#Spain, Health authorities have established #criteria for #hospital discharge and follow-up for confirmed cases of #hantavirus (June 4 '26)

 

    Madrid, June 4, 2026 

    The Ministry of Health has updated the protocol for managing people affected by the Andes hantavirus outbreak associated with the MV Hondius cruise ship, establishing the clinical and microbiological criteria that will allow hospital discharge of confirmed cases and the conditions for the completion of contact tracing.

    According to the protocol approved by the Public Health Commission, people diagnosed with Andes hantavirus infection who remain admitted to a High Level Isolation and Treatment Unit (UATAN) may be discharged from the hospital once clinical recovery has been achieved, for which they must have remained at least three days without symptoms compatible with the disease and obtain two negative results in PCR tests performed on urine and oropharyngeal exudate, separated by a minimum interval of 48 hours.

    The most recent studies on Andes virus show that viral RNA can be detected in blood for an extended period after clinical recovery. 

    For this reason, discharge criteria are not based solely on a negative blood PCR test, but also on the absence of symptoms and negative results in biological samples most directly related to possible viral shedding, such as urine and oropharyngeal swabs.

    Consequently, the protocol expressly acknowledges that some individuals may continue to test positive for COVID-19 via PCR in their blood after hospital discharge. 

    Available scientific evidence indicates that this persistence of viral genetic material can continue after clinical recovery, without posing a risk of disease transmission. 

    In these cases, they will remain under clinical follow-up for six months to monitor their progress, detect any potential long-term effects, and undergo regular check-ups until the test is negative.

    Those being monitored as contacts must complete the maximum quarantine period established by the protocol. 

    If they remain asymptomatic throughout the home monitoring period, a sample will be taken at the end of this period and analyzed by the National Microbiology Center. 

    Only after obtaining a negative result will they be able to end the monitoring measures and fully resume their normal activities.

    These measures are part of the surveillance and control system designed to ensure the safety of patients, healthcare professionals and the general population, applying the precautionary principle while international monitoring of this outbreak continues.

Source: 

Link: https://www.sanidad.gob.es/gabinete/notasPrensa.do?id=6928

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First reported case of #Andes #hantavirus cardiopulmonary syndrome treated with a combination of #favipiravir, #ribavirin, icatibant and baricitinib

 

ABSTRACT

Objectives

To describe the first documented case of Andes virus (ANDV) hantavirus cardiopulmonary syndrome (HCPS) in Spain and the first worldwide use of a therapeutic regime including two antivirals (favipiravir and ribavirin) and two host-directed drugs (baricitinib and icatibant).

Methods

A 69-year-old Spanish man, repatriated following a multinational ANDV outbreak aboard a cruise ship, was managed in a high-level isolation unit. Diagnosis was established by RT-PCR and serology while he was still asymptomatic as part of protocol-driven screening. Under compassionate-use authorisation and written informed consent, the patient received ribavirin (initially intravenous, then switched to oral on day +4), oral favipiravir, subcutaneous icatibant, and oral baricitinib, with serial clinical, laboratory, and radiological monitoring.

Results

Hypoxaemia, bilateral B-lines, thrombocytopenia, lymphopenia, and hyponatraemia developed within 24 hours after diagnosis. The combination regimen was initiated on day 0, and baricitinib was added on day +1, coinciding with the need for high-flow nasal oxygen. Sustained clinical, laboratory, and radiological recovery occurred from day +2 onwards, without progression to invasive ventilation or vasopressors. Mild diarrhoea attributed to ribavirin led to its discontinuation on day +5, shortly after the IV-to-oral switch. Severe recurrent diarrhoea on day +8, attributed to favipiravir, prompted its withdrawal before completion of the planned 10-day course; baricitinib was completed on day +10.

Conclusions

This sentinel case of imported HCPS in non-endemic Europe was managed with, to our knowledge, the first reported combined antiviral and host-directed regimen for this syndrome and the first reported use of favipiravir in a patient with hantavirus infection. The favourable outcome supports prospective evaluation of antiviral combinations and adjunctive immunomodulation within international preparedness protocols.

Source: 

Link: https://www.clinicalmicrobiologyandinfection.org/article/S1198-743X(26)00310-1/fulltext

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#Zoonotic #infections and genomic #evolution associated with novel #reassortants swine-origin #influenza A viruses in #Spain

 

Abstract

Influenza A virus (IAV) circulates widely in European pig populations and continues to diversify through frequent introductions from humans, followed by reassortment within swine. Spain represents a particularly dynamic ecological setting due to the coexistence of intensive white pig production, extensive Iberian pig systems, and abundant wild boar populations. This study provides an integrated analysis of IAV evolution and genomic diversity in swine in Spain between 2019 and 2022, expanding on previous surveillance from 2016 to 2019. Sampling across 24 provinces yielded 66 new whole genome sequences from Iberian and white pigs. We identified 18 genotypes, including 11 novel reassortants not detected in our previous survey. Several genotypes, such as H1huN2 G21 and G22, H3N2 G23, and the unusual H3N1 G12, were exclusive to the country. Some genotypes were detected across white pigs, Iberian pigs, and wild boar in Toledo and Badajoz, suggesting viral flow among swine populations. Phylogenetic analyses revealed ongoing introductions of H1N1pdm09 from humans into pigs, generating at least five reassortant genotypes (G10, G16 to G19). These lineages incorporated pandemic internal cassettes and, in some cases, human seasonal N2 segments, highlighting the continued role of humans as a source of viral incursions. Conversely, four zoonotic infections (H1N1v) detected in Spain between 2022 and 2026 were linked to genotypes circulating in white pigs, underscoring the bidirectional nature of IAV transmission at the human swine interface. Overall, this study demonstrates that Spain provides ecological conditions conducive to IAV diversification, reassortment, and zoonotic risk. The findings reinforce the need for sustained One Health surveillance.

