Hantavirus outbreak on cruise ship not ‘another COVID’, WHO clarifies

• A hantavirus outbreak aboard a cruise ship in the Atlantic Ocean poses a low global public health risk and is “not the start of another COVID pandemic”, the World Health Organisation (WHO) said on May 7.

• WHO Director-General Tedros Adhanom Ghebreyesus said eight cases had been reported so far, including five laboratory-confirmed infections and three suspected cases linked to the rare Andes strain of hantavirus.

• Three people have died and several others have fallen ill aboard the Dutch-flagged MV Hondius, prompting a major international public health response involving countries across Europe, Africa and Latin America.

• The first alert came from the United Kingdom, which notified WHO under International Health Regulations (IHR) of the outbreak after passengers aboard the vessel developed severe respiratory illness during the trip from Argentina to Cabo Verde.

• The first known patient developed symptoms on April 6 and later died aboard the vessel. His wife also became ill and died after being evacuated to South Africa, where laboratory testing confirmed hantavirus infection.

• Prior to boarding, the pair had travelled through Argentina, Chile and Uruguay on a birdwatching trip, including visits to sites where the rodent species known to carry the virus is present.

• Another passenger died on May 2 and one man remains in intensive care in South Africa. WHO said his condition is improving. Other patients have been transferred to hospitals in the Netherlands for treatment.

• More than 140 passengers and crew members are still aboard the ship.

• Spain has agreed to allow the vessel to dock in the Canary Islands after Cabo Verde declined the request because of public health concerns.

• Infection has occurred in a confined setting involving prolonged close contact among passengers aboard the ship, similar to a limited Andes hantavirus outbreak recorded in Argentina in 2018-2019. 

• In that case, transmission was linked to a social gathering involving a symptomatic individual and resulted in only a small number of cases.

• WHO officials are clear that the outbreak is very different from the 2020 coronavirus pandemic which killed millions worldwide.

• This is not SARS-CoV-2. Hantaviruses have been around for quite a while, they said.

• The outbreak has triggered action under the International Health Regulations, the global framework designed to coordinate responses to cross-border health threats.

• WHO is working closely with authorities in Cabo Verde, Spain, the Netherlands, South Africa, the United Kingdom and Argentina, alongside the European Centre for Disease Prevention and Control.

Key facts on hantavirus:

• Hantaviruses are zoonotic viruses carried by rodents and are usually transmitted to humans through contact with infected animals or their urine, saliva or droppings.

• Infection may also occur, although less commonly, through rodent bites. 

• Activities that involve contact with rodents such as cleaning enclosed or poorly ventilated spaces, farming, forestry work and sleeping in rodent-infested dwellings increase exposure risk.

• Hantaviruses belong to the family Hantaviridae, within the order Bunyavirales. 

• Each hantavirus is typically associated with a specific rodent reservoir species, in which the virus causes long‑term infection without apparent illness.

• Although many hantavirus species have been identified worldwide, only a limited number are known to cause human disease.

• Worldwide, it is estimated that from 10,000 to over 100,000 infections occur each year, with the largest burden in Asia and Europe.

• The Andes strain, found in parts of Latin America, is the only known hantavirus capable of limited human-to-human transmission.

• When it occurs, transmission between people has been associated with close and prolonged contact, particularly among household members or intimate partners, and appears most likely during the early phase of illness, when the virus is more transmissible.

• Hantavirus found in the Western Hemisphere can cause hantavirus pulmonary syndrome (HPS). The most common hantavirus that causes HPS in the US is spread by the deer mouse.

• HPS is a severe and potentially deadly disease that affects the lungs. It can be deadly. About 38 per cent of people who develop respiratory symptoms may die from the disease.

• Hemorrhagic fever with renal syndrome (HFRS) is a group of clinically similar illnesses caused by hantaviruses found mostly in Europe and Asia. However, Seoul virus, a type of hantavirus that causes HFRS, is found worldwide.

• HFRS is a severe and sometimes deadly disease that affects the kidneys.

• There is no specific treatment for hantavirus infection. Patients should receive supportive care, including rest, hydration, and treatment of symptoms.