Abstract
Has the re-emergence of Hantavirus infection on a cruise ship threatened yet another COVID-like pandemic? On 2 May, an outbreak of Hantavirus infection on a cruise ship sailing from Argentina to Europe was reported to the World Health Organization (WHO). A cluster of passengers was affected by severe respiratory illness. A total of eight cases linked to the ship were identified. Three deaths have been reported in April and May 2026 (case fatality rate 38%). Six cases have been laboratory-confirmed as Hantavirus infections, with all identified as Andes virus (ANDV). The cruise ship departed from Ushuaia, Argentina, on 1 April 2026, and travelled across the South Atlantic Ocean, stopping at several remote locations, including Antarctica, South Georgia Island, Tristan da Cunha, Saint Helena and Ascension Island. It carried 147 people (86 passengers and 61 crew members) from 23 countries. One of the affected persons was the ship doctor, and the other was a ship guide. The WHO Chief has stated that it is highly unlikely that Hantavirus would spread to human populations. However, the horror of the coronavirus pandemic remains in the minds of global citizens.
Hantavirus disease is not a new infection, but a re-emerging viral disease known from ancient times, although it was microbiologically detected only in the latter half of the twentieth century. Hantavirus infections are relatively uncommon globally. In 2025, in the WHO Region of the Americas, 229 cases and 59 deaths were reported, and 1,885 cases in the European Region. Hantavirus haemorrhagic fever with renal syndrome (HFRS) accounts for several thousand cases annually in East Asian countries.
Hantavirus is harboured by rodents and is primarily a zoonotic disease. Humans may contract the virus by coming into contact with rodent droppings and secretions, or with fomites contaminated by them. Human-to-human spread is rare. When dried rodent droppings or excreta are transported with dust, they can enter the human lungs and cause a pneumonia-like disease, Hantavirus Cardiopulmonary Syndrome (HCPS), also known as hantavirus pulmonary syndrome. Human-to-human transmission of Hantavirus occurs only with the ANDV strain and only in South America. Hantaviruses found in Europe and Asia are known to cause HFRS, which primarily affects the kidneys and blood vessels. Human-to-human transmission has not been documented with these strains.
Re-emerging viral infections have posed a serious threat to human populations worldwide, while there is a significant shift in disease burden patterns with the rising prevalence of diabetes, hypertension, cardiovascular and cerebrovascular diseases, cancers, and injuries and accidents. Nevertheless, emerging infections (e.g., COVID) and re-emerging infections are of great public health importance, as they may take epidemic form, affect many people, and cause deaths. The recent Ebola epidemic in Congo and Uganda is currently raging in these countries. The outbreak is caused by the Bundibugyo strain, a rarer form of Ebola for which there is no vaccine and no treatment. As of 21 May, 746 cases and 176 deaths have been reported in Congo. The disease is 25%–35% fatal. The nearby country of Uganda is also reporting an outbreak of Ebola. The WHO has declared the epidemic a public health emergency.
There is a continuing need to build public health competencies to identify, investigate, and contain epidemics, strengthen health systems, and build their capacity and preparedness to manage public health disasters. Strengthening ongoing surveillance and monitoring is crucial for the early detection of outbreaks and disease trends.