#UK Health Security Agency #update on the #hantavirus multi-country #outbreak (May 14 '26, Edited)

 

Latest update

    -- Yesterday, UKHSA confirmed that 6 individuals from Arrowe Park had returned home, or to other suitable accommodation, to complete their 45 day isolation period. 

    -- A further individual is leaving Arrowe Park today, who will complete their 45 day isolation period at home after a clinical and public health assessment confirmed it was safe for them to do so.

    -- Working closely with FCDO and UK overseas territories, UKHSA is also supporting the relocation of 9 asymptomatic people from the UK overseas territories of St Helena and Ascension Island. 

    -- These people will be brought to the UK to complete their self-isolation as a precautionary measure. 

    -- This will ensure they can be provided with the best possible support from England’s High Consequence infectious disease network should they become unwell. 

    -- They are expected to arrive in the UK on Sunday and will be transferred to Arrowe Park where they will be closely monitored and offered all necessary support. 

    -- The chartered flight will operate under strict infection prevention and control measures and medical checks will be carried out before the flight to ensure passengers are asymptomatic.

    -- One contact, a medic on Ascension Island who developed symptoms, will be medically evacuated to the UK separately for specialist assessment in the UK and they will be cared for at a High Consequence Infectious Disease Unit in the South of England as a highly precautionary measure. 

    -- Their samples were taken to the UK on 8 May and tested negative. 

    -- We continue to work closely with the FCDO to provide support to UK Overseas Territories.

    Dr William Welfare, Director Health Protection in Regions at UKHSA, said:

    ''UKHSA continues to work with FCDO, DHSC and NHS colleagues on the repatriation of British nationals currently isolating on St Helena and Ascension Island. We expect the flight to land on Sunday, with all individuals then safely transported to Arrowe Park where they will receive clinical assessment testing and follow up.

    ''We would like to thank those who remain in isolation at Arrowe Park, as well as those now self-isolating at home, for their cooperation and we’re pleased to see further people heading home today to continue their self-isolation. Our teams will continue to work closely with all those affected by this outbreak, ensuring everyone has the necessary support in place.

    -- The risk to the general public remains very low.

Source: 

Link: https://www.gov.uk/government/news/ukhsa-update-on-the-hantavirus-cruise-ship-outbreak

____

#Reassortant High Pathogenicity Avian #Influenza #H5N1 Viruses During the Reemergence in #Uruguay Suggest Increasing #Genetic Diversity in South #America

 

Abstract

Highly pathogenic avian influenza (HPAI) H5N1 viruses of the goose/Guangdong (Gs/GD) lineage have driven a global panzootic since 2020, with clade 2.3.4.4b establishing sustained transmission in wild birds. In South America, early outbreaks were largely associated with the North American-derived B3.2 genotype, which showed limited diversification after its introduction. Here, we report the genomic characterization of eight H5N1 viruses detected in Uruguay during the reemergence of avian influenza in February–March 2026. Complete genomes were obtained from wild birds exhibiting neurological signs, predominantly Coscoroba coscoroba. All viruses belong to clade 2.3.4.4b but exhibit a reassortant genomic constellation distinct from B3.2. The HA, NA, and MP segments retain the Eurasian backbone, whereas internal genes derive from both South American and North American low-pathogenicity avian influenza lineages. PB2 variation distinguishes two closely related viral groups differing in PB2 origin, whereas the remaining genomic segments retain a shared background. Sequence variation in the neuraminidase gene reduced the sensitivity of a widely used N1-specific RT-qPCR assay, highlighting limitations of existing diagnostic tools during viral evolution. These findings confirm the presence of reassortant H5N1 viruses in Uruguay and, together with recent reports from Argentina and Brazil, support an emerging pattern of genomic diversification in southern South America.

Source: 

Link: https://www.mdpi.com/1999-4915/18/5/558

____

#Diagnostic and #clinical #challenges of #hantavirus-associated acute #kidney injury

 

Abstract

Introduction: 

Hantavirus infection is an uncommon zoonosis in Europe but remains an important cause of acute kidney injury, particularly in patients with environmental exposure to rodents. Renal involvement is the hallmark of the disease, although pulmonary manifestations may coexist and mimic immune-mediated pulmonary–renal syndromes, leading to diagnostic challenges in internal medicine.

Case description: 

A 46-year-old previously healthy man living in a rural area was admitted for acute febrile illness with asthenia and myalgia. Initial investigations revealed severe thrombocytopenia and acute kidney injury with proteinuria and microscopic haematuria. A computed tomography scan of the chest and abdomen showed bilateral pulmonary abnormalities, consistent with an acute pulmonary–renal syndrome. Extensive immunological and infectious investigations excluded autoimmune disease and alternative infectious causes. Hantavirus infection was confirmed by positive IgM and IgG serology, with molecular identification of Puumala virus. Renal biopsy demonstrated moderate acute tubular necrosis with minimal interstitial inflammation and preserved glomeruli. The patient was treated with supportive care only, resulting in rapid clinical improvement and complete recovery of renal function.

Conclusion: 

Hantavirus infection should be considered in patients presenting with acute pulmonary–renal syndrome, thrombocytopenia, and compatible epidemiological exposure. Early diagnosis allows appropriate supportive management, avoids unnecessary immunosuppressive therapy, and is associated with an excellent renal prognosis in Puumala virus infection.

Source: 

Link: https://www.ejcrim.com/index.php/EJCRIM/article/view/6159

____

#Advice on laboratory #testing of #Andes virus (ANDV) for high-risk #contacts under the MV Hondius #outbreak, 14 May 2026 (ECDC, summary)

 

Scope of this document

    This document provides practical considerations for public health authorities in European Union/European Economic Area (EU/EEA) countries on laboratory testing for Andes virus (ANDV), with a focus on asymptomatic high-risk contacts of cases from the cruise ship MV Hondius [1].  

    The aim of this document is to support informed decision-making around testing, with a focus on the potential benefits, limitations and consequences of testing asymptomatic high-risk contacts, based on the available scientific evidence. 

    This document does not prescribe a single approach and is intended to help national public health authorities decide if, when, and how laboratory testing could be used in this context, considering the local epidemiological situation, resources and public health policies. 

    This document complements case finding and contact tracing activities as well as guidelines on contact management [1], and assumes regular and active symptom monitoring. 

    In this document, ECDC provides the following support to countries in the decision-making process: 

        • Recommendations for testing symptomatic and asymptomatic contacts; 

        • Advantages and disadvantages of PCR testing for ANDV in asymptomatic high-risk contacts from the MV Hondius outbreak; 

        • A decision tree with more information on the testing strategy proposed. 

Recommendations for testing symptomatic and asymptomatic contacts 

    In this document, Day 0 refers to the date of last known possible exposure to ANDV. 

    For cruise ship passengers and crew who disembarked in Tenerife, this is defined as 10 May 2026. 

