Hantavirus cluster linked to cruise ship journey, Multi-country

On 2 May 2026, WHO obtained notification from the IHR NFP of the United Kingdom of Great Britain and Northern Ireland (hereafter known as the United Kingdom) relating to a cluster of extreme acute respiratory sickness, together with two deaths and one critically sick passenger, aboard the Dutch-flagged cruise ship MV Hondius.

As of 13 May, a complete of 11 instances (eight confirmed, one inconclusive and two possible instances), together with three deaths (two confirmed and one possible), have been reported. Since the final Disease Outbreak News was printed on 8 May, two further confirmed instances and one inconclusive case have been reported amongst passengers. These are one confirmed case from France, who turned symptomatic throughout repatriation, one confirmed case from Spain, examined upon arrival following repatriation however at present effectively and asymptomatic, and one case thought of inconclusive. The latter was repatriated to the United States of America, is at present asymptomatic with inconclusive laboratory outcomes (one optimistic and one detrimental end result from two totally different laboratories), and is being retested. The particular person was sampled attributable to high-risk publicity to confirmed instances on board.  All laboratory-confirmed instances are confirmed for ANDV an infection. All had been passengers onboard the MV Hondius. 

Figure 1. Epidemiological curve of Andes hantavirus instances (n = 11) reported to WHO as of 13 May 2026, 17:00. 

Based on at present out there data, the working speculation is that the primary case acquired the an infection previous to boarding the cruise, by means of publicity on land. Investigations are ongoing to elucidate the potential circumstances of publicity and the supply of the outbreak, in collaboration with authorities in Argentina and Chile. Current proof suggests subsequent human-to-human transmission onboard the ship. This can also be supported by a preliminary evaluation of the sequences, which present a detailed, near-identical sequenced from totally different instances.^[1]

The outbreak is being managed by means of a coordinated worldwide response, together with in-depth epidemiological investigations, case isolation and scientific administration, medical evacuations, laboratory testing and worldwide contact tracing, quarantining and monitoring. Recommendations could also be up to date as further epidemiological and laboratory proof, together with genetic sequencing information, turns into out there.

Follow-up and make contact with tracing for all contacts of hantavirus instances linked to the cruise ship is ongoing. This consists of passengers who disembarked in Saint Helena, United Kingdom, on 24 April; Praia, Cabo Verde, on 6 May; and Tenerife, Spain, on 10 and 11 May. Passengers who travelled on flights who might have had publicity to subsequently confirmed instances have been recognized and contacted. Contacts are being monitored by native well being authorities of their respective nations.  

On 10 May, the ship arrived within the Canary Islands, Spain, the place disembarkation started.  Passengers and a lot of the crew had been repatriated from the Canary Islands to their respective residence nations or transit factors by way of specifically organized non-commercial flights, with WHO and companions supporting the disembarkation course of. The ship left the Canary Islands on 11 May and is crusing to the Netherlands, with 25 crew members remaining on board, together with two Dutch well being and care employees to conduct their well being monitoring and supply any healthcare that could be needed. 

Hantavirus cardiopulmonary syndrome (HCPS), also called hantavirus pulmonary syndrome (HPS), is a zoonotic, viral respiratory illness attributable to hantaviruses of the genus Orthohantavirus, household Hantaviridae, order Bunyavirales. More than 20 viral species have been recognized inside this genus.  

Hantaviruses are related to two main distinct scientific syndromes in people: HPS predominantly reported within the Americas, and hemorrhagic fever with renal syndrome (HFRS), primarily reported in Europe and Asia. However, human-to-human transmission has solely been reported for HPS related to Andes virus an infection. Andes virus is endemic in South America, with confirmed circulation and human instances reported primarily in Argentina and Chile, and extra instances and associated strains recognized in Uruguay, southern Brazil, and Paraguay.

Human Hantavirus an infection is primarily acquired by means of contact with the urine, faeces, or saliva of contaminated rodents or by touching contaminated surfaces. Exposure sometimes happens throughout actions comparable to cleansing buildings with rodent infestations, although it might additionally happen throughout routine actions in closely infested areas. Human instances are mostly reported in rural settings, comparable to forests, fields, and farms, the place rodents are current, and alternatives for publicity are higher.

