US Flies Back American Passengers from Cruise Ship Affected by Hantavirus Exposure

Updated May 11 Report:
The U.S. Department of Health and Human Services, working through the Administration for Strategic Preparedness and Response and the Centers for Disease Control and Prevention, is assisting the U.S. Department of State in the medical repatriation of 17 American citizens from the cruise ship MV Hondius following confirmed and suspected cases of the Andes variant of hantavirus.¹

All 17 passengers are currently being transported to the United States via a State Department-organized airlift. Out of precaution, 2 individuals are traveling in onboard biocontainment units. Among the group, 1 passenger is experiencing mild symptoms consistent with hantavirus infection, while another has tested mildly PCR-positive for the Andes virus.¹

Upon arrival, the patients will be transferred to the University of Nebraska Medical Center’s Regional Emerging Special Pathogen Treatment Center (RESPTC) in Omaha for initial evaluation and care. Depending on clinical assessments, the individual with symptoms will then be moved to a secondary specialized treatment center for continued monitoring and treatment.¹

Health officials emphasized that each passenger will receive individualized clinical assessment and supportive care based on their condition, as part of coordinated federal efforts to manage potential high-consequence infectious disease exposure.¹

Luis A. Marcos, MD, who has treated a patient with hantavirus, provides insights around the Andes virus, which is the species involved in the ongoing outbreak cluster on the cruise ship, as well as its transmissibility and treatment.

Updated May 7 Report:

The World Health Organization (WHO) is coordinating an international response after a cluster of hantavirus cases was identified aboard the MV Hondius, with 8 reported infections and 3 deaths confirmed so far. Five of the cases have had positive test results for the Andes virus, the only hantavirus species known to allow limited human-to-human transmission through close and prolonged contact.² Speaking to reporters today, WHO Director-General Tedros Adhanom Ghebreyesus, PhD, emphasized that the overall public health threat remains limited despite the seriousness of the incident. “While this is a serious incident, WHO assesses the public health risk as low,” he said, adding that “it’s possible that more cases may be reported” because of the virus’s incubation period. WHO is working with multiple countries under the International Health Regulations, which guide international cooperation during cross-border public health emergencies.²

WHO officials said their immediate focus is on patient care, passenger safety, and preventing further transmission.2

“Our priorities are to ensure the affected patients receive care, that the remaining passengers on the ship are kept safe and treated with dignity, and to prevent any further spread of the virus,” he said. Since being notified of the outbreak on May 2, the WHO has deployed an expert to the ship to conduct medical assessments of passengers and crew and gather information on potential exposures. The agency has also arranged for the shipment of 2500 diagnostic kits from Argentina to laboratories in 5 countries and is preparing operational guidance for the safe disembarkation and onward travel of those onboard.²

Updated May 5 Report:

As of May 4, 2026, 7 cases have been identified, including 2 laboratory-confirmed hantavirus infections and 5 suspected cases. Among those affected, 3 individuals have died, 1 remains critically ill, and 3 have reported mild symptoms. Illness onset occurred between April 6 and 28, with patients initially presenting with fever and gastrointestinal symptoms before rapidly progressing to pneumonia, acute respiratory distress syndrome, and shock.³

Investigations into the outbreak are ongoing and are being managed through a coordinated international response. Efforts include detailed epidemiological investigations, case isolation and clinical care, medical evacuations, and laboratory testing to better understand the extent and source of the outbreak.³

Hantavirus infection in humans is typically acquired through contact with the urine, feces, or saliva of infected rodents. Although rare, the disease can be severe and sometimes fatal. Limited human-to-human transmission has been documented in past outbreaks involving the Andes virus, a specific hantavirus strain. At present, the World Health Organization assesses the risk to the global population as low and continues to monitor the situation and update its risk assessment as new information becomes available.³

Original May 4 Report:

The World Health Organization (WHO) is actively supporting a public health response to a hantavirus-related incident aboard a cruise vessel traveling in the Atlantic Ocean, following reports of severe illness among passengers. Health officials have confirmed 1 case of hantavirus infection, with 5 additional suspected cases currently under investigation. Among the 6 affected individuals, 3 have died and 1 remains in intensive care in South Africa, underscoring the seriousness of the situation.⁴

Public health authorities are conducting detailed epidemiological and laboratory investigations to better understand the source and spread of the infections. Efforts include virus sequencing and expanded testing, while medical care continues for both passengers and crew. The WHO is also coordinating with national authorities and the ship’s operators to facilitate the medical evacuation of 2 symptomatic individuals and ensure appropriate monitoring and support for those still onboard.⁴

