Expedition #cruises, island hopping, and #zoonotic #risk: #governance and operational lessons from the MV #Hondius #Andes hantavirus outbreak

 

Abstract

The Andes orthohantavirus outbreak linked to the MV Hondius expedition cruise illustrates how a probable land-based zoonotic exposure can become a multinational public health event when it intersects with enclosed shipboard environments, delayed clinical recognition, remote navigation, medical evacuation, and international passenger dispersal. Although hantavirus infection is classically associated with exposure to infected rodents or contaminated environments, Andes virus is exceptional among orthohantaviruses because limited person-to-person transmission has been documented, particularly after close and prolonged contact. This Perspective uses the MV Hondius outbreak as an analytical case study to identify governance and operational gaps in expedition-era travel medicine. Existing International Health Regulations, WHO ship-event guidance, and ECDC recommendations provide essential foundations for coordination, notification, isolation, and contact tracing; however, this outbreak exposed expedition-specific gaps in safe port access, medical evacuation, onboard recognition of nonspecific febrile illness, diagnostic escalation, passenger traceability, and post-disembarkation monitoring. We therefore propose an accountability-oriented One Health preparedness model that operationalizes existing guidance through route-level risk assessment, exposure-history assessment, onboard syndromic surveillance, isolation and telemedicine triggers, reference-laboratory pathways, port-of-call agreements, auditable passenger and excursion records, and cross-border post-travel monitoring. The central lesson is not that expedition cruises, birdwatching, or ecological tourism are inherently unsafe, but that their expanding geographic reach requires binding, auditable, and expedition-specific outbreak protocols before passengers embark.

Source: 

Link: https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1892006/full

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#Hantavirus #outbreak linked to cruise #ship travel, Multi-locations (WHO, July 3 '26): End of the Event

 

Situation at a glance

    This is the fifth Disease Outbreak News posting on the Andes hantavirus (ANDV) outbreak linked to the cruise ship M/V Hondius. 

    The outbreak identification followed the notification to the World Health Organization (WHO) on 2 May 2026 of severe acute respiratory illness cases onboard. 

    Since the previous Disease Outbreak News was published on 28 May 2026, one of the probable cases from Tristan da Cunha, an Overseas Territory of the United Kingdom of Great Britain and Northern Ireland (hereafter referred to as the United Kingdom), was laboratory confirmed. 

    As of 2 July, a total of 13 cases, including three deaths, have been notified (case fatality ratio 23%). 

    Twelve cases have been laboratory-confirmed for ANDV infection, and one is a probable case. 

    All confirmed cases are among individuals who travelled onboard the M/V Hondius. 

    Among the ten cases admitted to hospitals, eight have recovered and have been discharged, while two are still undergoing medical treatment. 

    All identified contacts have completed the 42 day follow-up period by local health authorities in line with WHO guidance. 

    The completion of the contact follow up without detection of additional secondary cases demonstrates effective interruption of transmission and confirms outbreak containment. 

    This outbreak no longer poses a public health risk and no further related transmission is expected.

Description of the situation

    On 2 May 2026, in accordance with the International Health Regulations (2005) (IHR), WHO received a notification from the National IHR Focal Point (NFP) of the United Kingdom of a cluster of severe acute respiratory illness aboard the Netherlands-flagged cruise ship M/V Hondius, with further details rapidly notified authorities in the Netherlands and South Africa.

    As of 2 July, a total of 13 cases (12 confirmed and one probable case), including three deaths (two confirmed and one probable), have been reported globally linked to the cruise ship. 

    The case fatality ratio for this outbreak to date is 23%. 

    Since the last Disease Outbreak News was published on 28 May 2026, ANDV infection was laboratory confirmed in a probable case in Tristan da Cunha who developed signs and symptoms after disembarkation from the cruise ship. 

    The early detection and isolation of the case prevented further transmission of the virus, but the limited diagnostic capacities on the island delayed the confirmation of the case until a sample was shipped and tested in the United Kingdom. 

    The patient has recovered and has been discharged.

    Among the confirmed cases admitted to hospital, eight have recovered and been discharged, while two, one in South Africa and one in France, continue to be hospitalized. 

    All 13 cases are among people who travelled on board the M/V Hondius.

(...)

    Nine of the reported cases were males, and four were females. The median age was 65-years-old (IQR 56-70), similar to the median age of the passengers onboard the ship (...). The ages of the three deceased cases were 69, 70 and 79-years-old.

(...)

    Currently available information suggests that infection of initial cases was likely acquired on land prior to embarkation, although the exact source and route of exposure remain undetermined, with subsequent human-to-human transmission occurring aboard the vessel. 

