Abstract
The 2026 Andes virus (ANDV) cluster associated with the merchant vessel (MV) Hondius cruise ship highlights the limitations of hantavirus control strategies that have traditionally focused on rodent-source exposure alone. No evidence supports heating, ventilation, and air conditioning (HVAC)-mediated long-distance ANDV spread. Such strategies are insufficient for ecologically sensitive cruise routes, enclosed ocean-going environments, international passenger movement, and limited onboard medical capacity. Current evidence indicates that ANDV has limited but documented potential for person-to-person transmission. Transmission is most plausibly associated with acute-phase viremia, exposure to body fluids or short-range droplets, prolonged close contact, caregiving, and specific contextual conditions; it should not be equated with sustained community transmission by highly efficient respiratory viruses. On the basis of epidemiologic investigations, clinical shedding studies, animal models, viral genetic evidence, and environmental stability data, this review analyzes how high-consequence pathogens may have their public health impact amplified in cruise-ship settings. It further proposes prevention and control measures covering pre-voyage ecological exposure assessment, embarkation screening, early onboard recognition, tiered isolation, rapid shipboard testing, medical evacuation, and cross-border coordination. The central lesson from the MV Hondius event is that cruise ships operating on ecologically sensitive routes should move beyond conventional sanitation-centered management toward a whole-of-journey biosecurity model based on evidence stratification and graded response.
Source: Biosafety and Health Journal, https://doi.org/10.1016/j.bsheal.2026.07.006
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