    For others, the last known date of possible exposure (Day 0) may differ between individuals depending on their specific exposure history (e.g. passengers and crew who disembarked at different locations or subsequent close contacts). 

    The quarantine period starts on Day 0 and lasts six weeks. 

Symptomatic contacts: 

    We recommend testing symptomatic contacts as soon as possible after the onset of symptoms, combined with active monitoring during the six-week quarantine period, as this remains the most evidence-based approach.  

Asymptomatic contacts: 

    Testing asymptomatic contacts for ANDV can in some cases detect infection before symptom onset, but the results do not predict infectiousness or disease progression. 

    Asymptomatic testing can be considered if resources allow, providing the results are interpreted cautiously and communicated to patients clearly. 

    Testing asymptomatic contacts in the context of the ANDV disease outbreak on the MV Hondius could provide data on the timing from testing positive to developing symptoms. 

    If repeat testing is offered, data on peak viral load, viral clearance, seroconversion and potentially other findings, depending on the research protocols, can also be collected. 

    These data could support the risk assessment in subsequent outbreaks.  

(...)

Suggested citation: European Centre for Disease Prevention and Control. Advice on laboratory testing of Andes virus (ANDV) for high-risk contacts under the MV Hondius outbreak – 14 May 2026. Stockholm: ECDC; 2026. 

Source: 

Link: https://www.ecdc.europa.eu/en/publications-data/advice-laboratory-testing-andes-virus-andv-high-risk-contacts-under-mv-hondius

____

#Andes #hantavirus multi-country #outbreak, 14 May 2026 Update (ECDC, edited)

 

    ECDC was notified on 2 May 2026 of a cluster of severe respiratory illness on MV Hondius, a Dutch-flagged cruise ship with passengers and crew from 23 countries, including nine EU/EEA countries. The virus has been identified as Andes hantavirus.

    As of 14 May, a total of eleven cases have been reported, including eight confirmed, two probable, and one inconclusive. 

    No new cases or deaths have been reported since the previous update. 

    The risk to the EU/EEA general population remains very low.

___

    ° Confirmed cases***: 8

    ° Probable cases**: 2

    ° Suspected cases*: 0

    ° Inconclusive cases****: 1

    ° Number of deaths: 3

___

{*} A suspected case is a person who:

    - Has been on or visited the same transport (e.g. ship or plane) where a confirmed or probable Andes hantavirus (ANDV) case was present, 

    - OR - 

    - Has been in contact with a passenger or crew member of the MV Hondius since 5 April,

    - AND - 

        ° Has a fever (currently or recently),

        ° Plus at  least one of the following symptoms: 

            - muscle aches

            - chills

            - headache

            -stomach problems (such as nausea, vomiting, diarrhoea, or abdominal pain)

            - breathing problems (such as cough, shortness of breath, chest pain, or difficulty breathing)

{**} A probable case is a person who:

    ° Has the symptoms listed above, 

    - and - 

    ° Is known to have been in contact with a confirmed or probable ANDV case

{***} A confirmed case is a person who:

    ° Meets the suspected or probable case definition, 

    - and -

    ° Has a laboratory test that confirms ANDV infection (PCR or antibody test)

{****} An inconclusive case means awaiting further laboratory investigations.

Non-case: A non-case is a person who was initially considered a suspected or probable case, but tests negative for ANDV using laboratory tests (PCR or antibody test).

Source: 

Link: https://www.ecdc.europa.eu/en/infectious-disease-topics/hantavirus-infection/surveillance-and-updates/andes-hantavirus-outbreak

____

Concurrent #Detection of #Swine-Origin #Influenza #H1N1 Virus in #Pigs and #Farmer, #Switzerland

 

Abstract

We report zoonotic transmission of Eurasian avian-like swine influenza A(H1N1) virus from pigs to a farmer. The pigs and farmer experienced influenza-like illness. Whole-genome sequencing revealed >99.9% isolate sequence identity between hosts. Our findings highlight the risk posed by enzootic swine influenza A virus and the need for genomic and epidemiologic surveillance.

Source: 

Link: https://wwwnc.cdc.gov/eid/article/32/6/25-1487_article

____

#USA, #Andes #Hantavirus Update: No Cases in #California (Dept. of Health, May 14 '26)

 

May 13, 2026​ | NR26-020

One additional Californian with possible exposure, no cases of Andes hantavirus disease in the state ​

    SACRAMENTO – The U.S. Centers for Disease Control and Prevention (CDC) has notified the California Department of Public Health (CDPH) of a fifth California resident with potential exposure to Andes hantavirus as a result of the outbreak aboard the MV Hondius cruise ship. 

    This individual disembarked the MV Hondius before the outbreak was identified, returned briefly to California and left for additional travel also before the outbreak was identified. 

    The individual is currently in the Pitcairn Islands, a British Overseas Territory in the South Pacific. Their health is being monitored by the CDC, in coordination with British health officials, and they remain asymptomatic. 

Andes Hantavirus Investigation in California 

    There are currently no reported cases of Andes hantavirus disease in California or in California residents, nor in United States residents.  ​

    In total, there are now five possibly exposed Californians undergoing monitoring for their health status. 

    In addition to the person in the Pitcairn Islands, two individuals are in California in Santa Clara and Sacramento counties, and two are in the National Quarantine Unit at the University of Nebraska Medical Center (UNMC) in Omaha, Nebraska. 

    At this time, CDPH does not have additional information to share regarding the two Californians in Nebraska, including when they will return to the state. 

    Currently, to our knowledge, all five individuals undergoing public health monitoring do not have any symptoms of illness from hantavirus, and the two individuals in California are in close contact with local public health officials to assure they remain healthy and following public health direction to limit interaction with others.    ​

    CDPH remains in close contact with the CDC and the World Health Organization (WHO). This is an evolving situation, and information is current as of May 13. New or changing information will be updated as it becomes available.   

Helpful Language for Media and Communicators 

    CDPH, in coordination with its partners, is monitoring five individuals with possible exposure. There are no cases in California or among California residents. 

Table of California Possible Exposures 

    1) ​Exposure Location​: ​Onboard MV Hondius

        - ​Current Location: ​Santa Clara County

        - ​Current Status: ​Undergoing monitoring; asymptomatic

        - ​Number of California Residents: 1

    2-3) ​Exposure Location: ​Onboard MV Hondius  ​

        - ​Current Location: ​Nebraska

        - Current Status: ​Undergoing monitoring; asymptomatic

        - ​Number of California Residents: ​2

    4) ​Exposure Location: ​On Flight with Known non-CA Case

        - ​Current Location: ​Sacramento County

        - Current Status: ​Undergoing monitoring; asymptomatic

        - ​Number of California Residents: ​1

    5) ​Exposure Location: ​Onboard MV Hondius  ​

        - Current Location: ​Pitcairn Islands  

        - Current Status: ​Undergoing monitoring; asymptomatic  

        - Number of California Residents: 1

    -- ​Total: ​5​

Source: 

Link: https://www.cdph.ca.gov/Programs/OPA/Pages/NR26-020.aspx

____

#USA, Transcript - #Update on #CDC's #Hantavirus #Response (May 14 '26)

 

Please Note: This transcript is not edited and may contain errors.