    Investigations remain underway to establish the circumstances and source of the outbreak, including genomic sequencing of ANDV samples from surveillance cases in Chile and Argentina, and will be published as soon as these are available.

    This outbreak was managed through a coordinated international response, which included comprehensive epidemiological investigations, case isolation and clinical management, medical evacuations, laboratory testing, repatriation of passengers and crew from the ship and international contact tracing, as well as quarantine and monitoring measures.

    Contact identification and follow-up of contacts of hantavirus cases linked to the cruise ship has been conducted in 33 countries and overseas territories. 

    This included passengers and crew onboard the ship, contacts of the case on Tristan da Cunha, contacts from two different international flights, healthcare workers and airport crew who assisted cases before the detection of the outbreak. 

    As of 2 July 2026, 317 high-risk contacts have completed quarantine and monitoring by local health authorities in the countries and territories where they were repatriated, evacuated or identified. 

    Some 336 low-risk contacts completed self-monitoring in line with the updated guidance on management of contacts of Andes virus (ANDV) cases from the MV Hondius cruise ship published on 17 May 2026. 

Epidemiology

    Hantavirus disease is a zoonotic viral disease caused by hantaviruses of the genus Orthohantavirus, family Hantaviridae, order Elliovirales, class Bunyaviricetes. More than 20 viral species have been identified within this genus. 

    Human hantavirus infection is primarily acquired through contact with the urine, faeces, or saliva of certain species of (specific) 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.

    Limited human-to-human transmission has currently only been reported for hantavirus pulmonary syndrome (HPS) associated with ANDV virus infection. 

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

Andes virus transmission between humans

    Based on the available information and the existing observations of the current outbreak, limited human-to-human transmission of ANDV is known to occur. 

    However, no large-scale human-to-human outbreaks have been observed historically.[1] 

    ANDV circulates in specific species of rodents in the Americas, and there have been many sporadic cases reported in Argentina and Chile that have not led to onward transmission.[2]  

    Clusters of human cases have been reported in multiple past outbreaks and have been typically associated with close and prolonged interactions, often in shared indoor environments such as households.  

    The largest reported outbreak of ANDV was reported in Argentina in 2018-2019,2 where high viral titres in combination with attendance at large social gatherings or extensive contacts among people were associated with higher transmission.  

    While the available evidence suggests that there are multiple modes of transmission that occur with ANDV, the probability of onward transmission between humans remains low.

    Initial epidemiological investigation and the genomics analysis[3] of the identified cases show that in this outbreak of ANDV infection, human-to-human transmission has occurred on the ship. 

    While detailed information on the interaction between cases or with a contaminated environment aboard the ship is currently not available, these exact modes of transmission might be elucidated by upcoming results from an in-depth epidemiological investigation, as well as publication of the environmental sampling performed after the disembarkation.  

Response activities operated under the assumption that ANDV transmission:

    ° may have included contact with an infected individual or contaminated surfaces;

    ° and/or through-the-air transmission (via direct deposition of infectious respiratory particles onto exposed facial mucosal surfaces—mouth, nose, or eyes);

    ° and/or airborne transmission (via inhalation of infectious respiratory particles).

    Given the attack rate among the ship passengers, as well as the absence of secondary cases among contacts off the ship, the virus did not exhibit transmission dynamics consistent with highly transmissible airborne pathogens (such as measles).

Public health response

    Authorities from States Parties managing cases and/or contacts, WHO, and partners such as the European Centre for Disease Prevention and Control have coordinated response measures, including:

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

        ° International contact tracing and follow-up of contacts was conducted by local health authorities in line with national arrangements.

        ° WHO requested regular information sharing and periodic updates from States Parties through IHR channels regarding the follow-up of contacts and their health status.

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

    A prospective natural history study designed to improve understanding of Andes virus (ANDV) transmission dynamics, incubation periods, immune responses, viral kinetics, and the determinants of severe disease through harmonised longitudinal follow-up of exposed individuals. The study uses a standardised prospective protocol implemented across 21 participating countries.[4]

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

        ° Technical guidance on the management of hantavirus onboard ships was shared with States Parties through IHR channels

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

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

        ° Laboratory testing of Andes virus (Orthohantavirus andesense) infection: Interim guidance

    The NFPs of countries managing cases and/or contacts have been exchanging passenger- and crew-related information.

    WHO provided risk communication coordination and support, ensured timely evidence-based information sharing, activated the coordination mechanisms across the three organizational levels, and supported national authorities in implementing public health measures, including in accordance with IHR provisions.

