Understanding Hantavirus: What Healthcare Facilities Need to Know

Recent reports of hantavirus cases linked to the MV Hondius cruise ship have raised questions among healthcare providers, infection prevention professionals, and environmental services (EVS) professionals. On May 2, 2026, the World Health Organization (WHO) was notified of a cluster of severe acute respiratory illness (SARI) among passengers and crew of a cruise ship in the Atlantic Ocean.¹

^{Image Source: https://www.cdc.gov/hantavirus/hcp/clinical-overview/index.html}

On May 6, 2026, WHO confirmed that the type of hantavirus responsible for this outbreak as the Andes virus.¹ As of May 15, 2026, WHO has reported 10 cases (8 confirmed, 2 probable), including three deaths.² Investigations are ongoing to assess exposure risk among passengers onboard and any individuals who may have been exposed. On May 8, 2026, the Centers for Disease Control and Prevention (CDC) issued a Health Alert (“HAN”) and on May 12, 2026, the CDC published the event as international outbreak.^3,4

While these developments are being closely monitored by public health authorities, the current risk to the general public in the United States remains low.⁴

Below is what you need to know about hantavirus and its implications for environmental hygiene and infection prevention.

What to know about the Andes virus

^{Image Source: CDC}

Hantaviruses are a group of enveloped viruses that can cause severe respiratory disease in people called hantavirus Pulmonary Syndrome (HPS) and viral hemorrhagic fever (VHF). The mortality rate in the Americas is 25.7%.⁵

Transmission primarily occurs through the inhalation of aerosolized rodent urine, droppings or saliva, making exposure to contaminated environments the primary risk factor.⁵

The Andes virus, a specific type of hantavirus, is unique in that it can spread person-to-person. However, this mode of transmission is rare and typically occurs through limited close contact with an infected individual and/or touching an object or surface contaminated with the virus, then touching the mouth, nose or eyes.⁶

Signs and symptoms of infection appear 4 to 42 days after exposure and early symptoms can look like other respiratory viruses and include:⁶

• Headache
• Fever
• Muscle ache/back pain
• Nausea or vomiting
• Diarrhea
• Cough
• Chest pain
• Loss of appetite
• Difficulty breathing

According to the CDC, people are typically only infectious while they have symptoms.⁵

Infection prevention guidelines for the Andes virus

As mentioned, the risk of the Andes virus remains low for the general public. CDC guidelines reiterate the same precautions we have in place for other hantaviruses. These include:⁶

• Avoiding areas infested with rodents
• Avoiding spread between people by:
  ○ Washing hands frequently
  ○ Avoiding kissing and sexual contact with someone who may have Andes virus
  ○ Maintaining distance from someone who may have been exposed to the Andes virus

Currently, suspect and exposed persons are being managed in US Regional Emerging Special Pathogen Treatment Centers (RESPTCs).7 Because all contacts are being very closely monitored, the likelihood of a case presenting to a frontline hospital or other healthcare setting in the US is low. However, should a suspect case turn up, the following infection prevention and control measures are recommended:

Patient management

• Isolation: Use of airborne infection isolation rooms (AIIR)⁹

Infection control precautions

• Personal Protective Equipment (PPE): Ensure that all healthcare personnel entering the patient’s room are equipped with:⁸
  ○ Gown
  ○ Gloves
  ○ Eye protection (i.e., goggles or a face shield that covers the front and sides of the face) ○ NIOSH-approved particulate respirator equipped with N95 filters or higher
• Perform frequent hand hygiene per facility policy
• Handle waste in accordance with U.S. Department of Transportation regulations. Note that any solid waste (including used PPE and linens) generated associated with the patient’s care is to be managed as Category A waste — a waste stream that is separate from the typical regulated medical waste stream. Consider quarantining this waste until the diagnosis is confirmed.^9,10
• Avoid activities that could aerosolize viral particles, such as dry dusting, sweeping or vacuuming. Use wet cleaning methods whenever possible.¹¹
• Use EPA-registered hospital-grade disinfectants with emerging viral pathogen claims. The Andes virus (hantavirus) is an emerging viral pathogen situation defined by EPA’s policy. Products with Emerging Viral Pathogens claims may be found on EPA's List Q.

While the Andes virus outbreak underscores the need for vigilance, it does not signal a shift in overall risk for U.S. healthcare settings. Instead, it reinforces a familiar reality for infection prevention professionals: rare pathogens with high severity demand consistent execution of foundational practices.

Adherence to airborne precautions, appropriate PPE use, hand hygiene, and rigorous environmental hygiene, particularly avoiding aerosolization and following approved disinfection protocols, remain the most effective and reliable defenses. Maintaining readiness through these core principles ensures that healthcare facilities are well positioned to respond safely and effectively.