    -- Operator:

    - Good afternoon and thank you for standing by for the duration of today's call. All listeners are in a listen only mode until the question and answer session. At that time, credentialed members of the media press can press star one to ask a question or star two to withdraw a question. Today's call is being recorded. If you have any objections, you may disconnect at this time. I would now like to introduce Mr. Benjamin Haynes. Thank you, sir. You may begin.

    

    -- Benjamin Haynes:

    - Thank you, Shirley. And thank you all for joining us today for CDC's Hantavirus response update. Here to discuss the response is CDC's hantavirus response lead, Dr. David Fitter and CDC's Nebraska team lead, Dr. Brendan Jackson. Both will share brief remarks before we take your questions and at this time I'd like to turn the call over to Dr. Fitter.

    

    -- Dr. David Fitter:

    - Thank you, Ben and good afternoon everybody and thank you for joining us. My name is Dr. David Fitter and I'm with the Centers for Disease Control and Prevention and I am the Incident Manager for the hantavirus response here. 

    - I want to start by saying hantavirus is a known pathogen. While Andes virus has some distinct characteristics including rare person-to-person transmission, our experts have allowed us to respond effectively while remaining vigilant about its unique features. 

    - At this moment I want to emphasize that the risk to the general public is low. Our top priority is both the passengers who are on the ship and American communities. 

    - From the earliest stages of this outbreak, CDC has been working in close coordination with state and public health authorities with federal partners including ASPR and the State Department and international health partners, including countries that have been impacted by this. 

    - CDC activated our emergency response in Atlanta immediately and has more than 100 staff actively working on this response. Operationally, we've been engaged at every step. As soon as we were notified by the IHR, we responded and connected with international partners and developed guidance for the American passengers in the ship. 

    - We provided information about the Andes virus to the passengers on board and also have kept them updated here in the United States through our staff on the ground as well as through calls with them to answer their questions. 

    - A CDC team was deployed to the Canary Islands to provide public health expertise on site, including speaking with each individual U.S. citizen about their potential exposure. 

    - Two members of that team actually then joined the American passengers on the repatriation flight back to Nebraska. The additional CDC team met the plain when it landed in Nebraska and is conducting assessments and supporting the passengers now that they've returned to the United States. 

    - CDC also published a HAN prior to the repatriation of the American citizens. In addition, CDC has posted a toolkit, an FAQ document, current situation overview, and fact sheet on our updated web page. 

    - We've held two Hill briefings, and have just completed a call with the governors from the States with repatriated Americans. We've also held daily calls with state health officials. 

    - Our role now is to continue our conversations with each passenger about their potential exposure and work with partners to ensure appropriate monitoring. 

    - We're sharing real-time information with state and federal partners so decisions are based on the health assessments of each passenger and the best available evidence. 

    - CDC currently recommends testing only for people with symptoms. There is a blood test specifically for Andes that has been validated as well as a PCR test for Andes, but it's currently for research use only and not used for patient care yet. And of course, we will continue to work with state and local health departments if needed. 

    - We are focusing on delivering safe, respectful care and transparent communication to the individuals who returned and their families. 

    - To the American public, please know we are here to protect your health and based on current information the risk to the general population remains low. 

    - So far our response has followed our playbook. A swift action across federal, state, and local public health. The systems and partnerships that we've built exist precisely for situations like this. The work isn't always visible. Sharing information with state and local health departments and coordinating guidance and monitoring, but it never stops. It's deliberate. It's coordinated and essential to keep our community safe. I'll now turn it over the call to Dr. Brendan Jackson, who's leading the CDC team in Nebraska.

    -- Dr. Brendan Jackson:

    - Great, thanks David. My name is Brendan Jackson, and as David said, I'm CDC's team lead in Nebraska, and I'm a medical epidemiologist. So we currently have a dedicated team of CDC health, health professionals deployed here in Nebraska responding. 

    - Our team's been working around the clock to ensure the health and safety of everyone involved. We're currently conducting public health assessments on site. These in-depth health assessments include asking each passenger about their exposure to the confirmed cases. And the University of Nebraska team here is conducting regular temperature monitoring, symptoms screening, and general wellness evaluations. 

    - This particular virus has a long incubation period, so the monitoring period is 42 days, and the 42 days started with the departure of the ship. 

    - So May 11th was the day one. We're here to support the people who have returned from the ship and the excellent Nebraska team here in Omaha. Thank you.

    -- Benjamin Haynes:

    - Thank you, Dr. Jackson and Dr. Fitter. At this time I'd like to open it up for questions.

    -- Operator:

    - Thank you. If you are a credentialed member of the media and would like to ask a question during the call, please press star one on your touch tone phone. Press star two to withdraw your question. You may queue up at any time. Our first question comes from Erika Edwards with NBC News. Your line is open, you may ask your question.

    -- Erika Edwards:

    - Okay, thanks so much for doing this. I was curious whether the passenger who was considered a mildly positive case has been retested back here in the U.S. Was that test, the one that Dr. Fitter mentioned and I'm curious what the turnaround time for those test results are. And also if you could just talk a little bit about the decisions being made about possibility of quarantining at home, any more specifics you have about what those people might be able to do or cannot do if they are determined to be able to quarantine at home. Thank you.

    -- Dr. David Fitter:

    - The initial test that we received was from abroad and it was inconclusive in its results. So we're in the process of testing currently and we hope to have those results back in a day or so. With regards to home monitoring, we're working very closely with states and jurisdictions as well as with the passengers themselves and other contacts to ensure that they have the information they need. We're taking a conservative approach on this and we really are encouraging people to stay at their homes and work very closely with the state and local health departments to ensure that they are appropriately monitored in that space.

    -- Benjamin Haynes: 

    - Next question please.

    -- Operator: 

    - Thank you one one moment please for our next question. Question comes from Wale Aliyu from Atlanta News First. Your line is open. You may ask your question.

    -- Wale Aliyu:

    - Hi, I have two questions. The first, can you hear me okay?

    -- Benjamin Haynes: 

    -  Yes, please go on.

    -- Wale Aliyu: 

    - Okay. First question, can you just elaborate on the couple taken to Emory and just their current conditions?

    -- Dr. David Fitter:

    - Yes, we don't talk about the specific individuals really to respect the privacy of everybody.

    -- Wale Aliyu:

    - I figured so totally understandable. The second question I had is I know most reports have said there's very low risk to the general public at this point. What would you say to people who have concerns about the comparison to COVID-19, if you remember some of those early reports also said low risk to the general public.