Competing Interest Statement

The A.G.-S. laboratory has received research support from Avimex, Dynavax, Pharmamar, and Accurius, outside of the reported work within the last three years. A.G.-S. has consulting agreements for the following companies involving cash and/or stock within the last three years: Castlevax, Amovir, Vivaldi Biosciences, Contrafect, Avimex, Pagoda, Accurius, Applied Biological Laboratories, Pharmamar, CureLab Oncology, CureLab Veterinary, Virofend and Prosetta, outside of the reported work. A.G.-S. has been an invited speaker in meeting events within the last three years organized by Seqirus, Novavax and Hipra. A.G.-S. is inventor on patents and patent applications on the use of antivirals and vaccines for the treatment and prevention of virus infections and cancer, owned by the Icahn School of Medicine at Mount Sinai, New York, outside of the reported work. The rest of the authors report no conflicts of interest.

Funder Information Declared

Centre for Research on Influenza Pathogenesis and Transmission (CRIPT), one of the National Institute of Allergy and Infectious Diseases (NIAID) funded Centres of Excellence for Influenza Research and Response (CEIRR), contract #75N93021C00014

Intramural Research Program of the National Library of Medicine at the US National Institutes of Health

Source: 

Link: https://www.biorxiv.org/content/10.64898/2026.05.22.724525v1

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#Spain, #Health authorities update #protocol for #hantavirus #outbreak and incorporate supervised home #quarantine (Min. Health, May 22 '26)

 

    ° Contacts who have not presented symptoms and maintain negative results in the PCR tests performed during the first 28 days of hospital quarantine may continue monitoring at their homes until completing the established 42 days.

    ° The protocol incorporates specific measures for transfers from the hospital to the home and regulates the conditions of isolation, health monitoring and prevention that must be maintained during home quarantine.

    ° People under home monitoring must take their temperature daily and report any symptoms. As long as they remain asymptomatic, no further follow-up PCR tests will be performed.

Madrid, May 22, 2026. - The Technical Committee of the Early Warning and Rapid Response System (SIAPR) has updated the hantavirus outbreak monitoring protocol to allow asymptomatic contacts to complete their quarantine at home after an initial period of hospital monitoring. The revision has been approved by the Public Health Commission.

    The update states that people under monitoring who have remained asymptomatic and with negative results in PCR tests performed during the first 28 days of hospital quarantine may continue monitoring at home until completing the maximum incubation period set at 42 days.

    The protocol states that this arrangement can only be implemented when the dwelling meets the necessary conditions to guarantee isolation and health safety. Among the established requirements are having a well-ventilated single room and, preferably, a private bathroom, as well as ensuring constant communication with health authorities via telephone or internet.

    In cases where the conditions of the home or family environment do not allow these measures to be ensured, the Public Health authorities of the autonomous communities must enable alternative resources to guarantee a safe quarantine.

    The review also incorporates specific conditions for transfers from the hospital to the patient's home. The protocol stipulates that these transfers must be carried out using conventional ambulance transport, avoiding the use of public transport at all times. During the journey, both the patient and the driver must wear an FFP2 mask and perform hand hygiene before and after the transfer. Furthermore, the driver must remain physically separated from the patient, and unnecessary stops along the way must be avoided.

    The public health authorities of each autonomous community will be responsible for the daily monitoring of individuals who continue their home quarantine. During this period, two daily temperature checks must be carried out, and any symptoms consistent with the illness, such as fever, cough, shortness of breath, muscle aches, vomiting, diarrhea, or lower back pain, must be reported immediately.

    The protocol also establishes prevention and hygiene measures for both those being monitored and their household members, including the use of FFP2 masks in shared spaces, limiting visits, maintaining interpersonal distance, and specific cleaning and waste management guidelines. As long as individuals remain asymptomatic during home monitoring, additional follow-up PCR tests will not be necessary.

    The protocol will continue to be subject to review and ongoing updates based on the epidemiological evolution of the outbreak and the available scientific evidence.

Source: 

Link: https://www.sanidad.gob.es/gabinete/notasPrensa.do?id=6916

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#Spain, The Public Health #Commission sets May 10 as "day zero" for the official start of the #quarantine (Min. Health, May 12 '26)

 

The Public Health Commission approved this afternoon the updated protocol for handling people in relation to the hantavirus outbreak.

Only those evacuated from the cruise ship will be quarantined at the Gómez Ulla Hospital. 

For any other contacts, health authorities will conduct an individual assessment.

The protocol will be re-evaluated, at the latest, after 28 days, to adapt the measures to the epidemiological evolution and the available scientific knowledge.

- - - 

Madrid, May 12, 2026 – The Public Health Commission approved this afternoon the updated protocol for managing individuals under observation in Spain in relation to the Andes hantavirus outbreak associated with the MV-HONDIUS cruise ship. 

The document, previously agreed upon by the Technical Committee of the Early Warning and Rapid Response System (SIAPR), establishes May 10, 2026, as “day zero” for the official start of quarantine, coinciding with the date on which the isolation of those evacuated from the ship in individual rooms began.

The protocol updates the definition of contact to enhance surveillance. 

A contact is defined as any person who was on the ship between April 1 and May 10, or who had contact with a confirmed case during their infectious period, which officially begins two days before the onset of the first symptoms or a positive PCR test in asymptomatic cases. 

Under this criterion, this includes those who share a room or bathroom, sexual partners, direct physical contacts, and airline passengers seated in the same row or two adjacent rows on long-haul flights as a laboratory-confirmed case.

