One of cruise passengers’ biggest fears is the spread of infectious diseases at sea.
Two Texans were recently on a cruise ship, and 147 passengers and crew members may have been infected with hantavirus. Hantaviruses are serious and potentially fatal respiratory viruses that originate from rodent feces. The outbreak was reported to the World Health Organization on May 2, 2026, and the disease was quickly identified as an Andean strain of hantavirus.
In the United States, hantavirus infections are rare, with fewer than 900 cases reported between 1993 and 2023. When infections occur in the United States, they usually cause hantavirus pulmonary syndrome (HPS), a serious respiratory infection. Asian hantavirus strains can also cause hemorrhagic fever with renal syndrome (HFRS), which can cause the kidneys to shut down.
Andes virus usually spreads from person to person within the first 24 hours after developing a fever. This means that patients who have been unwell for several days and have severe symptoms are at low risk of spreading the virus.
Unlike the new coronavirus that caused COVID-19, this strain of hantavirus does not pose a pandemic risk. While this is good news, this outbreak is a stark reminder that serious viruses can emerge wherever humans and animals coexist.
What is hantavirus?
Hantaviruses are actually a group of at least 20 viruses within a genus called hantaviruses. orthohantavirus. Each virus species exhibits unique characteristics.
Rodents such as rats and mice are the most common carriers. You can become infected with hantavirus by coming into contact with or inhaling particles from infected rodent feces, urine, saliva, or in rare cases from a rodent bite. This often occurs when people are exposed to aerosolized rodent urine. You can inhale the virus while cleaning, dusting, or doing other activities that stir up dry rodent urine.
In the latest case, global health officials suspect the passengers may have been exposed to hantavirus before boarding the cruise ship. These tourist boats can be breeding grounds for hantaviruses due to their close quarters and crowding.
Andes virus is the only known strain of hantavirus that can be transmitted from human to human through respiratory droplets. Most strains are unable to spread beyond the human host. This particular strain is typically transmitted in the Andean region of South America.
The Sin Nombre virus strain is more common in the southwestern United States, where 10 to 50 cases are reported annually. It is usually spread by deer mice and other rodents, but is generally not transmitted from person to person. Hantavirus pulmonary syndrome, which is likely caused by the Sin Nombre strain, was recognized as the cause of death of actor Gene Hackman’s wife Betsy Arakawa in February 2025.
In 1993, an outbreak of the Sin Nombre strain of hantavirus occurred in western Colorado in the Four Corners region, where Colorado, Arizona, Utah, and New Mexico meet. More than 50 patients developed hantavirus pulmonary syndrome, and the outbreak led to the recognition of hantaviruses as a traceable disease in the United States in 1995.
Unlike the novel coronavirus that causes COVID-19, hantaviruses do not pose a large-scale pandemic risk. ”
John Beckham, MD, Chief of the Department of Infectious Diseases and Geographical Medicine, Utah Southwestern University
What are the symptoms of hantavirus infection?
The time from exposure to onset of symptoms is 1 to 8 weeks. However, once symptoms appear, they progress rapidly.
hantavirus pulmonary syndrome
HPS typically occurs in two phases. In phase 1, initial flu-like symptoms occur, including:
- fatigue
- heat
- Severe muscle pain (thighs, hips, back, etc.)
- dizziness
- cold
- headache
- nausea, vomiting, diarrhea
- abdominal pain
The second stage begins 4 to 10 days later with the onset of respiratory symptoms such as coughing, shortness of breath, and chest tightness caused by the buildup of excess fluid in the lungs. Hantaviruses also cause a drop in white blood cell counts as the body tries to eliminate the infection. Approximately 38% of people develop respiratory symptoms due to hantavirus pulmonary syndrome, and the infection can lead to death.
Hemorrhagic fever with renal symptoms
People with early signs of HFRS may experience flu-like symptoms, including back or abdominal pain, blurred vision, severe headaches, flushed face, bloodshot eyes, and rashes on the body. Phase 2 symptoms include:
- low blood pressure
- decreased blood flow
- internal bleeding
- Kidney failure that causes severe fluid retention
Up to 15% of people with hemorrhagic fever with renal syndrome caused by the Dobrava or Hantan hantavirus strains may die from this infection. More moderate strains of the virus, such as Soul virus, Saaremaa virus, and Puumara virus, typically have a mortality rate of less than 1% of cases. The infection that causes HFRS is more common in Asia and Europe.
How is hantavirus diagnosed and treated?
Diagnosis of hantavirus is complex. Patients often develop acute respiratory distress with fluid leakage into the lungs, high fever, or other serious symptoms before seeking medical attention. Infectious disease specialists can examine patients and order testing for zoonotic diseases (viruses such as hantaviruses that spread from animals to humans). In many hospitals, these samples are sent to an outside laboratory, which can take several days to analyze and provide a final diagnosis.
University of Texas Southwestern infectious disease experts are actively improving their ability to diagnose hantavirus in the field. We are working with epidemiologists to develop a new sequencing lab that will allow us to analyze viral and bacterial samples at UTSW for their genetic material without having to send them to a third-party lab. Our goal is to have the lab up and running by 2027.
There is currently no treatment or vaccine for hantavirus. Treatment usually involves managing symptoms and often includes hydration, rest, and breathing support. In the intensive care unit, doctors may use extracorporeal membrane oxygenation (ECMO), or a ventilator, to help people breathe until their lungs heal.
If you have a high fever or severe body aches, contact your doctor. Even if hantavirus is not the cause, these symptoms may indicate a serious illness. Be especially careful if you have symptoms that don’t usually occur together, such as flu-like symptoms with skin rash, confusion, or memory loss.
How can I prevent hantavirus infection?
Although hantavirus infections are rare in the United States, they can occur not only during travel but also in areas where rodents are present, such as attics and garages, as seen recently.
To reduce your risk, take the following precautions:
- please wear a mask In an area that has become uninhabited. Examples include cleaning sheds that have been vacant for a period of time, or working in environments where there may have been a rodent infestation or where rodent droppings have been found.
- Ensure proper ventilationIf you are working in a space where there may have been rodent activity, filter the air and open windows and doors.
- avoid direct contact With rodent feces or urine if possible.
Hantavirus has been dominating the headlines lately, but that doesn’t necessarily mean you need to cancel your vacation plans this summer. Hundreds of cruises depart without incident every day. That being said, it’s important to be aware of the potential risks when large groups gather in close proximity.
If you develop serious respiratory symptoms, do not delay treatment. Consult your doctor immediately. Remember any details that might help with your diagnosis, such as recent travel or spring cleaning. The more information you share, the earlier diagnosis can be made and the more likely you are to avoid serious respiratory complications.
sauce:
UT Southwestern Medical Center