    -- Dr. David Fitter:

    - Yeah, this is not a novel virus. This is a known virus and we've seen this in the United States before and we know how to respond to it. And that's what we're doing and we're putting into action all the things that we have in place to ensure that American communities remain safe and healthy. What we really want to do is ensure that we're also communicating about this. We'll continue to update the U.S. about everything that we're doing in multiple ways through our websites and other endeavors like this.

    -- Benjamin Haynes:

    - Next question, please.

    -- Operator:

    - Thank you. Our next question then comes from Pien Huang with NPR. Your line is open, you may ask your question.

    -- Pien Huang:

    - Hi, thanks so much for doing this. I have two questions as well, both about quarantine. So first of all, I'm wondering if any federal or state authorities are currently being used to quarantine any of the people exposed to hantavirus or if it's all voluntary at this point. And secondly, I want to ask about the home quarantine situation because the people's homes don't have isolated negative air pressure rooms. It's hard to guarantee 100% adherence. I'm wondering if that worries you or concerns you at all about the people who are or will be monitoring from home.

    -- Dr. David Fitter:

    - So currently, there are no state or federal quarantine orders that have been drawn. We're working really closely with all contacts to ensure that they understand what is expected for them to appropriately monitor themselves. But we also want to make sure that they have the right information so that they can understand the situation as best as possible. I can't tell you how much I appreciate our state and health local partners, what they've been doing. They've been doing multiple checks daily to ensure that everything is going well for people. They've been explaining the situation to them as well. I think everybody should be extraordinarily proud of the network of partners, of state and local health partners that we have in the United States. Our goal is to ensure that we're able to follow our monitoring guidelines, but to work with passengers to ensure that they're able to do it. And if they need to do it somewhere else, we will work with them, will work with state and local health departments to ensure that that happens as well. Again, I just really want to reiterate the safety and health of the passengers is critical to us as well as the safety and health of the American communities.

    -- Benjamin Haynes:

    - Next question please.

    -- Operator:

    - Thank you. Our next question comes from Maggie Vespa with NBC News, your line is open. You may ask your question.

    -- Maggie Vespa:

    - Hi there. Yeah. Thank you so much for this. I have two questions. The first is a clarification of my colleagues' question. Did you say that specific to the asymptomatic patients or passengers in quarantine in Nebraska that you are encouraging them to isolate at home or just what can we know about whether they'll be encouraged to stay here during the full six week incubation period?

    -- Dr. David Fitter:

    - The people that are in Nebraska currently, they have been encouraged that they can, to stay in Nebraska. It is a fantastic facility. We really appreciate the state of Nebraska as well as the University of Nebraska Medical Center for everything they have done. And that is a great place for them to be able to do this, but also as we continue to coordinate the best monitoring for them.

    -- Maggie Vespa:

    - And there's no version of keeping them here? And I'm using that verbiage really intentionally.

    -- Dr. David Fitter:

    - Our goal is to continue to work with them for the best possible place for them and we encourage them to be there.

    -- Maggie Vespa: 

    - Okay, I really appreciate it. My question prior to needing that clarification, and thank you so much for that. A number of exposures popping up in other states came from residents, according to health officials, who said they were traveling with exposed passengers inadvertently. So my question is, why weren't the exposed cruise ship passengers transported in a way that kept them away from the general public, like on a private plane or something like that?

    -- Dr. Brendan Jackson: 

    - I can jump in here. This is Brendan Jackson. So the passengers that are being monitored were on shared flights were passengers were separate from the passengers who were on the ship at the time the outbreak was detected. So they had actually left the ship before the outbreak was detected. All the passengers that were on the ship after that detection phase were transported just several days ago on a private plane directly from the Canary Islands to here in Omaha, Nebraska.

    -- Maggie Vespa: 

    - Okay. In other words, if they were inadvertently on the same flight, it would be because those passengers had left early and didn't yet know about the outbreak.

    -- Dr. Brendan Jackson 

    - Correct.

    -- Maggie Vespa:

    - Okay, thank you so much for that. I really appreciate it.

    -- Benjamin Haynes: 

    - We're ready for the next question. Could you also remind the reporters how to raise their hand for a question, please?

    -- Operator: 

    - Certainly, you can press star one to ask a question. Our next question comes from Michael Erman with Reuters. Your line is open. You may ask your question.

    -- Michael Erman: 

    - Hi, this is Mike Irman from Reuters. You know, I just wanted, you know, a little bit of clarification on the passenger and the biocontainment unit in Nebraska. On Monday, the briefing said that that passenger had tested positive. I think mildly positive was the language used. And now you call that test inconclusive. So I'm wondering if you could give us some clarification or understanding why that test is being called inconclusive now instead of positive. And then the other question is, will that passenger remain in the biocontainment unit if they test negative again?

    -- Dr. David Fitter:

    - Thank you. The test that we initially got, there was a positive and a negative. From our standpoint, we wanted to redo the test to ensure that we had a test that was done here and we had the results. And thus, that's what we are waiting for. We want to make sure that we have the best possible information so that we can help that passenger.

    -- Michael Erman: 

    - And if they test negative, will they remain in the Bio Containment Unit or will they be moved to the quarantine unit with the rest of the passengers?

    -- Dr. David Fitter: 

    - We're coordinating with the University of Nebraska Medical Center to ensure appropriate disposition.

    -- Benjamin Haynes: 

    - Next question please.

    -- Operator:

    - Thank you. And as question comes from John LaPook with CBS News, your line is open.

    -- John LaPook:

    - Yeah, hi, thanks a lot. Two questions. First, quick, you say only you're only testing people with symptoms. Why not collect and store blood for research purposes or are you already doing that. And then do you believe you have all the potentially exposed people identified how many are outside of Nebraska and Atlanta and has anybody elected not to stay at home? And finally if you know it, can you tell us the cycle time for that PCR that was sort of inconclusive?

    -- Dr. David Fitter: 

    - So I'll start from the top and thank you for the questions. We are recommending that symptomatic people with an exposure risk get tested. However, we're also working with states and partners on ways to better understand the virus, for other testing modalities. We are working very closely with the states and local health departments and the passengers that are home and the contacts that are home. Everybody is working well together to ensure monitoring follows our recommendations.

    -- John LaPook:

    - And for the PCR? Do we have the actual number on that?

    -- Dr. David Fitter:

    - We're working to get all the information from the country where that test was run.

    -- John LaPook:

    - Okay, and we don't know the number of people who are outside of Nebraska and Atlanta?

    -- Dr. David Fitter:

    - With respect for privacy of all individuals, we're not sharing locations.

    -- Benjamin Haynes:

    - Next question please.

    -- Operator: 

    - Thank you and this question comes from Kevin Stewart with WAGA TV Fox 5 Atlanta. Your mic is open, you may ask your question.

    -- Kevin Stewart:

    - Good afternoon, regarding the Atlanta passengers. We know yesterday that one of the passengers tested negative. Will that person and the asymptomatic person be clear to leave before the 42 days are up? And also where, what is the status of the two Georgia passengers who got back home last week and are being monitored by the Department of Health here in Georgia?