The protocol introduces a differentiated approach to contact tracing, stipulating that only those evacuated from the cruise ship must undergo mandatory quarantine in individual rooms at the Gómez Ulla Central Defense Hospital in Madrid. 

For any other contacts identified outside this group, health authorities will conduct an individualized assessment of their situation, allowing quarantine to take place in other facilities designated for isolation and health monitoring.

All identified contacts, regardless of where they quarantine, will be subject to enhanced health surveillance for the first 28 days, the period considered most likely for the appearance of symptoms consistent with the disease. 

During this time, a PCR test will be performed every seven days, and the results will only be considered conclusive after official confirmation from the National Microbiology Center. 

This measure will be complemented by supervised active surveillance, including twice-daily temperature checks and monitoring for possible symptoms such as fever, shortness of breath, or muscle aches.

To promote the well-being of those in quarantine, the protocol allows for more flexible isolation conditions after the first week. 

If the PCR test performed on day 7 is negative, those isolated in the hospital setting may receive visitors using appropriate personal protective equipment and may take supervised walks out of their rooms into the common areas of the ward, while maintaining the mandatory use of FFP2 masks at all times.

Should any of the individuals being monitored develop symptoms consistent with the disease—such as fever, cough, shortness of breath, muscle aches, vomiting, or diarrhea—they will be considered a probable case and transferred to a negative-pressure isolation room for specific diagnostic testing. 

In such cases, the network of High-Level Isolation and Treatment Units (UATAN) will also be notified to ensure an immediate response in the event of a confirmed diagnosis.

Regarding the management of confirmed cases following a positive laboratory test, the protocol stipulates their admission to a High-Level Isolation and Treatment Unit (UATAN). 

The length of stay in this specialized unit will depend on the patient's condition: those with symptoms will remain hospitalized until their full clinical recovery, while asymptomatic cases must remain in isolation until they obtain a negative test result.

The protocol will be re-evaluated, at the latest, after 28 days, to adapt the measures to the epidemiological evolution and the available scientific knowledge.

Source: 

Link: https://www.sanidad.gob.es/gabinete/notasPrensa.do?id=6907

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#Message by #WHO #DG to the people of #Tenerife regarding the #hantavirus response (May 9 '26)

 

To the people of Tenerife,

My name is Tedros, and I serve as the Director-General of the World Health Organization, the United Nations agency responsible for global public health. 

It is not common for me to write directly to the people of a single community, but today I feel it is not only appropriate, it is necessary.

I want to speak to you directly, not through press releases or technical briefings, but as one human being to another, because you deserve that.

I know you are worried. I know that when you hear the word “outbreak” and watch a ship sail toward your shores, memories surface that none of us have fully put to rest. The pain of 2020 is still real, and I do not dismiss it for a single moment.

But I need you to hear me clearly: this is not another COVID. The current public health risk from hantavirus remains low. My colleagues and I have said this unequivocally, and I will say it again to you now.

The virus aboard the MV Hondius is the Andes strain of hantavirus. It is serious. Three people have lost their lives, and our hearts go out to their families. The risk to you, living your daily life in Tenerife, is low. This is the WHO’s assessment, and we do not make it lightly.

Right now, there are no symptomatic passengers on board. A WHO expert is on that ship. Medical supplies are in place. Spain’s authorities have prepared a careful, step-by-step plan: passengers will be ferried ashore at the industrial port of Granadilla, far from residential areas, in sealed, guarded vehicles, through a completely cordoned-off corridor, and repatriated directly to their home countries. You will not encounter them. Your families will not encounter them.

I also want to say something else, something that goes beyond the science.

I personally thanked Prime Minister Sanchez for Spain’s decision to receive this ship. I called it an act of solidarity and moral duty. Because that is what it is. I want you to know that the WHO’s request to Spain was not made arbitrarily. It was made in full accordance with the International Health Regulations, the legally binding framework that defines the rights and obligations of countries and the WHO when responding to public health events of international concern. Under those rules, the nearest port with sufficient medical capacity must be identified to ensure the safety and dignity of those on board. Tenerife met that standard. Spain honoured it. Nearly 150 people from 23 countries have been at sea for weeks, some of them grieving, all of them frightened, all of them longing for home. Tenerife has been chosen because it has the medical capacity, the infrastructure, and the humanity to help them reach safety.

And because I believe that so deeply, I will be there myself. I intend to travel to Tenerife to observe this operation firsthand, to stand alongside the health workers, port staff, and officials who are making it happen, and to personally pay my respects to an island that has responded to a difficult situation with grace, solidarity, and compassion. Your humanity deserves to be witnessed, not just acknowledged from a distance.

As I have said many times: viruses do not care about politics, and they do not respect borders. The best immunity any of us has is solidarity.

Tenerife is demonstrating that solidarity today. The ship’s captain, Jan Dobrogowski, crew and the company operating the vessel have shown exemplary collaboration at this challenging time.  On behalf of the World Health Organization, and on behalf of those passengers and their families around the world, I thank the people of Tenerife and everyone else involved.

Please take care of yourselves and of each other. Trust in the preparations that have been made. And know that the WHO stands with you, and with every person on that ship, every step of the way.

With respect, care, and gratitude,

Tedros

Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization

Source: 

Link: https://www.who.int/news/item/09-05-2026-message-by-the-who-director-general-to-the-people-of-tenerife-regarding-the-hantavirus-response

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#Spain, #Hantavirus: The #protocol for handling people disembarked from the #ship MV #HONDIUS has been approved (Min. of Health, May 8 '26)

 

* The protocol has been approved at an extraordinary meeting of the Public Health Commission.

* It establishes quarantine measures and active surveillance for people disembarked and under monitoring in Spain.