    WHO convened regular Member State briefings, expert discussions covering key technical, laboratory, clinical care and infection prevention and control (IPC) topics, and global webinars via the EPI-WIN knowledge platform to facilitate experience sharing and coordinate support.

    WHO supported the development of research protocols with national and international partners and planned a hantavirus consultation on medical countermeasures.

    WHO coordinated the distribution of the laboratory testing and reference materials made available by Chile and Argentina, as well as diagnostic protocols and information on available test kits and their performance.

WHO risk assessment

    The ANDV outbreak associated with the MV Hondius cruise ship no longer poses a public health risk and no further related transmission is expected.  

    ANDV remains endemic in South America, and it is associated with hantavirus pulmonary syndrome with substantial case fatality, its transmissibility remains limited, typically requiring close and prolonged exposure, and tends to result in temporally and spatially restricted clusters.

    While the confined maritime environment of this event likely facilitated transmission during the voyage, epidemiological and genomic evidence supports a point source outbreak, originating either from contact with an infected animal or infected person, followed by limited chains of human-to-human secondary transmission, without evidence of sustained transmission.

    The completion of the 42-day follow-up period for all identified contacts without further detection of additional secondary cases demonstrates effective interruption of transmission and confirms outbreak containment. 

    Additionally, IPC measures continue to be applied for the management of the two cases still hospitalized.

WHO advice

    WHO advises all countries to sustain strong engagement and collaboration to document and learn from this outbreak response, including both successes and operational challenges, and to apply the lessons identified to strengthen preparedness, surveillance including international tracing and follow up of contacts, clinical care, IPC, risk communication, and response capacities for future public health emergencies.

    WHO further encourages the continuation of epidemiological, clinical, laboratory, and ecological studies to better understand the outbreak, its transmission dynamics, risk factors, and determinants of disease severity.

    In areas where hantavirus is endemic, WHO recommends strengthening measures to prevent and control transmission through enhanced surveillance, public awareness, environmental management, reduction of exposure to rodent reservoirs and contaminated environments, and early detection, implementation of IPC measures and management of cases.

    WHO also encourages continued investment in research and development to advance the availability of effective diagnostics, therapeutics, and vaccines, and to improve preparedness and response capabilities for future hantavirus outbreaks.

Further information

    ° 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

    ° 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

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

    ° 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

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

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

    ° World Health Organization. Handbook for management of public health events in air transport, https://www.who.int/publications/i/item/9789241510165

    ° World Health Organization. Guide to hygiene and sanitation in aviation, 3rd edition, https://www.who.int/publications/i/item/9789241547772

    ° 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

    ° 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

    ° 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

    ° 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 travel, Multi-country. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON600

    ° 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

    ° 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

    ° World Health Organization Health Emergencies EPI-WIN webinar: Hantavirus in Focus I: what we know and what it means. https://www.who.int/news-room/events/detail/2026/05/20/default-calendar/hantavirus-in-focus-i-what-we-know-and-what-it-means

    ° World Health Organization Health Emergencies EPI-WIN webinar: Hantavirus in Focus II: hantavirus natural history, infection control and clinical management of patients in hospital. https://www.who.int/news-room/events/detail/2026/05/22/default-calendar/who-health-emergencies-epi-win-webinar-hantavirus-in-focus-ii-hantavirus-in-an-international-maritime-setting-natural-history-infection-control-and-clinical-management-of-patients-in-hospital

    ° World Health Organization Health Emergencies EPI-WIN webinar: Hantavirus in focus III: reflections from the IHR Border Health and Points of Entry perspective. https://www.who.int/news-room/events/detail/2026/06/04/default-calendar/who-health-emergencies-epi-win-webinar--hantavirus-in-focus-iiireflections-from-a-border-health-and-point-of-entry-perspective

    ° World Health Organization Health Emergencies EPI-WIN webinar: Hantavirus in focus IV: Infection prevention and control: from isolation to safe discharge and quarantine. https://www.who.int/news-room/events/detail/2026/06/16/default-calendar/who-health-emergencies-epi-win-webinar-hantavirus-in-focus-iv-infection-prevention-and-control-from-isolation-to-safe-discharge-and-quarantine

    ° Pan American Health Organization / World Health Organization. Infection prevention and control of hantavirus infection, including Andes virus disease. Interim regional guidance for suspected or confirmed cases. https://iris.paho.org/items/bc5a7b5a-5a0a-4407-829e-663c762ad615