    -- Dr. David Fitter: 

    - So again, with respect for the passengers that are in monitoring right now, I'm not going to go into a lot of details, but we're working very closely with Emory to ensure that they have the appropriate disposition. With regards to Georgia and the contacts that are here, we're working very closely with the state of Georgia health department and the local health departments to ensure that they are appropriately monitored.

    -- Kevin Stewart:

    - Will they be cleared, they can lead before the 42 days, correct?

    -- Dr. David Fitter:

    - They'll continue to be monitored.

    -- Kevin Stewart:    

    - But whether that is at Emory or at home.

    -- Dr. David Fitter:

    - Currently we're working on the appropriate disposition for them.But again, as you can imagine, out of respect for privacy for them, I'm going to stop there.

    -- Kevin Stewart:

    - Can you confirm they're still at Emory?

    -- Dr. David Fitter: Yes. 

    -- Benjamin Haynes:

    - We have time for two more questions, please.

    -- Operator:

    - Thank you. Our next question actually, we didn't get the name, but from WSB Channel 2, you may ask your question.

    -- Courtney Francisco:

    - Can you hear me? It's Courtney Francisco. I'm hoping you can tell me -- it went out on May 2nd. I need to know how many people are being monitored.

    -- Dr. David Fitter:

    - At this time, we're not putting out exact numbers. Again, we want to ensure that we are protecting and respecting the privacy of all the individuals.

    -- Benjamin Haynes:

    - Shirley we'll take one more if they have it.

    -- Operator:

    - Certainly, one second here. And we have a question from Lila Perry with Baltimore Sun, your line is open you may ask your question.

    -- Lila Perry:

    - Hi, thanks so much for doing this. Back to the topic of passengers on planes who were inadvertently exposed to people from the cruise ship. You know, when state departments of health are saying that they're monitoring these airline passengers, what does that look like if they're exposed from a distance or for a short time? Are they being monitored in state facilities or asked to stay home and how closely are you advising state partners to be monitoring these people?

    -- Dr. David Fitter:

    - We're working very closely to ensure that our guidance is consistent across all of the contacts. And for those on the -- that were contacts on the planes, they also would fall into the appropriate category and we're working with state and locals to ensure that those monitoring recommendations are followed very closely. And we're in such close coordination with their state and local health departments, talking with the them daily thus far it is working very well with the systems that they have in place and they're developing their systems themselves to ensure that it follows the guidance that we've put out.

    -- Benjamin Haynes:

    - Thank you, Dr. Fitter and thank you, Dr. Jackson. At this time we will conclude the call and we appreciate you all joining us for this brief update. Thank you.

    -- Operator:

    - Thank you and that does conclude today's conference. Thank you for your participation. And at this time you may disconnect your lines.

Source: 

Link: https://www.cdc.gov/media/releases/2026/transcript-update-on-cdcs-hantavirus-response.html

____

#Ensitrelvir for #Covid19 Postexposure #Prophylaxis in #Household Contacts

 

Abstract

Background

Ensitrelvir, an oral inhibitor of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 3C-like protease, is approved in Japan for the treatment of mild-to-moderate coronavirus disease 2019 (Covid-19). Previously, no antiviral agents were approved for postexposure prophylaxis in household contacts of patients with Covid-19.

Methods

In this double-blind, randomized, placebo-controlled trial, we randomly assigned persons who were SARS-CoV-2–negative on local diagnostic testing but were household contacts of a patient with Covid-19 (the index patient) to receive either ensitrelvir (375 mg on day 1 and 125 mg daily on days 2 through 5) or placebo within 72 hours after symptom onset in the index patient. The primary end point was Covid-19 (defined by a central laboratory–confirmed positive reverse-transcriptase–polymerase-chain-reaction assay and the presence of ≥1 of 14 prespecified Covid-19 symptoms lasting ≥48 hours) by day 10 in a household contact in the modified intention-to-treat population (all the participants who underwent randomization, had a central laboratory–confirmed negative RT-PCR test for SARS-CoV-2 at baseline, and received at least one dose of the trial drug or placebo).

Results

The modified intention-to-treat population included 1030 participants in the ensitrelvir group and 1011 in the placebo group. The mean age of the participants was 42.4 years; 71.1% had undergone randomization within 48 hours after symptom onset in the index patient, and 37.0% had at least one risk factor for severe Covid-19. The incidence of Covid-19 was lower in the ensitrelvir group than in the placebo group (2.9% vs. 9.0%; risk ratio, 0.33; 95% confidence interval [CI], 0.22 to 0.49; P<0.001). The incidence of adverse events during the trial was similar in the two groups (15.1% in the ensitrelvir group and 15.5% in the placebo group), as was the incidence of serious adverse events (0.2% in each group). No Covid-19–related hospitalizations or deaths were reported.

Conclusions

Ensitrelvir administered to household contacts of a patient with Covid-19 within 72 hours after symptom onset in the index patient was effective in preventing Covid-19 in the contacts. (Funded by Shionogi; SCORPIO-PEP Japan Registry for Clinical Trials number, jRCT2031230124; ClinicalTrials.gov number, NCT05897541.)

Source: 

Link: https://www.nejm.org/doi/full/10.1056/NEJMoa2509306?query=TOC

____

#Hantavirus #cluster linked to cruise ship travel, Multi-country (#WHO D.O.N., May 13 '26)

 

Situation at a glance

    -- This is the third Disease Outbreak News report on the hantavirus cluster, following the notification to the World Health Organization (WHO) on 2 May 2026 of severe respiratory illness cases aboard MV Hondius, a cruise ship. 

    -- Since the last DON was published on 8 May, two additional confirmed cases were reported from France and Spain. 

    -- In addition, there is one inconclusive result for a case in the United States of America. 

    -- All were passengers on the ship. 

    -- As of 13 May, a total of 11 cases, including three deaths, have been reported (case fatality ratio 27%). 

    -- Eight cases were laboratory-confirmed for Andes virus (ANDV) infection, two are probable, and one case remains inconclusive and undergoing further testing. 

    -- Through the International Health Regulations (2005) (IHR) channels, National IHR Focal Points (NFPs) have all been informed and are supporting international contact tracing efforts. 

    -- WHO has assessed the risk posed by this event to the global population as low and will continue to monitor the epidemiological situation and update the risk assessment as needed.

Description of the situation

    -- On 2 May 2026, WHO received notification from the IHR NFP of the United Kingdom of Great Britain and Northern Ireland (hereafter referred to as the United Kingdom) regarding a cluster of severe acute respiratory illness, including two deaths and one critically ill passenger, aboard the Dutch-flagged cruise ship MV Hondius.

    -- As of 13 May, a total of 11 cases (eight confirmed, one inconclusive and two probable cases), including three deaths (two confirmed and one probable), have been reported. 

