mild)
- 1 confirmed case hospitalized in Johannesburg (critically ill)
- 2 suspect cases in Düsseldorf and Leyden
- 1 confirmed case hospitalized in Zurich (mild)
KEY DETAILS:
- Two early confirmed cases had travelled in South America before boarding the cruise ship.
- Andes virus infection was confirmed by PCR at the HUG reference laboratory.
- Human-to-human transmission of Andes virus is possible, particularly after close and prolonged contact. The risk appears highest during the first days of symptoms.
- A coordinated international response is ongoing, involving the United Kingdom, the Netherlands, South Africa, Spain, and Cabo Verde.
- Passengers have been advised to maintain physical distancing and remain in cabin isolation.
- Additional cases among cruise ship passengers remain possible, given the long incubation period of hantavirus infection, which can extend up to 6–8 weeks. Monitoring should therefore continue for several weeks.
- WHO press conference, 07.05.2026; youtube
Hantaviruses are zoonotic viruses maintained in rodents and transmitted to humans mainly through contact with contaminated rodent urine, droppings, or saliva. Human disease is uncommon but can be severe and sometimes fatal.
Two main clinical syndromes are recognized:
Hantavirus cardiopulmonary syndrome (HCPS) occurs mainly in the Americas. It can progress rapidly from fever and flu-like symptoms to respiratory failure, pulmonary oedema, shock, and death. Case fatality is often high, commonly around 20–40%, and may reach 50%.
Hemorrhagic fever with renal syndrome (HFRS) occurs mainly in Europe and Asia. It primarily affects the kidneys and blood vessels and may cause hypotension, bleeding abnormalities, and renal failure. Case fatality is generally lower, ranging from under 1% to 15% depending on the virus and setting.
Most hantaviruses are linked to specific rodent reservoir species, which carry the virus without apparent illness. Human-to-human transmission is not typical and has only been documented with Andes virus in South America, mainly among close and prolonged contacts.
Exposure risk is increased during activities that disturb rodent-contaminated environments, such as cleaning enclosed spaces, farming, forestry work, or sleeping in rodent-infested dwellings.
Symptoms usually begin 1–8 weeks after exposure and include fever, headache, myalgia, abdominal pain, nausea, and vomiting. Diagnosis can be difficult early because symptoms overlap with influenza, COVID-19, leptospirosis, dengue, viral pneumonia, and sepsis. Confirmation relies on serology, especially IgM or rising IgG titres, and RT-PCR during acute illness.
There is no licensed specific antiviral treatment or vaccine. Management is supportive, with close monitoring and treatment of respiratory, cardiac, and renal complications. Early recognition and access to intensive care when needed are essential to improve survival.
Current event: Risk for european is very low. About 100 cruise passengers are still on board under strict IPC measures and those who left the ship are being monitored, isolated, and evaluated if symptoms, as well as passengers that were on the same flight as confirmed case of hantaviorus (25 April 2026). Air plus contact precautions are recommended for healthcare workers; no travel restrictions recommended (see ECDC assessment and recommendations). WHO assesses the global risk as very low.
Travel in endemic areas: Very low risk for travellers.
- Avoid contact with rodents and their feces (wear a mask and gloves when handling a dead/sick animal or cleaning contaminated surfaces). When camping/ecotourism, close tents and cabins to prevent rodents from entering and protect your food from contamination in airtight boxes.