    ° Pan American Health Organization / World Health Organization. Clinical management of hantavirus infection, including Andes virus disease: Interim regional guidance for suspected or confirmed cases. https://iris.paho.org/items/0fa0dcb1-4395-467d-a431-5408b4eff337    

    ° 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

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

    ° Hantavirus in the Americas: Guidelines for diagnosis, treatment, prevention and control. 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, professional version: https://www.msdmanuals.com/professional/infectious-diseases/arboviruses-arenaviridae-and-filoviridae/hantavirus-infection

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

___

    [1] “Super-Spreaders” and Person-to-Person Transmission of Andes Virus in Argentina | New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMoa2009040

    [2] Padula PJ, Edelstein A, Miguel SD, López NM, Rossi CM, Rabinovich RD. Hantavirus pulmonary syndrome outbreak in Argentina: molecular evidence for person-to-person transmission of Andes virus. Virology. 1998 Feb 15;241(2):323-30. doi: 10.1006/viro.1997.8976. PMID: 9499807.  https://pubmed.ncbi.nlm.nih.gov/9499807/

    [3] 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

    [4] Twenty-one countries launch coordinated Andes virus research initiative following hantavirus outbreak. https://www.who.int/news/item/12-06-2026-twenty-one-countries-launch-coordinated-andes-virus-research-initiative-following-hantavirus-outbreak  

__

Citable reference: World Health Organization (2 July 2026). Disease Outbreak News. Hantavirus outbreak linked to cruise ship travel, Multi-locations. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON611

Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON611

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#Andes Virus on a Cruise #Ship, what it Tells us About the #Global #Pandemic #Preparedness Agenda

 

Summary

The outbreak of hantavirus disease caused by Andes virus aboard a cruise ship is a reminder of the challenges posed by emerging diseases in the modern era. While Andes virus-associated disease can be particularly severe, it is unlikely to spread extensively beyond the current number of cases or emerge as a large epidemic, especially if public health measures are followed. Nonetheless, the outbreak exemplifies the complexity of international outbreak response with differences in national preparedness frameworks and the rapid spread of mis-/disinformation. We discuss this outbreak in the context of global epidemic and pandemic preparedness and emphasize the importance of sustained, inclusive global collaborative One Health approaches to preparedness and response. We stress the urgent need for global coordination, discuss specific challenges, and provide recommendations for further strengthening of global preparedness.

Source: 

Link: https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(26)00167-5/fulltext

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#WHO DG's opening #remarks at the media #briefing – 24 June 2026 {#Ebola in #DRC} (Edited): #France reported a NGO #HCW positive for the virus

 

    Good afternoon to those in the room, and good morning, good afternoon and good evening to those online, wherever you are in the world.

    We begin with the Ebola outbreak in the Democratic Republic of the Congo.

    It’s encouraging to see that since the outbreak was first reported five weeks ago, the response has scaled up significantly, under the leadership of the government.

    In the past five weeks, the number of treatment beds has increased from less than 10 to over 500 in 19 health centres.

    With support from WHO and the Africa CDC, laboratory capacity has increased from 30 tests a day at the central laboratory in Kinshasa to over 2000 tests a day in nine labs across three provinces.

    More communities are becoming aware of the risks of Ebola, and asking for the tools and support to protect themselves.

    And more than 100 people have now recovered. With early detection and supportive care, many can survive this disease.

    But we could save many more lives with therapeutics.

    Preparations are now complete for a trial of two therapeutics that is expected to start in DRC next week.

    The trial will evaluate whether two antivirals, MBP134 and remdesivir, can help to reduce mortality in patients with Bundibugyo virus disease, alone or in combination.

    We thank the United States and Gilead Sciences for donating doses for the trial. Together with our partners we will announce more information next week.

    WHO and our partners are working closely with the communities to inform and involve them in the trial.

    We are also working to ensure the communities have access to the therapeutics should they prove safe and efficacious.

    The trial will be conducted by a consortium of partners including DRC’s National Institute for Biomedical Research, ALIMA, Oxford University and WHO.

    Despite the good progress we have made, we still face major challenges, and the outbreak is continuing to outpace the response.

    There are now 1094 confirmed cases, with 277 deaths.

    The outbreak is continuing to move fast.

    Political advocacy and action are essential to create the conditions for increased humanitarian access and a scaled-up response, because the outbreak is happening in a complex situation.

    In neighbouring Uganda, a new case was reported last Sunday, the first in two weeks.

    This brings the total in Uganda to 20 confirmed cases, with two confirmed deaths.

    All cases in Uganda are linked to the outbreak in DRC.