    -- Since the last Disease Outbreak News was published on 8 May, two additional confirmed cases and one inconclusive case have been reported among passengers. 

    -- These are one confirmed case from France, who became symptomatic during repatriation, one confirmed case from Spain, tested upon arrival following repatriation but currently well and asymptomatic, and one case considered inconclusive. 

    -- The latter was repatriated to the United States of America, is currently asymptomatic with inconclusive laboratory results (one positive and one negative result from two different laboratories), and is being retested. 

    -- The individual was sampled due to high-risk exposure to confirmed cases on board.  

    -- All laboratory-confirmed cases are confirmed for ANDV infection. 

-- All were passengers onboard the MV Hondius. 

___

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

{Click on Image ot Enlarge}

____

    -- Based on currently available information, the working hypothesis is that the first case acquired the infection prior to boarding the cruise, through exposure on land. 

    -- Investigations are ongoing to elucidate the potential circumstances of exposure and the source of the outbreak, in collaboration with authorities in Argentina and Chile. 

    -- Current evidence suggests subsequent human-to-human transmission onboard the ship. 

    -- This is also supported by a preliminary analysis of the sequences, which show a close, near-identical sequenced from different cases.[1]

    -- The outbreak is being managed through a coordinated international response, including: 

    ° in-depth epidemiological investigations, 

    ° case isolation and clinical management, 

    ° medical evacuations, 

    ° laboratory testing and international contact tracing, 

    ° quarantining and monitoring. 

    -- Recommendations may be updated as additional epidemiological and laboratory evidence, including genetic sequencing data, becomes available.

    -- Follow-up and contact tracing for all contacts of hantavirus cases linked to the cruise ship is ongoing. 

    -- This includes 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 may have had exposure to subsequently confirmed cases have been identified and contacted. 

    -- Contacts are being monitored by local health authorities in their respective countries.  

    -- On 10 May, the ship arrived in the Canary Islands, Spain, where disembarkation began.  

    -- Passengers and most of the crew were repatriated from the Canary Islands to their respective residence countries or transit points via specially arranged non-commercial flights, with WHO and partners supporting the disembarkation process. 

    -- The ship left the Canary Islands on 11 May and is sailing to the Netherlands, with 25 crew members remaining on board, along with two Dutch health and care workers to conduct their health monitoring and provide any healthcare that may be necessary. 

Epidemiology

    -- Hantavirus cardiopulmonary syndrome (HCPS), also known as hantavirus pulmonary syndrome (HPS), is a zoonotic, viral respiratory disease caused by hantaviruses of the genus Orthohantavirus, family Hantaviridae, order Bunyavirales. 

    -- More than 20 viral species have been identified within this genus.  

    -- Hantaviruses are associated with two major distinct clinical syndromes in humans: HPS predominantly reported in the Americas, and hemorrhagic fever with renal syndrome (HFRS), mainly reported in Europe and Asia. 

    -- However, human-to-human transmission has only been reported for HPS associated with Andes virus infection. 

    -- Andes virus is endemic in South America, with confirmed circulation and human cases reported primarily in Argentina and Chile, and additional cases and related strains identified in Uruguay, southern Brazil, and Paraguay.

    -- Human Hantavirus infection is primarily acquired through contact with the urine, faeces, or saliva of infected rodents or by touching contaminated surfaces. 

    -- Exposure typically occurs during activities such as cleaning buildings with rodent infestations, though it may also occur during routine activities in heavily infested areas. 

    -- Human cases are most commonly reported in rural settings, such as forests, fields, and farms, where rodents are present, and opportunities for exposure are greater.

    -- HPS is characterized by headache, dizziness, chills, fever, myalgia, and gastrointestinal symptoms, such as nausea, vomiting, diarrhoea, and abdominal pain, followed by sudden onset of respiratory distress and hypotension. Symptoms of HPS typically occur from 1-6 weeks after initial exposure to the virus. However, symptoms may appear as early as one week and as late as eight weeks following exposure.

    -- Hantavirus infections are relatively uncommon globally.  In 2025, in the Region of the Americas, eight countries reported HPS, 229 cases and 59 deaths with a CFR of 25.7%.[2] 

    -- HPS is not reported in other parts of the world. 

    -- In the European Region, 1885 hantavirus infections causing HFRS were reported in 2023 (0.4 per 100 000), marking the lowest rate observed between 2019 and 2023.[3] 

    -- In East Asia, particularly China and the Republic of Korea, HFRS continues to record thousands of cases annually, although incidence has declined in recent decades.

    -- The overall CFR for HPS can be as high as 50%. While there are no licensed treatment nor vaccines for hantavirus infections, early supportive care and immediate referral to a facility with a complete ICU can improve survival.

    -- Environmental and ecological factors affecting rodent populations can influence disease trends seasonally. Since hantavirus reservoirs are sylvatic rodents, transmission can occur when people come into contact with rodent habitats.

    -- Although uncommon, limited human‑to‑human transmission of HPS due to Andes virus has been reported in community settings involving close and prolonged contact. 

    -- Secondary infections among healthcare workers have been previously documented in healthcare facilities, though remain rare. 

    -- Secondary transmission appears most likely during the early phase of illness, when the virus is more transmissible. 

    -- Currently, little evidence is available due to the scarcity of hantavirus outbreak related to human-to-human transmission.

Public health response

    -- Authorities from States Parties managing cases and/or contacts, WHO, and partners have initiated coordinated response measures, including:

    ° Ongoing engagement between WHO and the NFPs of countries managing cases and/or contacts to ensure timely information sharing and coordination of response actions.

    ° International contact tracing is ongoing.

    ° WHO is requesting regular information sharing and periodic updates from States Parties through IHR channels regarding contact monitoring and the health status of high-risk contacts

    ° Crew members still onboard, to take the MV Hondius to the Netherlands, have been advised to practice physical distancing and remain in their cabins where possible, while on the cruise ship.

    ° Experts from WHO and the European Centre for Disease Prevention and Control (ECDC) were deployed on board the ship to support epidemiological investigation and provide public health advice before disembarkation in the Canary Islands, Spain.

    ° Two Dutch medical doctors boarded the ship in Cabo Verde to conduct health monitoring and provide any health care that may be necessary. One disembarked in Tenerife, while a Dutch nurse boarded, to assist in monitoring and providing any healthcare to the remaining crew members on board.

    ° WHO Director-General Dr Tedros Adhanom Ghebreyesus travelled to the Canary Islands on 9 May, along with other experts from WHO, to meet with the national authorities, including ministers, and support the coordination of the operations. He met with the Prime Minister of Spain on 12 May.[4]

    ° Epidemiological investigations continue to better define epidemiological links between cases and exposure factors on the ship, as well as to try to understand the potential source of exposure

    -- WHO has developed and published specific technical guidance documents to support response to the event, including:

    ° Technical guidance on the management of hantavirus on board the ship;

    ° Technical note for the disembarkation and onward management of passengers and crew in the context of an Andes-virus-associated cluster;

    ° Management of contacts of Andes Virus (ANDV) cases from the MV Hondius cruise ship

    -- NFPs of affected countries have been in contact about passenger and crew information through established IHR channels for those on the ship, as well as on planes where a known case was on board.