* The planned actions are based on the precautionary principle and will be reviewed continuously.

Madrid, May 8, 2026 - The Public Health Commission, which includes all the autonomous communities and the Ministry of Health, has approved the protocol for handling people disembarked from the ship MV HONDIUS, affected by an outbreak of Andes hantavirus (ANDV), with the aim of strengthening the protection of public health and ensuring a coordinated response throughout the national territory.

The protocol, previously agreed upon by the Technical Committee of the Early Warning and Rapid Response System (SIAPR), defines the criteria for action to monitor people who have been on the ship between April 1 and May 10, 2026, as well as for possible close contacts of confirmed cases.

The document establishes the definitions of contact, probable case and confirmed case of Andes virus disease, and is based on the criteria of the World Health Organization.

Quarantine measures and active monitoring

All people considered contacts — those who remained on the ship between April 1 and May 10 or who were in contact with a confirmed case — must undergo mandatory quarantine at the Gómez Ulla Central Defense Hospital in Madrid.

Passengers will remain in single rooms and will not be allowed visitors. 

During this period, they will undergo a PCR test upon arrival and another seven days later. 

In addition, active monitoring will be carried out, including twice-daily temperature checks to detect any compatible symptoms early.

Management of probable and confirmed cases

The protocol defines a probable case as any contact who develops symptoms such as fever, shortness of breath, muscle aches, or vomiting. 

In this situation, the patient will be immediately transferred to a negative pressure isolation room.

If a laboratory test is positive by the National Microbiology Center, the patient will become a confirmed case and will be admitted to a High Level Isolation and Treatment Unit (UATAN) until clinical recovery.

The document also incorporates detailed biosafety measures for healthcare, laboratory and cleaning personnel, including the use of personal protective equipment, protocols for handling and transporting biological samples and cleaning and disinfection procedures adapted to the level of biological risk associated with the Andes virus.

The Ministry of Health emphasizes that all actions outlined in the protocol are guided by the precautionary principle and may be continuously updated based on the evolution of the outbreak and the scientific knowledge available nationally and internationally. 

Furthermore, the emotional well-being of those in quarantine will be ensured by maintaining electronic communication with their families and loved ones.

Source: 

Link: https://www.sanidad.gob.es/gabinete/notasPrensa.do?id=6903

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{#Hantavirus} #Spain #Government holding seven coordination #meetings today with countries involved and with Government of the Canary Islands (May 7 '26)

 

• Mónica García and Ángel Víctor Torres have met with the President of the Canary Islands to analyze the situation and the procedure to follow for the transfer of the passengers of the MV Hondius.
• Anchoring the ship in Granadilla (Tenerife) is an option that was already being considered due to the technical characteristics of the Port, which is not prepared for the disembarkation of people.

Madrid, May 7, 2026 - The Minister of Health, Mónica García, and the Minister of Territorial Policy and Democratic Memory, Ángel Víctor Torres, held an information meeting today with the President of the Canary Islands, Fernando Clavijo, at the headquarters of the Ministry of Health, regarding the protocols that will be followed with the passengers of the MV Hondius who will disembark in the Canary Islands, for their control and subsequent transfer to Madrid, in the case of the 14 Spaniards, and to their countries of origin, in the case of the rest of the passengers.

This meeting is part of the ongoing communication that has existed between the Government of Spain and the Government of the Canary Islands at both a technical and institutional level since the beginning of the hantavirus health crisis.

Ministers García and Torres have expressed their full willingness to assist since learning of the infections on the cruise ship and their commitment to ensuring that the transfers are carried out with the utmost safety for both the patients and the public. 

In this regard, the Canary Islands president has been informed that the 147 passengers currently en route to the Canary Islands from Cape Verde remain asymptomatic and that the option of anchoring the ship upon arrival at the Port of Granadilla (Tenerife) was already being considered for various reasons, including the port's technical limitations, as it is not equipped for disembarking passengers.

In addition to appealing for responsibility and trust in science, the ministers recalled that today, as has been the case since Tuesday, two more technical meetings are planned between the Ministries of Health and the Interior with the Government of the Canary Islands, which are part of the seven coordination meetings that the Government of Spain will hold today with the Government delegations and, at the European level, with those responsible for health security and Civil Protection of the EU.

Source: 

Link: https://www.sanidad.gob.es/gabinete/notasPrensa.do?id=6902

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#Hantavirus #outbreak {in cruise ship}: Another #passenger contracts disease {total so far 8, of these 3 confirmed} (UN News Centre, May 6 '26)

 

It’s been confirmed that another passenger from the cruise liner linked to the outbreak of hantavirus has contracted the disease, which has claimed the lives of three people on board and sparked an international alert coordinated by the UN World Health Organization (WHO).

The individual, who is male, had been travelling on the Dutch-flagged vessel, the Hondius, at the centre of the outbreak. 

He is being treated in a Zurich hospital after returning to Switzerland and responding to an email from the ship’s operator.

“In line with the International Health Regulations (IHR), WHO is working with relevant countries to support international contact tracing, to ensure that those potentially exposed are monitored and that any further disease spread is limited,” the agency said in a post on X.

As of Wednesday, three of the ship’s 147 passengers have died since it sailed across the Atlantic Ocean from Argentina, to its current berth off the coast of Cabo Verde, according to the WHO. 

On X, WHO Director-General Tedros Adhanom Ghebreyesus reported that three passengers “have just been evacuated” from the ship and were en route to the Netherlands for treatment.

“At this stage, the overall public health risk remains low,” Tedros stressed.

Expedition ship

Publicly available data indicates that the vessel was built in Croatia and launched in June 2018. The Hondius is around 108 metres long and is listed under ship identification number 9818709 with the UN International Maritime Organization (IMO). 