    Today, France reported that a health worker with the NGO ALIMA, who returned to the country after caring for an Ebola patient in DRC, tested positive for the virus, and is now being monitored and receiving care.

    This case is a reminder of the risks faced by frontline responders.

    Almost 80 health workers have been infected, highlighting the risks they face and the importance of strengthening infection prevention and control.

    WHO advises countries to support the safe deployment of personnel responding to this outbreak.

    This includes ensuring that organizations deploying staff provide clear information on risks, how to reduce and manage the risk of exposure, and that countries are prepared to facilitate evacuation if needed.

    Still, the risk to the rest of the world remains low.

    Under the government’s leadership, the coordinated response to the outbreak is starting to take hold.

    But continued scale up is needed.

    Contact tracing is still not at the level needed;

    Capacity at treatment and isolation centres is insufficient;

    Safe and dignified burials remain a major challenge;

    The health system is under pressure;

    Border closures continue to hinder the response;

    Multiple security incidents have been reported;

    The affected area is in the grip of a decades-long humanitarian crisis;

    And financial support is still insufficient.

    Earlier this month, WHO and the Africa CDC announced a joint Continental Preparedness and Response Plan that reflects the funding needs of partners, with an ask of 518 million U.S. dollars.

    Next week, the first financial reporting on pledges and commitments to the plan are expected to be available, providing a clear understanding of gaps and needs. 

===

    Now to the outbreak of hantavirus.

    The total number of cases from the hantavirus outbreak remains 13, including three deaths.

    In all, more than 650 contacts have been identified and followed up by local health authorities in 33 countries and territories.

    All but 54 contacts have completed their period of quarantine, and the remaining contacts are scheduled to complete their quarantine period by the 2nd of July.

    If no further cases are reported by then, WHO will consider the outbreak to be over.

    However, WHO will continue working to advance our understanding of this outbreak, and hantavirus more generally.

    Working with governments and partners, we are continuing investigations into how the outbreak started and spread among those on board.

    We are also working with partners who have collected environmental samples onboard the ship.

    In addition, we are coordinating a study among people exposed to the virus involving 21 countries, to better understand how the disease develops.

    We are also working on having a sample of the virus shared with the WHO BioHub in Switzerland.

    This will be important for developing diagnostics, therapeutics and vaccines for future outbreaks.

    I thank all countries that have contributed in different ways to the response to this outbreak, with special thanks to the leadership and solidarity shown by Spain, especially to Prime Minister Pedro Sánchez.

    I also thank the Captain of the MV Hondius, Captain Jan Dobrogowski, his crew and all passengers for their cooperation in what has been a very difficult situation.

(..)

Source: 

Link: https://www.who.int/news-room/speeches/item/who-director-general-s-opening-remarks-at-the-media-briefing---24-june-2026

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#UK Health Security Agency# update on the #hantavirus cruise ship #outbreak (June 22 '26): All remaining quarantined passengers released from isolation

 

Latest update

    The UK Health Security Agency (UKHSA) can confirm that all remaining individuals have now left Arrowe Park.

    All passengers from the MV Hondius who subsequently returned to the UK have now completed their self-isolation periods.

    Professor Robin May, Chief Scientific Officer at UKHSA, said: 

    ''We would like to reiterate our thanks and gratitude to passengers, crew and other contacts for their cooperation throughout what has been a very challenging time for everyone affected.

    ''Our teams will continue to work closely with local authorities and the NHS to ensure everyone affected by this outbreak has the necessary support in place.

Source: 

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

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Beyond the cruise #ship: #Andes #hantavirus and the neglected #onehealth dimensions of global #outbreak #preparedness

 

{Summary}

The ongoing multi-country outbreak of Andes hantavirus linked to an expedition cruise travel has drawn global public health attention. The outbreak was reported to the World Health Organization on 02 May 2026 after a cluster of severe respiratory illness occurred among passengers and crew aboard the MV Hondius, which travelled across remote regions of the South Atlantic following departure from Ushuaia, Argentina. As of 18 May 2026, the European Centre for Disease Prevention and Control (ECDC) reported 12 cases, including nine confirmed, two probable, and one inconclusive case, as well as three deaths linked to the outbreak. While response efforts have appropriately focused on case detection, isolation, contact monitoring, and clinical management, the event highlights broader gaps in how emerging zoonotic threats are managed globally. Rather than viewing this solely as a cruise-associated outbreak, it should also be understood as a One Health warning signal emerging at the intersection of rodent ecology, environmental and climatic change, expedition tourism, and global human mobility.

(...)