    -- The NFP of Argentina aided in the reconstruction of the travel itinerary of the first two cases in the Southern Cone subregion of the Americas and assess any potential exposure to hantavirus. They also shared the National Hantavirus Epidemiological Circular: Update epidemiological Surveillance and Management Standards on Hantavirus. 

    -- WHO supported collaboration across relevant laboratories with prior experience to ensure timely testing, with further analyses ongoing, including serology, molecular diagnostics, sequencing, and metagenomics.

    -- Risk communication coordination and support are being provided to ensure sharing of regular, timely and evidence-based information. WHO has activated three-level coordination and is supporting national authorities in implementing risk-based, evidence-informed public health measures in accordance with the provisions of the IHR and related WHO technical guidance documents.

    -- WHO regularly convenes expert calls across laboratory, clinical management, epidemiology, and Infection prevention and control (IPC) domains to facilitate timely experience sharing and coordinated expert support.

    -- WHO supported the streamlining and development of research protocols on the natural clinical history in collaboration with national partner institutions and planned a hantavirus scientific consultation on medical countermeasures.

WHO risk assessment

    -- WHO currently assesses the public health risk for those who were onboard the cruise ship as moderate, and at the Global level as low for the following reasons:

    ° Andes virus has demonstrated limited human-to-human transmission in previous outbreaks, typically occurring among close contacts and within household settings, generally requiring prolonged close exposure. Transmission can be contained through early detection, isolation of cases, clinical management, and contact management. However, the ship environment presented an increased risk due to close living quarters, shared indoor spaces, prolonged exposure, and frequent interpersonal interactions, all of which likely facilitated transmission.

    ° The HCPS with hantaviruses in the Americas, including Andes can have a high case fatality ratio, reaching 40-50%, particularly among elderly individuals and those with co-morbidities. The average age of passengers on board the ship was 65 years old.

    ° Investigations on the travel history and potential exposures of the first case in the Southern Cone subregion of the Americas are ongoing and suggest possible exposure to rodents during bird watching activities. Viral sequencing analyses are also ongoing and will compare the ANDV strain associated with this outbreak with strains circulating in Argentina and Chile, where the disease is enzootic. The preliminary sequencing analysis for the cases indicates a high degree of genetic similarity—showing no more than one single nucleotide polymorphisms (SNP) difference per individual—strongly indicates that the outbreak likely arose from a single zoonotic spillover event, or from a very small number of closely related spillover events.[1]

    ° Additional cases may occur among individuals exposed before implementation of containment measures. However, the current response, including quarantine for those who have left the ship and rapid isolation of any new suspect cases and the monitoring of contacts, is expected to limit the risk of further spread.

    ° As there is no specific antiviral treatment for HPS, suspected cases require prompt transfer to an adequately equipped emergency department or intensive care unit, where available, for close monitoring and supportive management to improve chances of recovery. Consequently, for remote areas, rapid transfer to a mainland healthcare facility is required, which may be challenging under the current conditions.

    ° For the general public, including people not exposed on board the ship or through close contact with a confirmed case, the overall probability of infection remains low. Current evidence indicates that transmission occurs through close and prolonged contact, and can be effectively limited through early detection, isolation of cases, and contact tracing.

    -- More detailed epidemiological, clinical and laboratory investigations are required to inform further iterations of this risk assessment. 

WHO advice

    -- WHO advises that States Parties involved in this event continue public health coordination and management efforts related to the ship and relevant flights, and in countries where cases and/or contacts are present or will be returning to. 

    -- Based on information available and ongoing epidemiological, clinical and environmental investigations, and applying the precautionary principle, this includes: 

    ° contact tracing and monitoring, 

    ° detection, investigation, reporting of suspected cases, 

    ° laboratory testing of suspected cases, 

    ° case management, 

    ° infection prevention and control measures, and 

    ° clear and transparent communication to affected individuals and the general public.

    -- Outside the context of the ship, high-risk contacts may include intimate partners, household members and persons with prolonged close indoor exposure, healthcare workers with unprotected exposure, and individuals handling contaminated materials or body fluids without appropriate personal protective equipment, outlined in the interim guidance published on 8 May. 

    -- Given that infectiousness peaks in the early phase of illness, and that pre-symptomatic transmission cannot be entirely ruled out, as a precautionary principle, WHO recommends active monitoring and home or facility quarantine of high-risk contacts for 42 days following last exposure. 

    -- Current evidence does not support routine laboratory testing of contacts for outbreak control nor the quarantine of low-risk contacts; low-risk contacts should undertake passive self-monitoring and seek medical evaluation if symptoms occur. Recommendations are dynamic and will be adapted as more evidence emerges.

    -- Contact investigations should use available information sources, including interviews, passenger manifests, seating arrangements and activity logs, to improve completeness of contact identification.

    -- Early recognition of suspected cases, prompt isolation, and consistent adherence to recommended infection prevention and control measures remain essential to protect healthcare personnel, other passengers and crew members.

    -- In healthcare settings:

    ° Apply standard precautions* at all times for all patients, including hand hygiene, environmental cleaning, and waste management.

    ° Isolate any suspected or confirmed case in a single, well‑ventilated room with doors closed.

    ° Implement transmission‑based precautions in addition to standard precautions for suspected or confirmed cases.

    ° Ensure health and care workers wear appropriate personal protective equipment (respirators, eye protection, gowns, and gloves).

    ° Perform hand hygiene before and after the use of personal protective equipment.

    ° Manage waste generated from suspected or confirmed cases as infectious waste.

    ° Apply airborne precautions during aerosol‑generating procedures.

    -- When HPS is suspected, patients should be promptly transferred to an emergency department or intensive care unit for close monitoring and supportive management. 

    -- Initial management should include supportive care with antipyretics and analgesics as needed. 

    -- For confirmed hantavirus, antibiotics are not routinely indicated. However, before a definitive diagnosis is established (and bacterial infection is a diagnostic possibility), or if secondary bacterial infection is suspected, empiric broad-spectrum antibiotics may be appropriate. 

    -- Clinical management relies primarily on careful fluid administration, hemodynamic monitoring, and respiratory support. 

    -- Given the rapid progression of HPS, close monitoring and early transfer to ICU are critical for more severe cases. 

    -- Mechanical ventilation, judicious fluid management, and vasopressors may be required. 

    -- For severe cardiopulmonary insufficiency, extracorporeal membrane oxygenation may be lifesaving.[5] In severe cases of renal dysfunction, dialysis may be required.