The vessel has capacity for 196 passengers and 72 crew; it is named after the 17th century map publisher and engraver Jodocus Hondius. 

The expedition ship’s maiden voyage in 2019 took it from Vlissingen in the Netherlands to the volcanic island of Jan Mayen and Spitzbergen in the Arctic Circle.

The UN agency said that the victims may have been infected with the disease prior to boarding. It has reported eight cases of infection so far, including three confirmed as Andes hantavirus by laboratory testing.

On Tuesday, the WHO said that one individual was in intensive care in South Africa, although their condition was “improving”. 

Work to identify the virus has involved the National Institute for Communicable Diseases in South Africa and Geneva University Hospitals (HUG). The Pasteur Institute in Dakar and Argentina’s National Administration of Health Laboratories and Institutes also provided further “critical” support, WHO noted.

Patient care is ‘highest priority’

“WHO will continue to work with countries to ensure that the patients, contacts, passengers and crew have the information and support they need to stay safe and prevent spread,” the agency said.

At a press conference on Tuesday, WHO said that the “highest priority” was to evacuate the two ill passengers still on board “to make sure that they have the care that they receive”.

Once the ship reaches the Canary Islands, the agency’s Dr Maria Van Kerkhove explained that the Spanish authorities would carry out a full epidemiological investigation and full disinfection of the ship, before assessing the risk passengers remaining on board.

“We have heard from quite a few people, you know, on the boat. We just want you to know we are working with the ship's operators. We are working with the countries where you are from. We hear you. We know that you are scared.” said Dr. Van Kerkhove, WHO Director (a.i) Epidemic and Pandemic Preparedness and Prevention, speaking to journalists in Geneva on Tuesday.

As a precaution, passengers have been asked to remain in their cabins while disinfection and other public health measures are carried out. 

Source: 

Link: https://news.un.org/en/story/2026/05/1167449

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#Spain, Ministry of Health is coordinating with #WHO and international authorities response to #hantavirus #outbreak on MV #Hondius ship

 

• From the outset, Spain activated international health coordination mechanisms together with the WHO, the ECDC, the European Commission, the Netherlands, South Africa, Cape Verde and the Government of the Canary Islands.
• The three symptomatic cases have been evacuated from the ship. The vessel, which will dock in the port of Granadilla de Abona (Tenerife), is carrying only passengers and crew without symptoms.
• Spanish citizens with habitual residence in Spain will be transferred to the Gómez Ulla Central Defense Hospital in Madrid, where they will undergo quarantine under health supervision.
• The Ministry of Health emphasizes that the risk to the general population is very low and reiterates that interpersonal transmission of Andean hantavirus is extremely rare.
• Spain is acting in compliance with the International Health Regulations and its humanitarian and health protection obligations, especially given the presence of Spanish citizens on board.

Madrid, May 6, 2026 - The Minister of Health appeared at a press conference to report on the situation arising from the hantavirus outbreak detected on the MV Hondius ship, a Dutch vessel from Argentina with an initial destination of Cape Verde after passing through South Africa, in which approximately 150 people of 23 different nationalities are traveling, including 14 Spanish citizens.

The minister explained that the Ministry of Health became aware of the situation last week through international health alert and coordination channels, immediately activating joint monitoring with the World Health Organization (WHO), the European Centre for Disease Prevention and Control (ECDC), the European Commission, the countries involved and the Government of the Canary Islands.

Since the beginning of the crisis, there has been constant coordination between all the administrations and institutions involved. The minister noted that she has been in continuous contact with the president of the Canary Islands government, Fernando Clavijo, while the Secretary of State for Health, the Directorate General of Public Health, Foreign Health, and the technical teams have worked in coordination with their regional and international counterparts to share information, assess risks, and prepare the health response.

Current epidemiological situation

According to updated information, the outbreak currently has eight linked cases, of which three have been confirmed by laboratory testing.

- Three deaths (one confirmed by laboratory test).

- A patient admitted to a hospital in Switzerland with a positive test (he disembarked from the ship in Saint Helena)

- Another patient in ICU in South Africa (the third with a diagnosis)

- Three symptomatic patients have already been evacuated by plane from Cape Verde to Amsterdam (one of them is the doctor)

Formal request for collaboration from the WHO

During the appearance, the minister explained that yesterday afternoon a meeting took place between the technical teams of the Ministry of Health and the World Health Organization, in which it was agreed to send a team of international epidemiologists to review the health situation of the ship in Cape Verde.

Subsequently, the WHO stated that Cape Verde does not currently have the necessary capabilities to independently carry out all the epidemiological, environmental and public health assessments required to manage a health incident of this nature.

In light of this situation, the WHO Director-General, Tedros Adhanom Ghebreyesus, formally requested the collaboration of the Spanish State to facilitate the arrival of the MV Hondius and to carry out the necessary health actions under international coordination.

The minister stressed that Spain's actions respond both to humanitarian principles and to international legal obligations derived from the WHO's International Health Regulations, of which Spain is a State Party.

In this regard, he recalled that Articles 13 and 44 of the Regulation establish the duty of technical and logistical cooperation between countries in the face of international health emergencies, while Articles 27 and 28 expressly regulate the management of infection situations on board international means of transport.

He also pointed out that these treaties are part of the Spanish legal system and are fully binding on public administrations.

Development of the health operation

Mónica García explained that the designed operation clearly distinguishes between symptomatic cases and passengers considered close contacts without symptoms.

Active or symptomatic cases will not travel to the Canary Islands. They will be evacuated directly from Cape Verde via medical aircraft to high-isolation hospital units to receive specialized care.

