Hantavirus: Case fatality rate, source, prevention — WHO, Spain race to contain Andes strain
Person-to-person spread, high fatality rate put health systems on heightened alert
Global health authorities are intensifying efforts to contain a rare outbreak of hantavirus on the MV Hondius cruise ship.
On Sunday, the cruise ship arrived in the Spanish island of Tenerife off west Africa.
As of May 10, 2026, the Andes strain of hantavirus has caused a total of 7 total cases — 3 deaths, 2 confirmed and 5 suspected — among 147 passengers and crew.
Andes, the variant of hantavirus involved in these infections, can cause hantavirus pulmonary syndrome (HPS), a severe and potentially deadly disease that affects the lungs, authorities warm.
The Andes strain has now claimed three lives, while others have been evacuated from the ship for medical treatment.
Updates as of May 10, 2026
147 passengers are expected to disembark in a carefully managed repatriation operation involving multiple nations.
MV Hondius will anchor at the Port of Granadilla, in the Canary Islands.
The passengers will be evacuated to their home countries after tests to confirm they remain without symptoms, officials said.
17 Americans are set to disembark the MV Hondius, get CDC escort to US on charter plane
No cases of Andes virus have been reported in the US as a result of this outbreak; overall risk to travelers and the American public remains "extremely low", as per the CDC.
Suspected source of outbreak
The outbreak likely originated from contaminated rodent waste during a shore excursion in Argentina, with the ship en route to Tenerife in Spain's Canary Islands for containment.
VACCINE, CARE: Hantaviruses cause severe illness via rodent excreta, saliva, or urine, with symptoms like fever progressing to respiratory failure. No vaccine exists, but supportive care aids recovery. This South American strain's rare person-to-person spread underscores the need for isolation, as per the CDC.
While most hantaviruses spread via rodents, this strain enables limited human-to-human transmission through close contact, raising concerns but not widespread panic.
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What WHO says
The World Health Organization rates the general public risk as low, stressing it "does not spread like COVID-19" and requires prolonged close exposure. Director-General Tedros Adhanom Ghebreyesus visited Tenerife to coordinate, assuring locals of preparations despite the virus's 25-50% mortality rate. WHO is tracking earlier disembarked passengers and aiding global contact tracing.
Case fatality rate for hantavirus infections
Hantavirus infections are associated with a case fatality rate of <1–15% in Asia and Europe and up to 50% in the Americas, according to the latest WHO update.
Treatment for hantavirus
While there are no licensed treatment nor vaccines for hantavirus infections, early supportive care and immediate referral to a facility with a complete ICU can improve survival.
Symptoms
HPS is characterised by the following:
headache,
Dizziness,
Dhills,
Fever,
Myalgia
Gastrointestinal symptoms, such as nausea, vomiting, diarrhoea, and abdominal pain
A sudden onset of respiratory distress and hypotension.
Appearance of symptoms
Symptoms of HPS typically occur from 1-6 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.
Spain's response so far
Authorities in Spain, with the European Centre for Disease Prevention and Control, are readying Tenerife's Granadilla Port for the ship's arrival early Sunday local time.
Plans include full disinfection, epidemiological probes, and nationality-based disembarkation with military escorts to airports, starting with 14 Spanish passengers to Madrid for quarantine. They're also probing a suspected Alicante case from a related flight.
US repatriation plans
Over 100 passengers remain aboard, including 17 Americans, none yet testing positive.
CDC officials confirm no mandatory quarantine; repatriated Americans will be evaluated in Nebraska, then monitor symptoms at home for 42 days with limited public contact. State health departments are tracking returnees.
Cases in Americas, Europe, Asia
In 2025, in the Region of the Americas, eight countries reported 229 cases and 59 deaths with a CFR of 25.7%. In the European Region, 1885 hantavirus infections were reported in 2023 (0.4 per 100 000), marking the lowest rate observed between 2019 and 2023.
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.
WHO FACT FILE: 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. Hantaviruses found in Europe and Asia are known to cause haemorrhagic fever with renal syndrome (HFRS), which primarily affects the kidneys and blood vessels.
Human-to-human transmission
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.