    -- Although ribavirin has shown efficacy against hantavirus haemorrhagic fever with renal syndrome, it has not demonstrated effectiveness for HPS and is not licensed for either treatment or prophylaxis of hantavirus pulmonary syndrome.  

    -- At present, there is no specific antiviral treatment approved for HPS; a number of existing drugs have antiviral activity in laboratory studies but not yet demonstrated in human disease.

    -- Public health awareness efforts should focus on improving early detection, ensuring timely treatment, and reducing exposure risks. 

    -- Preventive measures should address occupational and ecotourism-related exposures, emphasize infection prevention and control measures, and include rodent control strategies. Most routine tourism activities carry little or no risk of exposure to rodents or their excreta.

    -- Risk communication and community engagement (RCCE) interventions should prioritize transparent, timely, and culturally appropriate communication to raise awareness of hantavirus transmission risks. 

    -- RCCE strategies should support coordinated, timely and aligned evidence-based information to ensure concerned people receive clear, consistent and actionable information, including explanations of the public health measures being implemented. 

    -- RCCE activities should explicitly address public concerns regarding transmissibility, severity, and international travel, and clarify what actions are and are not necessary for different population groups. 

    -- Operational measures should integrate RCCE activities throughout all phases of the event. The implementation of integrated environmental management strategies aimed at reducing rodent populations is also recommended.

___

    -- At this time, WHO does not recommend any changes to routine activities for the general public. 

___

    -- People who were on board the affected ship, or who have had close contact with a confirmed case, should follow the specific monitoring and public health advice outlined above. Guidance may be updated as further evidence becomes available.

    -- Based on the current information available on this event, WHO advises against the application of any travel or trade restrictions beyond the restriction of movement of identified high-risk contacts.

___

{*} Standard precautions refer to a set of practices that are applied to the care of patients, regardless of the state of infection (suspicion or confirmation), in any place where health services are provided. These practices aim to protect both healthcare professionals and patients and include hand hygiene, use of personal protective equipment, respiratory hygiene and cough etiquette, safe handling of sharps materials, safe injection practices, use of sterile instruments and equipment and cleaning of hospital environments and the environment. Adapted from “Standard precautions for the prevention and control of infections: aide-memoire”- WHO, 2022.  Available at https://www.who.int/publications/i/item/WHO-UHL-IHS-IPC-2022.1  

Further information

1) World Health Organization. Management of contacts of Andes virus (ANDV) cases from the MV Hondius cruise ship. https://www.who.int/publications/m/item/management-of-contacts-of-andes-virus-(andv)-cases-fromthe-mv-hondius-cruise-ship

2) World Health Organization. WHO Technical note for the disembarkation and onward management of passengers and crew in the context of an Andes virus-associated cluster MV Hondius cruise ship. https://www.who.int/publications/m/item/who-technical-note-for-the-disembarkation-and-onward-management-of-passengers-and-crew-in-the-context-of-an-andes-virus-associated-cluster-mv-hondius-cruise-ship

3) World Health Organization. Hantavirus fact sheet. https://www.who.int/news-room/fact-sheets/detail/hantavirus 

4) World Health Organization.WHO’s response to hantavirus cases linked to a cruise ship. https://www.who.int/news/item/07-05-2026-who-s-response-to-hantavirus-cases-linked-to-a-cruise-ship

5) World Health Organization. Handbook for management of public health events on board ships https://www.who.int/publications/i/item/9789241549462

6) World Health Organization. Guide to Ship Sanitation, 3rd edition https://www.who.int/publications/i/item/9789241546690

7) Preliminary analysis of Orthohantavirus andesense virus sequences from a cruise-ship related cluster, May 2026. https://virological.org/t/preliminary-analysis-of-orthohantavirus-andesense-virus-sequences-from-a-cruise-ship-related-cluster-may-2026/1029

8) World Health Organization. Standard precautions for the prevention and control of infections: aide-memoire. https://www.who.int/publications/i/item/WHO-UHL-IHS-IPC-2022.1

9) World Health Organization. Transmission-based precautions for the prevention and control of infections: aide-memoire. https://www.who.int/publications/i/item/WHO-UHL-IHS-IPC-2022.2

10) World Health Organization. Hantavirus outbreak toolbox. https://www.who.int/emergencies/outbreak-toolkit/disease-outbreak-toolboxes/hantavirus-outbreak-toolbox

11) World Health Organization (8 May 2026). Disease Outbreak News. Hantavirus cluster linked to cruise ship travel, Multi-country. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON600

12) World Health Organization (4 May 2026). Disease Outbreak News. Hantavirus cluster linked to cruise ship travel- Multi-country. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON599

13) World Health Organization. A decision framework for effective, equitable and context-specific public health and social measures during public health emergencies: decision navigator: https://iris.who.int/server/api/core/bitstreams/ceaf4aa7-00c8-4681-9c35-965e231a3706/content

14) Pan American Health Organization / World Health Organization. PAHO supports the international response to hantavirus pulmonary syndrome cases linked to a cruise ship in the Atlantic. https://www.paho.org/en/news/7-5-2026-paho-supports-international-response-hantavirus-pulmonary-syndrome-cases-linked

15) Epidemiological Alert Hantavirus Pulmonary Syndrome (HPS). https://www.paho.org/en/documents/epidemiological-alert-hantavirus-pulmonary-syndrome-americas-region-19-december-2025   

16) Hantavirus in the Americas: Guidelines for diagnosis, treatment, prevention and control. Available at: https://iris.paho.org/handle/10665.2/40176

17) Hantavirus Prevention, CDC: https://www.cdc.gov/hantavirus/prevention/?CDC_AAref_Val=https://www.cdc.gov/hantavirus/hps/prevention.html

18) 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.

19) US CDC. How to Clean Up After Rodents: https://www.cdc.gov/healthy-pets/rodent-control/clean-up.html

20) Hantavirus, Washington State Department of Heath, https://doh.wa.gov/sites/default/files/2025-08/420-056-Guideline-Hantavirus.pdf

21) Hantavirus Infection, MDS Manual, professional version: https://www.msdmanuals.com/professional/infectious-diseases/arboviruses-arenaviridae-and-filoviridae/hantavirus-infection

22) Handbook for management of public health events on board ships. https://www.who.int/publications/i/item/9789241549462

23) Hantavirus pulmonary syndrome, https://www.mayoclinic.org/diseases-conditions/hantavirus-pulmonary-syndrome/symptoms-causes/syc-20351838

____

[1] Preliminary analysis of Orthohantavirus andesense virus sequences from a cruise-ship related cluster, May 2026. https://virological.org/t/preliminary-analysis-of-orthohantavirus-andesense-virus-sequences-from-a-cruise-ship-related-cluster-may-2026/1029

[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 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 at the media briefing on hantavirus – 12 May 2026. https://www.who.int/news-room/speeches/item/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 support improves survival of patients with severe 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 travel, Multi-country. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON601

Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON601

____