Meanwhile, those continuing their journey to the Canary Islands are close contacts or passengers without symptoms, whose arrival is expected within an estimated period of between 72 and 96 hours.

The disembarkation will be carried out through controlled health circuits, with direct transfer from the port to the airport and subsequent return to their countries of origin, avoiding at all times transit through spaces open to the general population.

Regarding the Spanish citizens on board, the Ministry is currently verifying whether they maintain their habitual residence in Spain. In those cases where this is the case, their evacuation will be carried out through an operation coordinated by the Ministry of Defense, and they will be transferred to the Gómez Ulla Central Defense Hospital in Madrid, where they will undergo the corresponding quarantine under medical supervision.

In case of the appearance of symptoms, the National Health System will activate the state UATAN network to guarantee immediate and safe care.

The minister wanted to convey a message of reassurance to the public, insisting that the risk to the general population remains very low.

Although hantavirus can have a high mortality rate in certain severe clinical forms, especially respiratory ones, the Ministry has explained that the specific context of the outbreak —a ship with close and prolonged cohabitation— much favors the possible interpersonal transmission.

International health authorities have also identified the variant involved as Andean hantavirus, one of the few variants in which human-to-human transmission has been documented. However, both the WHO and the ECDC agree that this type of transmission remains extremely rare and requires very close and prolonged contact, generally with symptomatic individuals.

Source: 

Link: https://www.sanidad.gob.es/gabinete/notasPrensa.do?id=6901

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#Spain will welcome the MV #Hondius vessel to the Canary Islands in compliance with International Law and the humanitarian spirit (Min. Health, May 5 '26)

 

The World Health Organization (WHO), in coordination with the European Union, has just requested that the Spanish government accept the MV Hondius in the Canary Islands in accordance with international law and humanitarian principles.

The vessel is currently in Cape Verde, where it has docked after detecting an outbreak of hantavirus infection.

The European Centre for Disease Prevention and Control (ECDC) is conducting a thorough examination of the ship to determine which individuals require urgent evacuation from Cape Verde. 

The remaining passengers will continue on to the Canary Islands, where they are expected to arrive within three to four days. 

The specific port has not yet been determined. Once there, the crew and passengers will be properly examined, treated, and transferred to their respective countries. 

The process will be managed according to a common protocol for case and contact tracing developed by the WHO and the ECDC, and will include all necessary safety measures. 

Both medical care and transfers will be carried out in special spaces and transports specifically set up for this situation, avoiding all contact with the local population and ensuring the safety of healthcare personnel at all times.

The Government will release the details of this protocol as soon as they are defined by the WHO and the ECDC. It will also provide timely updates on its implementation. 

The World Health Organization has explained that Cape Verde cannot carry out this operation. The Canary Islands are the closest location with the necessary capabilities. Spain has a moral and legal obligation to assist these people, among whom are several Spanish citizens. 

Following this same logic, and as part of the operation, the Government has also accepted a formal request from the Government of the Netherlands to receive the doctor from the MV Hondius, who is in serious condition and will be transported to the Canary Islands today on a hospital aircraft.

Source: 

Link: https://www.sanidad.gob.es/gabinete/notasPrensa.do?id=6900

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#Human spread of #hantavirus not ruled out on cruise #ship (UN News Centre, May 5 '26)

 

By Dominika Tomaszewska-Mortimer in Geneva

5 May 2026 

Hantavirus victims on a ship in the Atlantic Ocean may have been infected prior to joining the cruise and human-to-human transmission on board cannot be ruled out – although it is rare - the World Health Organization (WHO) said on Tuesday.

The deadly disease outbreak has triggered an international public health response. 

Seven individuals of the 147 passengers and crew have been reported ill and three have died in what remains a fluid situation, WHO’s chief of Epidemic and Pandemic Preparedness and Prevention Dr Maria Van Kerkhove told reporters in Geneva.

“One patient is in intensive care in South Africa, although we understand that this patient is improving,” she said, while two patients still on board the ship, which is currently off the coast of Cabo Verde, are being prepared for medical evacuation to the Netherlands for treatment. 

Dr Van Kerkhove stressed that the situation is being closely monitored. As a precaution, passengers have been asked to remain in their cabins while disinfection and other public health measures are carried out. Medical teams from Cabo Verde are providing support on board the ship.

“The plan is, and our highest priority is, to medically evacuate these two individuals” to make sure that they receive the required care, she insisted. 

There are no other symptomatic patients on board. A third suspected case who reported a mild fever at one point “is currently doing well”, the WHO official said.

Spain cooperation

The ship is set to continue on to the Canary Islands. Ahead of arrival, Dr Van Kerkhove said that WHO is working with the Spanish authorities who “have said that they will welcome the ship to do a full epidemiologic investigation, full disinfection of the ship, and of course to assess the risk of the passengers”. 

Hantaviruses are carried by rodents and can cause severe disease in humans. Thousands of infections are estimated to occur each year. People usually get infected through contact with infected rodents or their urine, their droppings, or their saliva. 

Discussing the suspected origins of the outbreak, Dr Van Kerkhove said that the initial patients, a husband and wife, boarded the boat in Argentina. 

“With the timing of the incubation period of hantavirus, which can be anywhere from one to six weeks, our assumption is that they were infected off the ship,” she said. “This was an expedition boat… many of the people on board were doing bird watching” and “seeing a lot of different wildlife.”

The cruise stopped at several islands off the coast of Africa, Dr Van Kerkhove continued, some of which “have a lot of rodents”. 

“There could be some source of infection on the islands as well for some of the other suspect cases,” she said. “However, we do believe that there may be some human-to-human transmission that's happening among the really close contacts” such as the husband and wife and others who have shared cabins.

