The World Health Organization (WHO) declared a hantavirus outbreak on May 4, 2026, after three passengers on the MV Hondius died and tested positive for hantavirus. The outbreak became the first to occur on a cruise ship.
Hantaviruses are zoonotic viruses that naturally infect rodents and are occasionally transmitted to humans. An infection in people can result in severe illness and often death, but the diseases vary by type of virus and geographical location.
The transmission of hantaviruses to humans occurs from prolonged contact with contaminated urine, droppings or saliva of infected rodents. Activities that involve contact with rodents, such as cleaning enclosed or poorly ventilated spaces, farming, forestry work and sleeping in rodent-infested areas, increase risk of exposure
In the Americas, hantaviruses are known to lead to hantavirus cardiopulmonary syndrome (HCPS), a rapidly progressive condition that impacts the lungs and heart, with a fatality rate up to 50%. In Europe and Asia, hantaviruses are known to cause hemorrhagic fever with renal syndrome (HFRS), impacting the kidneys and blood vessels, with a fatality rate of 1-15%.
There is no cure for the hantavirus diseases and all treatment focuses on close clinical monitoring and management of respiratory, cardiac and kidney complications.
The MV Hondius is a Dutch cruise ship whose voyage was scheduled to be weeks long. It departed April 1, 2026, from Ushuaia, Argentina and included destinations for Antarctica and other islands in the South Atlantic. However, in less than a week of departure, the first passenger fell ill.
On April 6, a 70-year-old Dutch man fell ill with symptoms including a fever, headache and mild diarrhea. According to WHO, both the man and his wife reportedly went sightseeing in Ushuaia and traveled around other areas in Argentina and Chile. On April 11, the man developed respiratory issues and died on the ship.
The man’s cause of death was not determined at the time. On April 15, six additional people joined the cruise when the ship made a stop at Tristan da Cunha, while the man’s body remained on board.
The man’s body was finally removed from the ship on April 24 at St. Helena. Here, his wife debarked along with over two dozen other passengers.
On April 25, the man’s wife took a commercial flight from St. Helena to South Africa with 88 other passengers and crew members, and on April 26, she died in South Africa after collapsing at the airport.
On April 27, the MV Hondius departed from St. Helena. The same day, a British man from the ship was evacuated to South Africa, where he was put in intensive care at a hospital with symptoms including fever, shortness of breath and signs of pneumonia.
On April 28, another passenger, a German woman, fell ill, and by May 2, she died on board. On the same day, South African health officials received a positive test for hantavirus from the British man, identifying the virus for the first time.
On May 4, South African officials received a posthumous positive result for hantavirus for the Dutch man’s wife, who died after collapsing at the airport. This is when WHO considered the virus an outbreak.
On May 5, the cruise ship was in conflict with Cape Verde authorities concerning the evacuation of more sick people and the possibility of letting other passengers and crew members debark. Although Cape Verde sent more health workers to the ship for assistance, they stated that no one could leave the ship, leaving one passenger and two crew members, including the ship’s doctor, critically ill.
On May 6, MV Hondius set sail for Spain’s Canary Island, and of those three people, two tested positive for the hantavirus and were evacuated from the ship and flown to specialized hospitals in Europe. Authorities in Switzerland announced an additional positive hantavirus test on a man who left the cruise earlier in St. Helena. At this time, health authorities in South Africa and Switzerland said it was specifically the Andes virus strain.
The Andes virus is the only documented human-to-human transmission of the hantaviruses in the Americas and is uncommon. Transmission between people has been associated with close and prolonged contact, particularly with household members, and appears during the early phase of illness when the virus is more transmissible.
After docking at Tenerife, the largest island of Spain’s Canary Islands, on May 10, passengers began flying home on military and government planes, leaving fewer than 60 passengers aboard. The destinations included Spain, France, Canada, the Netherlands, Britain, Ireland, Turkey and the United States. After reaching their destination, a French woman and an American tested positive for Hantavirus.
On May 18, the cruise ship ended its voyage at the Dutch port of Rotterdam. The ship carried a total of 150 passengers and crew members from 23 countries, with 11 people infected with the hantavirus, including three who died. Dutch authorities made quarantine arrangements for the ship’s skeleton crew, which consists of 27 people.
The ship’s operator, Oceanwide Expeditions, stated everyone who is still on board is asymptomatic and being closely monitored either in quarantine facilities or in self-isolation. The body of the German woman who died May 2 remained on board throughout the remainder of the cruise. Her body will be removed, and the ship will undergo deep cleaning and disinfection.
The French passenger that tested positive for the hantavirus remains in intensive care at Bichat Hospital. Although an official at Bichat told The Associated Press that the patient was on a life-support system with an artificial lung pumping blood, the hospital authority stated that is not the case and said the gravity of the patient’s condition could lead to this type of treatment.
In total, 18 American passengers were on the cruise ship. 16 were flown to the University of Nebraska Medical Center and then taken to the National Quarantine Unit for assessment and monitoring. The American passenger that tested positive for the hantavirus but showed no symptoms was taken to the Biocontainment Unit. The remaining two were sent to a similar unit at Emory University Hospital in Atlanta.
WHO Director-General Tedros Adhanom Ghebreyesus stated that the general public should not be worried about the outbreak and the risk to the public is low. Ghebreyesus stated, “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.”