Source: 

Link: https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(26)00160-2/fulltext

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#Andes virus #outbreak linked to expedition cruise #ship travel, multi-country #investigation and response, April to June 2026

Abstract

As at 18 June 2026, 13 cases (12 confirmed and one probable) of Andes orthohantavirus have been reported (case–fatality: 23%), linked to the Dutch-flagged expedition cruise ship MV Hondius. The event involved individuals from 23 nationalities and required medical evacuation, repatriation, coordinated international contact tracing, isolation, quarantine and clinical and laboratory testing follow-up. To date, all cases have been passengers (10/121; 8%) or crew members (3/61; 5%). Ongoing monitoring and investigations aim to clarify the source of the outbreak, identify risk factors and prevent further spread.

Source: 

Link: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2026.31.24.2600477?emailalert=true#abstract_content

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#Andes #hantavirus #outbreak in cruise ship (ECDC, June 17 '26): Some quarantined individuals have left isolation after completing follow-up

 

    On 2 May 2026, ECDC was notified 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 17 June 2026, 13 cases have been reported in total, including 12 confirmed and one probable case.

    As of 17 June 2026, some of the identified contacts associated with the outbreak have completed their quarantine period, while others are expected to do so in the coming days. 

    Public health authorities continue to monitor the identified contacts however, based on the information currently available, the likelihood of additional cases related to this event is considered very low. 

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

    ° Confirmed cases: 12

    ° Probable cases: 1

    ° Suspected cases: 0

    ° Number of deaths: 3

(...)

Source: 

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

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#Hantavirus #outbreak on a cruise #ship in the South Atlantic

 

{Excerpt}

On May 2, 2026, a cluster of severe respiratory illness among passengers aboard a cruise ship in the Atlantic was reported to WHO, and a suspected hantavirus outbreak was identified. The vessel departed from Ushuaia, Argentina, on April 1, 2026, carrying 147 individuals (88 passengers and 59 crew members) from 23 countries.1 This event raises concerns about surveillance, outbreak response, containment, and the potential for international spread of hantavirus. As of May 4, 2026, seven cases (two laboratory confirmed and five suspected) have been identified, including three deaths, corresponding to a crude case-fatality rate of more than 40%.1 All patients presented with fever or gastrointestinal symptoms, or both, with rapid progression to pneumonia, acute respiratory distress syndrome, and shock in severe cases.1 The overall attack rate was 4·8% (seven of 147 individuals on board infected).1

(...)

Source: 

Link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00934-7/fulltext?rss=yes

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Cruise #ship #hantavirus #outbreak in remote #island communities

 

On April 27, 2026, the Dutch-flagged expedition cruise ship MV Hondius arrived at Ascension Island, a remote mid-Atlantic UK Overseas Territory (UKOT). The vessel had left Ushuaia (Argentina) on April 1, 2026, then visited the Antarctic Peninsula and other UKOT islands in the south Atlantic: the British Antarctic Territory, South Georgia, Tristan da Cunha, and St Helena (figure).1 At Ascension Island, a 69-year-old man (case 3) with a severe respiratory syndrome was admitted into the care of the island's small medical team. This team resuscitated the patient and arranged for a medical evacuation service in South Africa to transfer him to intensive care in Johannesburg. 

(...)

Source: 

Link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01014-7/fulltext?rss=yes

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Connecting the #region during #crisis: a Community of Practice #response to the MV Hondius #hantavirus #outbreak

 

Abstract

This article describes the rapid activation of the Asia Pacific Health Security Action Framework Community of Practice following the MV Hondius hantavirus outbreak. It highlights regional knowledge-sharing, multidisciplinary engagement, preparedness activities, and the importance of timely communication and collaboration in strengthening readiness and response during emerging public health emergencies.

Source: 

Link: https://ojs.wpro.who.int/ojs/index.php/wpsar/article/view/1488

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#Andes #Hantavirus #Outbreak on a Cruise #Ship, 2026 (NEJM, summary)

 

Published May 20, 2026 | DOI: 10.1056/NEJMc2606496 | Copyright © 2026

To the Editor:

    On April 27, 2026, a man (later classified as Patient 3 in the outbreak) was medically evacuated to Ascension Island from the Dutch-flagged expedition cruise ship MV Hondius; he had severe acute respiratory infection (SARI) and reported shortness of breath and fever that had begun on April 21. He had signs of pneumonia, although findings on chest radiography were unremarkable. While he was on Ascension Island, his condition worsened, and he was transferred to Johannesburg, South Africa, for ventilator support and intensive care.1 He was in shock and had acute respiratory distress syndrome; findings on chest radiography were consistent with atypical pneumonia. The differential diagnosis in this clinical context is very broad and includes atypical pneumonias, bacterial or fungal sepsis, and vectorborne diseases such as malaria or dengue. The diagnostic evaluation, including respiratory pathogen panels, malaria smear and antigen, fungal biomarkers, blood cultures, and legionella urinary antigen, was unrevealing. Further details are provided in the Supplementary Appendix, available with the full text of this letter at NEJM.org.