Hantavirus infections are typically associated with exposure to infected rodents, particularly through contact with their urine or feces. Although rare, limited person-to-person transmission has been documented, raising concern in confined settings such as cruise ships. The infection can lead to severe respiratory illness, requiring prompt recognition and supportive care.⁴

In response, the WHO has activated coordination mechanisms under the International Health Regulations, notifying national focal points and preparing a public Disease Outbreak News update. Officials emphasized that rapid response and cross-border collaboration remain critical to managing the outbreak and minimizing further risk.⁴

“WHO is working closely with member states and a ship’s operators in response to suspected cases of hantavirus detected onboard a cruise liner,” said WHO Director-General Tedros Adhanom Ghebreyesus in a tweet.⁵

About Hantavirus

According to the Centers for Disease Control and Prevention, “The hantaviruses are a family of viruses which can cause serious illnesses and death. These viruses cause diseases like hantavirus pulmonary syndrome (HPS) and hemorrhagic fever with renal syndrome (HFRS). They are spread mainly by rodents and are not spread from person-to-person.”⁶

Hantaviruses are responsible for 2 main disease syndromes. In the Western Hemisphere, including the United States, they cause HPS, most commonly transmitted by the deer mouse.⁶

A second condition, HFRS, includes a group of related illnesses caused by hantaviruses primarily found in Europe and Asia. However, Seoul virus—a hantavirus that leads to HFRS—has a global presence and is also found in the United States.⁶

HPS

HPS is a serious and potentially fatal respiratory illness. Symptoms typically develop 1 to 8 weeks after exposure to an infected rodent.⁶

Early signs often include fatigue, fever, and muscle aches—particularly in large muscle groups such as the thighs, hips, back, and sometimes the shoulders. About half of patients also report headaches, dizziness, chills, and gastrointestinal symptoms such as nausea, vomiting, diarrhea, and abdominal pain.⁶

Four to 10 days after the initial phase, more severe symptoms can develop, including coughing and shortness of breath. As the disease progresses, fluid can accumulate in the lungs, leading to chest tightness and difficulty breathing. HPS can be deadly, and 38% of people who develop respiratory symptoms may die from the disease.⁶

HFRS

HFRS is a serious and sometimes fatal illness that primarily affects the kidneys. Symptoms typically appear within 1 to 2 weeks after exposure, though in rare cases, they may take up to 8 weeks to develop.⁶

The illness usually begins with symptoms such as intense headaches, back and abdominal pain, fever, chills, nausea, and blurred vision. Some patients may also experience facial flushing, redness or inflammation of the eyes, or a rash.⁶

As the disease progresses, more severe complications can occur, including low blood pressure, shock due to reduced blood flow, internal bleeding caused by vascular leakage, and acute kidney failure that can lead to dangerous fluid buildup.⁶

Disease severity varies depending on the specific virus. Infections caused by Hantaan and Dobrava viruses tend to be more severe, with fatality rates of 5% to 15%. In contrast, infections from Seoul, Saaremaa, and Puumala viruses are generally milder, with mortality rates below 1%. Recovery can take several weeks to months.⁶

Unfortunately, there is no specific treatment for hantavirus infection. Patients receive supportive care, including rest, hydration, and treatment of symptoms.⁶

References
1.@HHS. May 10, 2026. Accessed May 11, 2026.
https://x.com/HHSGov/status/2053656580118216985
2. WHO’s response to hantavirus cases linked to a cruise ship. World Health Organization. May 7, 2026. Accessed May 7, 2026.
https://www.who.int/news/item/07-05-2026-who-s-response-to-hantavirus-cases-linked-to-a-cruise-ship
3. Hantavirus cluster linked to cruise ship travel, multi-country. World Health Organization. May 4, 2026. Accessed May 5, 2026.
https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON599
4.@WHO. WHO is aware of and supporting a public health event involving a cruise vessel sailing in the Atlantic Ocean. May 3, 2026. Accessed May 4, 2026.
https://x.com/WHO/status/2051029427614818551?s=20
5. @DrTedros. May 3, 2026. Accessed May 4, 2026.
https://x.com/DrTedros?lang=en
6. About hantavirus. Centers for Disease Control and Prevention. May 13, 2024. Accessed May 4, 2026. https://www.cdc.gov/hantavirus/about/index.html