What is hantavirus? What to know after 3 deaths tied to a cruise ship outbreak

• Hantavirus has been linked to three deaths on a cruise ship in the Atlantic Ocean, the WHO said.
• The health agency said it has confirmed at least five cases, including passengers who left the ship.
• The WHO said there is no need for concern or for travel restrictions.

Hantavirus has been linked to the deaths of three people who were aboard a cruise ship in the Atlantic Ocean, the World Health Organization said. Still, those with coming trips don't need to worry, according to experts.

"While this is a serious incident, the WHO assesses the public risk as low," said WHO Director-General Dr. Tedros Adhanom Ghebreyesus in a May 7 media briefing.

Eight cases of hantavirus have been reported, including the three deaths, according to the briefing. Five cases have been confirmed to be hantavirus through lab testing, and three are suspected.

The cases occurred on the MV Hondius, a cruise ship which can carry up to 170 passengers in 80 cabins, according to Oceanwide Expeditions, its Dutch operator.

Business Insider has reached out to Oceanwide Expeditions for comment.

The WHO confirmed that the specific type of hantavirus involved in the case is Andes hantavirus, which is known to have limited human-to-human transmission.

Health agencies are conducting a detailed investigation, including laboratory tests and epidemiological investigations.

The Centers for Disease Control and Prevention said in a statement that US officials are closely monitoring the situation and that the current risk to Americans is extremely low.

What we know about the hantavirus outbreak

The first hantavirus case on the ship involved a man who developed symptoms on April 6 and died on the ship on April 11, Tedros said. The symptoms were similar to those of other respiratory illnesses, so hantavirus was not suspected at the time.

The man's wife also developed symptoms and went ashore during a stop at the island of St. Helena, a British territory in the Atlantic. She was briefly on board a flight from Johannesburg, but was removed before takeoff due to her medical condition, according to a statement from carrier KLM Royal Dutch Airlines. She died the next day, April 26. Samples later confirmed she had hantavirus.

The third death linked to hantavirus was a woman on the ship who developed symptoms on April 28 and died on May 2, Tedros said.

Four other ship passengers, who developed symptoms, were evacuated for treatment: one is in intensive care, two are stable in the hospital, and one is asymptomatic.

The eighth known case is a cruise ship passenger who disembarked in St. Helena. He later saw a doctor in Zurich and was confirmed to be infected with hantavirus on May 6.

It's possible that more cases will be reported, as the incubation period of Andes hantavirus can be up to 6 weeks, according to Tedros.

The WHO is currently investigating other potential cases involving people with symptoms who were in contact with passengers of the ship, he said.

There are currently no other symptomatic passengers or crew on board the ship, which is en route to the Canary Islands, according to WHO, where containment protocols and medical monitoring will be implemented.

How is hantavirus spread?

Hantaviruses are carried by rodents and can cause severe illness in humans, including a life-threatening respiratory disease.

The virus typically spreads through contact with the urine, feces, or saliva of infected rodents.

The Andres hantavirus strain, involved in the current outbreak, can spread between humans, but transmission is uncommon.

"In previous outbreaks of Andes virus, transmission between people has been associated with close and prolonged contact, particularly among household members, intimate partners, and people providing medical care. That appears to be the case in the current situation," Tedros said.

Regarding hantavirus cases on the cruise ship, Dr. Benjamin Brennan, a senior lecturer at MRC-University of Glasgow Centre for Virus Research, said: "Not enough information is known about how this outbreak started. But due to the strong linkage to rodent-borne transmission, rodents are likely to be somehow implicated."

He added that the spread of the hantavirus "is usually associated with cleaning/dusting properties that have been dormant over winter where rodents have encroached into the property."

While infectious disease outbreaks on cruise liners are not uncommon, he said, pointing to norovirus, it's not yet clear whether the fact that the situation occurred on a cruise ship is relevant.

How contagious is hantavirus?

While Andes hantavirus can spread from person to person, it's less common than with other respiratory viruses.

"This is not COVID. This is not influenza. It spreads very, very differently," Maria Van Kerkhove, an epidemiologist, said during the WHO briefing.

Hantavirus appears to be most contagious during the early phase of the illness, according to the WHO.

Early symptoms can include fever, headache, body aches, nausea, and vomiting. The disease can progress to serious conditions, such ashantavirus cardiopulmonary syndrome, which can cause coughing and fluid buildup in the lungs. Hantavirus can also cause a severe illness called hemorrhagic fever with renal syndrome that can progress to kidney failure.

Hantavirus vaccine and prevention

There is currently no vaccine for hantavirus, although virologists are working to develop one.

To reduce the risk of hantavirus infection, the WHO recommends reducing contact between rodents and people in most cases. That includes proper food safety and storage, as well as workplace hygiene.

The WHO is working to prevent human-to-human transmission by tracing the travel of confirmed patients, monitoring for symptoms among anyone in contact with the ship's passengers, and distributing diagnostic kits.

Cure for hantavirus

There is no specific treatment or cure for hantavirus. Patients are typically treated by addressing symptoms, such as providing breathing support if necessary, according to the CDC.

Severe cases of hantavirus and related complications are sometimes treated with antiviral medications such as ribavirin, although no therapies are currently approved by the FDA or similar regulators.

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