HPS is characterised by headache, dizziness, chills, fever, myalgia, and gastrointestinal signs, comparable to nausea, vomiting, diarrhoea, and belly ache, adopted by sudden onset of respiratory misery and hypotension. Symptoms of HPS sometimes happen from 1-6 weeks after preliminary publicity to the virus. However, signs might seem as early as one week and as late as eight weeks following publicity.

Hantavirus infections are comparatively unusual globally.  In 2025, within the Region of the Americas, eight nations reported HPS, 229 instances and 59 deaths with a CFR of 25.7%.^[2] HPS shouldn’t be reported in different elements of the world. In the European Region, 1885 hantavirus infections inflicting HFRS had been reported in 2023 (0.4 per 100 000), marking the bottom fee noticed between 2019 and 2023.^[3] In East Asia, significantly China and the Republic of Korea, HFRS continues to report 1000’s of instances yearly, though incidence has declined in latest many years.

The total CFR for HPS may be as excessive as 50%. While there aren’t any licensed remedy nor vaccines for hantavirus infections, early supportive care and speedy referral to a facility with an entire ICU can enhance survival.

Environmental and ecological elements affecting rodent populations can affect illness traits seasonally. Since hantavirus reservoirs are sylvatic rodents, transmission can happen when folks come into contact with rodent habitats.

Although unusual, restricted human‑to‑human transmission of HPS attributable to Andes virus has been reported in group settings involving shut and extended contact. Secondary infections amongst healthcare employees have been beforehand documented in healthcare services, although stay uncommon. Secondary transmission seems more than likely throughout the early part of sickness, when the virus is extra transmissible. Currently, little proof is obtainable as a result of shortage of hantavirus outbreak associated to human-to-human transmission.

Authorities from States Parties managing instances and/or contacts, WHO, and companions have initiated coordinated response measures, together with:

• Ongoing engagement between WHO and the NFPs of nations managing instances and/or contacts to make sure well timed data sharing and coordination of response actions.
• International contact tracing is ongoing.
• WHO is requesting common data sharing and periodic updates from States Parties by means of IHR channels relating to contact monitoring and the well being standing of high-risk contacts
• Crew members nonetheless onboard, to take the MV Hondius to the Netherlands, have been suggested to observe bodily distancing and stay of their cabins the place potential, whereas on the cruise ship.
• Experts from WHO and the European Centre for Disease Prevention and Control (ECDC) had been deployed on board the ship to assist epidemiological investigation and supply public well being recommendation earlier than disembarkation within the Canary Islands, Spain.
• Two Dutch medical medical doctors boarded the ship in Cabo Verde to conduct well being monitoring and supply any well being care that could be needed. One disembarked in Tenerife, whereas a Dutch nurse boarded, to help in monitoring and offering any healthcare to the remaining crew members on board.
• WHO Director-General Dr Tedros Adhanom Ghebreyesus travelled to the Canary Islands on 9 May, together with different specialists from WHO, to fulfill with the nationwide authorities, together with ministers, and assist the coordination of the operations. He met with the Prime Minister of Spain on 12 May.^[4]
• Epidemiological investigations proceed to higher outline epidemiological hyperlinks between instances and publicity elements on the ship, in addition to to attempt to perceive the potential supply of publicity
• WHO has developed and printed particular technical steering paperwork to assist response to the occasion, together with:

• NFPs of affected nations have been involved about passenger and crew data by means of established IHR channels for these on the ship, in addition to on planes the place a recognized case was on board.
• The NFP of Argentina aided within the reconstruction of the journey itinerary of the primary two instances within the Southern Cone subregion of the Americas and assess any potential publicity to hantavirus. They additionally shared the National Hantavirus Epidemiological Circular: Update epidemiological Surveillance and Management Standards on Hantavirus.
• WHO supported collaboration throughout related laboratories with prior expertise to make sure well timed testing, with additional analyses ongoing, together with serology, molecular diagnostics, sequencing, and metagenomics.
• Risk communication coordination and assist are being offered to make sure sharing of standard, well timed and evidence-based data. WHO has activated three-level coordination and is supporting nationwide authorities in implementing risk-based, evidence-informed public well being measures in accordance with the provisions of the IHR and associated WHO technical steering paperwork.
• WHO usually convenes knowledgeable calls throughout laboratory, scientific administration, epidemiology, and Infection prevention and management (IPC) domains to facilitate well timed expertise sharing and coordinated knowledgeable assist.
• WHO supported the streamlining and improvement of analysis protocols on the pure scientific historical past in collaboration with nationwide companion establishments and deliberate a hantavirus scientific session on medical countermeasures.