(...)

Source: 

Link: https://www.nejm.org/doi/full/10.1056/NEJMc2606496?query=TOC#ap1

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#Netherlands, Arrival and #cleaning of the cruise #ship #Hondius (RIVM, May 18 '26)

 

    On 18 May 20206, at around 10.30 am, the cruise ship Hondius was moored at an enclosed part of the port of Rotterdam. 

    27 people are still on board the ship: crew members and medical personnel. 

    On arrival in Rotterdam, these people will disembark in a phased and controlled manner. 

    They will be accommodated in a special quarantine area in the port of Rotterdam. 

    Some crew members will remain on board to keep the ship running. They will later be escorted from the ship and given assistance. 

Testing and quarantine

    The people on board the ship have no symptoms. 

    They are medically examined on arrival  and blood is taken to test them for the Andes virus. 

    The port of Rotterdam is an official quarantine port and a quarantine area has been established. 

    The foreign persons on board are quarantined there in special temporary units as a precaution. 

    The Dutch crew members, when they disembark, go into home quarantine. 

    The municipal health service GGD has daily contact with the passengers. They will need to monitor their health. If they develop symptoms, they can receive medical care quickly and with the appropriate precautions. 

Cleaning and disinfecting the ship 

    The inspection of the ship and the collection of samples starts today at the port of Rotterdam. 

    Next, the ship is completely cleaned and disinfected. This is done by an experienced cleaning company. 

    RIVM advised the cleaning company about this last week. The cleaning process takes several days. Cleaners must use personal protective equipment to ensure safe and healthy working conditions. In this way, the organisations involved aim to ensure that no one is infected and that the ship can return to service without risk. 

The likelihood of spreading in the Netherlands remains very small 

    All measures taken are aimed at ensuring safe and controlled handling of the situation. 

    The likelihood of the Andes virus spreading in the Netherlands is therefore still very low.  

    RIVM, the  Rotterdam-Rijnmond Safety Region, GGD Rotterdam-Rijnmond, the Rotterdam Port Authority, the shipping company  and other partners are working closely together to bring this operation to a successful conclusion.

Source: 

Link: https://www.rivm.nl/en/news/arrival-and-cleaning-of-cruise-ship-hondius

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#WHO DG's opening #remarks at the #media #briefing on #hantavirus – 12 May 2026 (Edited): 11 cases among passengers and crew members so far.

 

Your Excellency Prime Minister Pedro Sánchez, 

Dear members of the media, 

Buenos dias a todos. By the way, I like “vamos vamos” – when the three ministers were leading this operation, Spain led in style. 

Let me begin by thanking Prime Minister Sánchez and his government for Spain’s outstanding leadership and partnership over the past week. 

I would especially like to thank Minister Mónica García, my sister, and now I’m introduced to two more ministers with whom we have been working closely, Minister Fernando Grande-Marlaska and Minister Ángel Víctor Torres. 

It seems incredible that it was only 10 days ago that WHO was first informed of a cluster of cases of hantavirus aboard the MV Hondius. 

Under the International Health Regulations, to which Spain is a party, as His Excellency said, countries are required not to allow people to be stranded at sea when they have the capacity to manage the risk safely and responsibly. 

At the time, the ship was near Cabo Verde, and I asked Prime Minister Ulisses Correia e Silva to assist with the evacuation of the three symptomatic passengers on the ship, which he did.

However, WHO’s assessment was that the situation exceeded Cabo Verde’s capacity to handle the full disembarkation and repatriation.

So, last Monday, I wrote to Prime Minister Sánchez asking if Spain would accept the ship and manage the disembarkation of the passengers, with support from the World Health Organization. 

By the way, the European Union’s assessment was the same, and the Prime Minister received the same request from the European Union. 

He responded immediately in the affirmative, and for the past week, Spain and WHO have worked together closely under Spain’s leadership, along with the government of the Netherlands and the ship’s operator, to coordinate and execute the operation that took place over the past two days. 

I thank Prime Minister Sánchez not only for meeting Spain’s legal duty under international law, but also for exercising his moral duty to show solidarity with, and compassion and kindness for the passengers on the ship. 