Past outbreak lessons

Transmission of infection between people is uncommon, but limited spread has been reported among close contacts in previous outbreaks of the Andes virus, which is part of the hantavirus group.

There are no specific treatments for hantavirus other than supportive care. 

“Typically, people will develop respiratory symptoms, so respiratory support is really important,” Dr Van Kerkhove said, stressing that some people require mechanical ventilation. Intensive care may be required, especially if the condition of patients deteriorates.

Directing her message at the people on the boat, where more than 20 nationalities are represented, the WHO official said: “We just want you to know we are working with the ship's operators” and with the travellers’ countries of origin.

“We hear you. We know that you are scared,” she said. “We're trying to make sure that the ship has as much information as they can…that you're cared for and of course, that you get home safely.”

Link: https://news.un.org/en/story/2026/05/1167440

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#Hantavirus #cluster linked to cruise #ship #travel, Multi-country (WHO D.O.N., May 5 '26)

 

Situation at a glance

-- On 2 May 2026, a cluster of passengers with severe respiratory illness aboard a cruise ship was reported to the World Health Organization. 

-- The ship is carrying 147 passengers and crew. 

-- As of 4 May 2026, seven cases (two laboratory confirmed cases of hantavirus and five suspected cases) have been identified, including three deaths, one critically ill patient and three individuals reporting mild symptoms. 

-- Illness onset occurred between 6 and 28 April 2026 and was characterized by fever, gastrointestinal symptoms, rapid progression to pneumonia, acute respiratory distress syndrome and shock. 

-- Further investigations are ongoing. 

-- The outbreak is being managed through coordinated international response, and includes: 

- in-depth investigations, 

- case isolation and care, 

- medical evacuation and 

- laboratory investigations. 

-- Human hantavirus infection is primarily acquired through contact with the urine, faeces, or saliva of infected rodents. 

-- It is a rare but severe disease that can be deadly. 

-- Although uncommon, limited human to human transmission has been reported in previous outbreaks of Andes virus (a specific species of hantavirus). 

-- WHO currently assesses the risk to the global population from this event as low and will continue to monitor the epidemiological situation and update the risk assessment.

Description of the situation

-- On 2 May 2026, WHO received notification from the National International Health Regulations (2005) (IHR) Focal Point 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 a Dutch-flagged cruise ship. 

-- On 2 May 2026, laboratory testing conducted in South Africa confirmed hantavirus infection in one patient who is critically ill and in intensive care. 

-- On 3 May, one additional death was reported. 

-- A further three suspected cases remain on board. 

-- As of 4 May, a total of seven (two confirmed and five suspected) cases, including three deaths, have been reported.

-- The vessel departed Ushuaia, Argentina, on 1 April 2026 and followed an itinerary across the South Atlantic, with multiple stops in remote and ecologically diverse regions, including mainland Antarctica, South Georgia, Nightingale Island, Tristan da Cunha, Saint Helena, and Ascension Island. 

-- The extent of passenger contact with local wildlife during the voyage, or prior to boarding in Ushuaia remains undetermined. 

-- The vessel carries a total of 147 individuals, including 88 passengers and 59 crew members. 

-- Onboard passengers and crew represent 23 nationalities.  

-- As of 4 May 2026, the vessel is moored off the coast of Cabo Verde.

Summary of cases:

-- Case 1: 

- An adult male developed symptoms of fever, headache, and mild diarrhoea on 6 April 2026 while on board the ship. 

- By 11 April, the case developed respiratory distress and died on board on the same day. 

- No microbiological tests were performed. 

- The body of the passenger was removed from the vessel to Saint Helena (a British Overseas Territory) on 24 April.

-- Case 2: 

- An adult female, who was a close contact of case 1, went ashore at Saint Helena on 24 April 2026 with gastrointestinal symptoms. 

- She subsequently deteriorated during a flight to Johannesburg, South Africa, on 25 April. 

- She later died upon arrival at the emergency department on 26 April. 

- On 4 May, the case was subsequently confirmed by PCR with hantavirus infection. 

- Contact tracing for passengers on the flight has been initiated.

- Cases 1 and 2, had travelled in South America, including Argentina, before they boarded the cruise ship on 1 April 2026.

-- Case 3: 

- An adult male presented to the ship's doctor on 24 April 2026 with febrile illness, shortness of breath and signs of pneumonia. 

- On 26 April, his condition worsened. 

- He was medically evacuated from Ascension to South Africa on 27 April, where he is currently hospitalised in an Intensive Care Unit (ICU). 

- Laboratory testing on an extensive respiratory pathogen panel was negative; however, polymerase chain reaction (PCR) testing confirmed hantavirus infection on 2 May 2026. 

- Serology, sequencing and metagenomics are ongoing.

-- Case 4: 

- An adult female, with presentation of pneumonia, died on 2 May 2026. 

- The onset of symptoms was on 28 April, with fever and a general feeling of being unwell.

-- Three suspected cases have reported high fever and/or gastrointestinal symptoms and remain on board. 

- Medical teams in Cabo Verde are evaluating the patients and collecting additional specimens for testing.

Public health response

-- Authorities from States Parties involved in the management of the event to date – Cabo Verde, the Netherlands, Spain, South Africa and the United Kingdom - have initiated coordinated response measures including:

- Ongoing engagement between WHO and the National IHR Focal Points of Cabo Verde, the Netherlands, South Africa, Spain and the United Kingdom, to ensure timely information sharing and coordination of response actions.

- WHO shared information about the events with National IHR Focal Points globally.

- Passengers onboard have been advised to practice maximal physical distancing and remain in their cabins where possible.

- Epidemiological investigations are underway to determine the source of exposure.