WHO at present assesses the general public well being danger for many who had been onboard the cruise ship as average, and on the Global degree as low for the next causes:

• Andes virus has demonstrated restricted human-to-human transmission in earlier outbreaks, sometimes occurring amongst shut contacts and inside family settings, usually requiring extended shut publicity. Transmission can be contained by means of early detection, isolation of instances, scientific administration, and make contact with administration. However, the ship atmosphere introduced an elevated danger attributable to shut dwelling quarters, shared indoor areas, extended publicity, and frequent interpersonal interactions, all of which probably facilitated transmission.
• The HCPS with hantaviruses within the Americas, together with Andes can have a excessive case fatality ratio, reaching 40-50%, significantly amongst aged people and people with co-morbidities. The common age of passengers on board the ship was 65 years previous.
• Investigations on the journey historical past and potential exposures of the primary case within the Southern Cone subregion of the Americas are ongoing and counsel potential publicity to rodents throughout hen watching actions. Viral sequencing analyses are additionally ongoing and can evaluate the ANDV pressure related to this outbreak with strains circulating in Argentina and Chile, the place the illness is enzootic. The preliminary sequencing evaluation for the instances signifies a excessive diploma of genetic similarity—displaying no multiple single nucleotide polymorphisms (SNP) distinction per particular person—strongly signifies that the outbreak probably arose from a single zoonotic spillover occasion, or from a very small variety of intently associated spillover occasions.^[1]
• Additional instances might happen amongst people uncovered earlier than implementation of containment measures. However, the present response, together with quarantine for many who have left the ship and fast isolation of any new suspect instances and the monitoring of contacts, is anticipated to restrict the chance of additional unfold.
• As there isn’t any particular antiviral remedy for HPS, suspected instances require immediate switch to an adequately geared up emergency division or intensive care unit, the place out there, for shut monitoring and supportive administration to enhance probabilities of restoration. Consequently, for distant areas, fast switch to a mainland healthcare facility is required, which can be difficult underneath the present situations.

For most of the people, together with folks not uncovered on board the ship or by means of shut contact with a confirmed case, the general likelihood of an infection stays low. Current proof signifies that transmission happens by means of shut and extended contact, and may be successfully restricted by means of early detection, isolation of instances, and make contact with tracing.

More detailed epidemiological, scientific and laboratory investigations are required to tell additional iterations of this danger evaluation. 

WHO advises that States Parties concerned on this occasion proceed public well being coordination and administration efforts associated to the ship and related flights, and in nations the place instances and/or contacts are current or will likely be returning to. Based on data out there and ongoing epidemiological, scientific and environmental investigations, and making use of the precautionary precept, this consists of contact tracing and monitoring, detection, investigation, reporting of suspected instances, laboratory testing of suspected instances, case administration, an infection prevention and management measures, and clear and clear communication to affected people and most of the people.

Outside the context of the ship, high-risk contacts might embrace intimate companions, family members and individuals with extended shut indoor publicity, healthcare employees with unprotected publicity, and people dealing with contaminated supplies or physique fluids with out applicable private protecting gear, outlined within the interim steering printed on 8 May. 

Given that infectiousness peaks within the early part of sickness, and that pre-symptomatic transmission can’t be completely dominated out, as a precautionary precept, WHO recommends lively monitoring and residential or facility quarantine of high-risk contacts for 42 days following final publicity. Current proof doesn’t assist routine laboratory testing of contacts for outbreak management nor the quarantine of low-risk contacts; low-risk contacts ought to undertake passive self-monitoring and search medical analysis if signs happen. Recommendations are dynamic and will likely be tailored as extra proof emerges.

Contact investigations ought to use out there data sources, together with interviews, passenger manifests, seating preparations and exercise logs, to enhance completeness of contact identification.

Early recognition of suspected instances, immediate isolation, and constant adherence to really helpful an infection prevention and management measures stay important to guard healthcare personnel, different passengers and crew members.