Especially during these difficult times, the world needs this kind of kindness and compassion. That’s what exactly Spain did, and we’re so proud to witness that, and I know the whole world is proud to witness that. 

I repeat, the world, if there is one thing it needs at this time, it’s kindness and compassion, and support for each other – apart from of course the legal obligations. 

We can say confidently that this phase of the operation was successful. As you have heard from Prime Minister Sánchez, all of the passengers have disembarked and left Tenerife, and MV Hondius – the ship – is now on its way to the Netherlands. 

Almost 150 people from 23 countries were on this ship for weeks, in what must have been a very frightening situation. Some of the passengers were facing mental breakdown. 

They have the right to be treated with dignity and compassion. 

There were some people around the world calling for the passengers to be contained on the ship for the full quarantine period. Our view was that would have been inhumane, and unnecessary. Yesterday during our press conference I called it even cruel to suggest that. 

We were convinced it was possible to disembark these passengers in a way that was safe for them and the people of Tenerife, and that was respectful of the human rights of the passengers and crew. 

Over the past week I have also been in regular contact with the ship’s captain Jan Dobrogowski, and I would like to thank him, the crew, the company that operates the ship, the CEO Mr Remy and all of the passengers for everything they have done. 

I fully understand why the people of Tenerife may have been concerned about passengers from the cruise ship disembarking on their shores. 

We said the risk was low, both to the people of Tenerife and globally, and all our efforts over the past week have been aimed at keeping it low. 

This is a serious situation, which we have taken – and continue to take – very seriously. 

A WHO expert boarded the ship in Cabo Verde, and was joined by two doctors from the Netherlands and an expert from the European Centre for Disease Prevention and Control. 

    WHO’s assessment continues to be that the risk to health globally is low. 

So far, eleven cases have been reported, including three deaths. All eleven cases are among passengers or crew on the ship. 

Nine of the eleven have been confirmed as Andes virus, and the other two are probable. 

Those numbers have changed little over the past week, thanks to the efforts of multiple governments and partners. There have been no deaths since the 2nd of May, when WHO was first informed of the cluster of cases. 

All suspected and confirmed cases have been isolated and managed under strict medical supervision, minimizing any risk of further transmission. 

    At the moment, there is no sign that we are seeing the start of a larger outbreak. 

But of course, the situation could change. 

And given the long incubation period of the virus, it’s possible we might see more cases in the coming weeks. 

Each of the countries to which the passengers have been repatriated is responsible for monitoring the health of those passengers. 

WHO is aware of reports of a small number of patients with symptoms consistent with Andes virus, and we are following up on each of those reports with the respective countries. 

WHO’s recommendation is that they should be monitored actively at a specified quarantine facility or at home for 42 days from the last exposure, which is the 10th of May, which takes us to the 21st of June. 

Anyone who becomes symptomatic should be isolated and treated immediately. 

Our work is not over. WHO will continue to work closely with experts in all affected countries. 

We have also requested countries to report regularly to WHO on the health and well-being of passengers and crew through the International Health Regulations. 

Once again, WHO expresses its deep appreciation to Prime Minister Pedro Sánchez and the Government of Spain for its outstanding leadership and partnership over the past week. 

As I have said many times: viruses do not respect borders. Our strongest immunity is solidarity – and that is the solidarity that Spain has demonstrated. 

It gives me great comfort that there are still people in our world who do things not because they are politically expedient, but simply because they are right – for the people of Spain and the people of the world. 

Muchas gracias.

Source: 

Link: https://www.who.int/news-room/speeches/item/who-director-general-s-opening-remarks-at-the-media-briefing-on-hantavirus---12-may-2026

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#USA, State of #Georgia, #Hantavirus: Two Individuals Being Transported to #Emory University’s Serious Communicable #Diseases Unit (Dept. Health, May 11 '26)

 

NEWS RELEASE | FOR IMMEDIATE RELEASE: May 11, 2026

Two Individuals Being Transported to Emory University’s Serious Communicable Diseases Unit

ATLANTA – The Georgia Department of Public Health (DPH) has been notified by the Centers for Disease Control and Prevention (CDC) that two individuals who disembarked the ship at the center of the hantavirus outbreak are being transported to Emory University’s Serious Communicable Diseases Unit.

Federal healthcare workers are taking every precaution needed in each of these cases, and there is no risk to the public at this time. 

DPH remains in active communication with the CDC and other partners and will continue to do so as needed, as we monitor developments over the coming days and weeks.           

##

Source: 

Link: https://dph.georgia.gov/press-releases/2026-05-11/two-individuals-being-transported-emory-universitys-serious-communicable

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