- The National IHR Focal Point of Argentina shared the passenger and crew lists with the National IHR Focal Points of the respective countries, according to each person’s nationality.

- In line with the Working Arrangement between the WHO Emergency Medical Team (EMT) Secretariat and the EU Emergency Response Coordination Centre (ERCC), the EMT Secretariat has launched formal discussions to support the clinical management and medical evacuation of symptomatic passengers.

- Logistic support has been provided, including sample collection items.

- Laboratory testing and confirmation of hantavirus infection have been conducted at the National Institute for Communicable Diseases (NICD) of South Africa. Serology, sequencing and metagenomics are ongoing.

- Additional laboratory samples from symptomatic passengers are being sent, with WHO support, to the Institut Pasteur de Dakar, Senegal, for testing.

- 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 risk assessment

-- 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. 

-- In the Americas, Sin Nombre virus is the predominant cause of HPS in North America, while Orthohantavirus andesense is responsible for most cases in South America.

-- 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 problems, such as nausea, vomiting, diarrhoea, and abdominal pain, followed by sudden onset of respiratory distress and hypotension. 

-- Symptoms of HPS typically occur from 2-4 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 (as of epidemiological week 47), in the Region of the Americas, eight countries reported 229 cases and 59 deaths with a CFR of 25.7%. [1] 

-- In the European Region, 1885 hantavirus infection reported in 2023 (0.4 per 100,000), marking the lowest rate observed between 2019 and 2023.[2] 

-- In East Asia, particularly China and the Republic of Korea, Hantavirus haemorrhagic fever with renal syndrome (HFRS) continues to account for many thousands of cases annually, although incidence has declined in recent decades.

-- Hantavirus infections are associated with a case fatality rate of <1–15% in Asia and Europe and up to 50% in the Americas. 

-- While there are no specific 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.

-- WHO currently assesses the risk to the global population from this event as low and will continue to monitor the epidemiological situation and update the risk assessment as more information becomes available.

WHO advice

-- WHO advises that States Parties involved in this event continue efforts in detection, investigation, reporting, case management, infection control, and public health management on board, including ship sanitation measures, in close coordination with the conveyance operator, to prevent and control infections caused by hantaviruses.

-- In the context of the current outbreak, passengers and crew members should practice frequent hand hygiene, remain vigilant of Hantavirus symptoms and undertake active symptom monitoring for 45 days.  

-- Crew must ensure adequate environmental cleaning (avoiding dry sweeping) and ventilation in the ship. 

-- Passengers and crew members experiencing symptoms should inform medical professionals on board and self-isolate. 

-- If respiratory symptoms are present to practice respiratory etiquette and wear a medical mask.

-- Vigilance among travellers, crew, including those involved in implementing ship sanitation measures, or other personnel returning from areas where hantavirus is known to be present, as well as on conveyances engaged in eco-tourism on a journey from and through those areas, is essential.

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

-- Diagnosis of HPS is with serologic testing for IgM or rising titres of IgG antibodies using enzyme-linked immunoassay (ELISA) or with reverse transcriptase polymerase chain reaction (RT–PCR) to detect viral RNA.

-- In healthcare environments, standard precautions* should be applied for all patients, including hand hygiene and safe handling of blood and body fluids. 

-- In addition to standard precautions, transmission-based precautions should be implemented for management of suspect or confirmed cases. 

-- Standard precautions combined with droplet precautions during close contact are considered sufficient. 

-- Routine airborne precautions are not typically required, except during aerosol‑generating procedures. [3]

-- 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 superadded 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 HCPS, close monitoring and early transfer to ICU are critical for more severe cases. 

-- Mechanical ventilation, meticulous volume control, and vasopressors may be required. 

-- For severe cardiopulmonary insufficiency, extracorporeal mechanical oxygenation may be lifesaving. 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 HCPS and is not licensed for either treatment or prophylaxis of hantavirus pulmonary syndrome. 

-- At present, there is no specific antiviral treatment approved for HCPS.

-- 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 standard and transmission-based infection prevention and control practices, and include rodent control strategies. 

-- Most routine tourism activities carry little or no risk of exposure to rodents or their excreta.

-- The potential for human-to-human transmission should be considered in areas where Andes and potentially other South American hantaviruses are endemic.

-- Individuals engaging in outdoor activities where endemic transmission is known, such as visiting rural areas, camping or hiking, should take precautions to minimise potential exposure to infectious materials.

-- Risk communication and community engagement interventions should prioritize transparent, timely, and culturally appropriate communication to raise awareness of hantavirus transmission risks—particularly exposure to rodent excreta in endemic areas—and promote practical preventive behaviours such as safe food storage, avoiding contact with rodents, wet-cleaning methods (no dry sweeping), and proper ventilation. 

-- Community engagement strategies should involve local leaders and workers in high-risk occupations to co-develop and disseminate tailored messages, address misinformation, and reinforce early care seeking.

-- Surveillance for HPS should be integrated into a comprehensive national surveillance system and include clinical, laboratory, and environmental components. The implementation of integrated environmental management strategies aimed at reducing rodent populations is also recommended.

-- WHO advises against the application of any travel or trade restrictions based on the current information available on this event. 

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{*} 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

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

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

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

-- Pan American Health Organization / World Health Organization (PAHO/WHO). 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.

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

-- 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

-- 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. Vector surveillance and control at ports, airports and ground crossings https://www.who.int/publications/i/item/9789241549592

-- Standard precautions for the prevention and control of infections: aide-memoire

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[1] 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 

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

[3] Standard precautions for the prevention and control of infections: aide-memoire. https://www.who.int/publications/i/item/WHO-UHL-IHS-IPC-2022.1 

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Citable reference: 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

Source: 

Link: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON599

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