In healthcare settings:

• Apply customary precautions* always for all sufferers, together with hand hygiene, environmental cleansing, and waste administration.
• Isolate any suspected or confirmed case in a single, effectively‑ventilated room with doorways closed.
• Implement transmission‑based mostly precautions along with customary precautions for suspected or confirmed instances.
• Ensure well being and care employees put on applicable private protecting gear (respirators, eye safety, robes, and gloves).
• Perform hand hygiene earlier than and after the usage of private protecting gear.

• Manage waste generated from suspected or confirmed instances as infectious waste.
• Apply airborne precautions throughout aerosol‑producing procedures.

When HPS is suspected, sufferers must be promptly transferred to an emergency division or intensive care unit for shut monitoring and supportive administration. Initial administration ought to embrace supportive care with antipyretics and analgesics as wanted. For confirmed hantavirus, antibiotics aren’t routinely indicated. However, earlier than a definitive prognosis is established (and bacterial an infection is a diagnostic risk), or if secondary bacterial an infection is suspected, empiric broad-spectrum antibiotics could also be applicable. Clinical administration depends totally on cautious fluid administration, hemodynamic monitoring, and respiratory assist. Given the fast development of HPS, shut monitoring and early switch to ICU are important for extra extreme instances. Mechanical air flow, considered fluid administration, and vasopressors could also be required. For extreme cardiopulmonary insufficiency, extracorporeal membrane oxygenation could also be lifesaving.^[5] In extreme instances of renal dysfunction, dialysis could also be required.

Although ribavirin has proven efficacy in opposition to hantavirus haemorrhagic fever with renal syndrome, it has not demonstrated effectiveness for HPS and isn’t licensed for both remedy or prophylaxis of hantavirus pulmonary syndrome.  At current, there isn’t any particular antiviral remedy accepted for HPS; plenty of current medicine have antiviral exercise in laboratory research however not but demonstrated in human illness.

Public well being consciousness efforts ought to concentrate on enhancing early detection, making certain well timed remedy, and decreasing publicity dangers. Preventive measures ought to handle occupational and ecotourism-related exposures, emphasize an infection prevention and management measures, and embrace rodent management methods. Most routine tourism actions carry little or no danger of publicity to rodents or their excreta.

Risk communication and group engagement (RCCE) interventions ought to prioritize clear, well timed, and culturally applicable communication to boost consciousness of hantavirus transmission dangers. RCCE methods ought to assist coordinated, well timed and aligned evidence-based data to make sure involved folks obtain clear, constant and actionable data, together with explanations of the general public well being measures being applied. RCCE actions ought to explicitly handle public considerations relating to transmissibility, severity, and worldwide journey, and make clear what actions are and aren’t needed for various inhabitants teams. Operational measures ought to combine RCCE actions all through all phases of the occasion. The implementation of built-in environmental administration methods geared toward decreasing rodent populations can also be really helpful.

At this time, WHO doesn’t advocate any modifications to routine actions for most of the people. People who had been on board the affected ship, or who’ve had shut contact with a confirmed case, ought to comply with the precise monitoring and public well being recommendation outlined above. Guidance could also be up to date as additional proof turns into out there.

Based on the present data out there on this occasion, WHO advises in opposition to the applying of any journey or commerce restrictions past the restriction of motion of recognized high-risk contacts.

*Standard precautions seek advice from a set of practices which can be utilized to the care of sufferers, whatever the state of an infection (suspicion or affirmation), in anywhere the place well being companies are offered. These practices goal to guard each healthcare professionals and sufferers and embrace hand hygiene, use of private protecting gear, respiratory hygiene and cough etiquette, protected dealing with of sharps supplies, protected injection practices, use of sterile devices and gear and cleansing of hospital environments and the atmosphere. Adapted from “Standard precautions for the prevention and control of infections: aide-memoire”- WHO, 2022.  Available at

• World Health Organization. Management of contacts of Andes virus (ANDV) instances from the MV Hondius cruise ship.
• World Health Organization. WHO Technical word for the disembarkation and onward administration of passengers and crew within the context of an Andes virus-associated cluster MV Hondius cruise ship.
• World Health Organization. Hantavirus reality sheet. https://www.who.int/news-room/fact-sheets/element/hantavirus
• World Health Organization.WHO’s response to hantavirus instances linked to a cruise ship.
• World Health Organization. Handbook for administration of public well being occasions on board ships https://www.who.int/publications/i/merchandise/9789241549462
• World Health Organization. Guide to Ship Sanitation, 3^rd version https://www.who.int/publications/i/merchandise/9789241546690
• Preliminary evaluation of Orthohantavirus andesense virus sequences from a cruise-ship associated cluster, May 2026.
• World Health Organization. Standard precautions for the prevention and management of infections: aide-memoire.
• World Health Organization. Transmission-based precautions for the prevention and management of infections: aide-memoire.
• World Health Organization. Hantavirus outbreak toolbox. https://www.who.int/emergencies/outbreak-toolkit/disease-outbreak-toolboxes/hantavirus-outbreak-toolbox
• World Health Organization (8 May 2026). Disease Outbreak News. Hantavirus cluster linked to cruise ship journey, Multi-country. Available at:
• World Health Organization (4 May 2026). Disease Outbreak News. Hantavirus cluster linked to cruise ship travel- Multi-country. Available at:
• World Health Organization. A call framework for efficient, equitable and context-specific public well being and social measures throughout public well being emergencies: resolution navigator:
• Pan American Health Organization / World Health Organization. PAHO helps the worldwide response to hantavirus pulmonary syndrome instances linked to a cruise ship within the Atlantic.
• Epidemiological Alert Hantavirus Pulmonary Syndrome (HPS). https://www.paho.org/en/documents/epidemiological-alert-hantavirus-pulmonary-syndrome-americas-region-19-december-2025
• Hantavirus within the Americas: Guidelines for prognosis, remedy, prevention and management. Available at: https://iris.paho.org/handle/10665.2/40176
• Hantavirus Prevention, CDC: https://www.cdc.gov/hantavirus/prevention/?CDC_AAref_Val=https://www.cdc.gov/hantavirus/hps/prevention.html
• Martínez Valeria, Paola N, et al.. (2020). “Super-Spreaders” and Person-to-Person Transmission of Andes Virus in Argentina. New England Journal of Medicine. 383. 2230-2241. 10.1056/NEJMoa2009040.
• US CDC. How to Clean Up After Rodents: https://www.cdc.gov/healthy-pets/rodent-control/clean-up.html
• Hantavirus, Washington State Department of Heath, https://doh.wa.gov/sites/default/files/2025-08/420-056-Guideline-Hantavirus.pdf
• Hantavirus Infection, MDS Manual, skilled model: https://www.msdmanuals.com/professional/infectious-diseases/arboviruses-arenaviridae-and-filoviridae/hantavirus-infection
• Handbook for administration of public well being occasions on board ships. https://www.who.int/publications/i/merchandise/9789241549462
• Hantavirus pulmonary syndrome, https://www.mayoclinic.org/diseases-conditions/hantavirus-pulmonary-syndrome/symptoms-causes/syc-20351838

[1] Preliminary evaluation of Orthohantavirus andesense virus sequences from a cruise-ship associated cluster, May 2026.

[2] Pan American Health Organization / World Health Organization (PAHO/WHO). Epidemiological Alert Hantavirus Pulmonary Syndrome (HPS). https://www.paho.org/en/documents/epidemiological-alert-hantavirus-pulmonary-syndrome-americas-region-19-december-2025

[3] Hantavirus an infection – Annual Epidemiological Report for 2023. https://www.ecdc.europa.eu/en/publications-data/hantavirus-infection-annual-epidemiological-report-2023

[4] WHO Director-General’s opening remarks on the media briefing on hantavirus – 12 May 2026. https://www.who.int/news-room/speeches/merchandise/who-director-general-s-opening-remarks-at-the-media-briefing-on-hantavirus—12-may-2026

[5] Dietl CA, Wernly JA, Pett SB, et al. Extracorporeal membrane oxygenation assist improves survival of sufferers with extreme Hantavirus cardiopulmonary syndrome. The Journal of Thoracic and Cardiovascular Surgery. 2008;135(3):579-584. doi:10.1016/j.jtcvs.2007.11.020. 

Citable reference: World Health Organization (13 May 2026). Disease Outbreak News. Hantavirus cluster linked to cruise ship journey, Multi-country. Available at: