Hantavirus outbreak update: Cruise ship passengers return to U.S. as case of Andes strain confirmed

As countries continue to deal with a hantavirus outbreak linked to passengers aboard the M/V Hondius cruise ship, government and public health agencies have begun repatriating both those confirmed to have the virus and those potentially exposed to it.

This includes the United States, where 17 American citizens who were on board the ship are being repatriated by the U.S. State Department.

Here’s what you need to know.

What’s happened?

On Monday night, the U.S. Department of Health & Human Services (HHS) confirmed that the repatriation of Americans aboard the M/V Hondius cruise ship had begun.

In a post on X, the HHS said that its Administration for Strategic Preparedness and Response (ASPR) division, along with the Centers for Disease Control and Prevention (CDC), is supporting the U.S. Department of State with the repatriation of 17 Americans who were on board the cruise ship.

That repatriation is being spearheaded by the State Department, which is airlifting the cruise passengers from Tenerife, Spain, where the ship was allowed to dock, to Offutt Air Force Base in Omaha, Nebraska.

The 17 Americans are being flown to Omaha because that’s where the National Quarantine Center at the University of Nebraska is located.

The National Quarantine Center is a federally funded facility, which “provides unmatched quarantine monitoring and care for those exposed to high-consequence pathogens,” according to the center’s website.

The HHS confirmed that two of the 17 Americans being airlifted are traveling in the plane’s biocontainment units. This is because one of these passengers has tested “mildly” positive for the Andes strain of hantavirus, and the other is currently experiencing “mild symptoms,” according to the HHS.

What are the symptoms of hantavirus?

Symptoms can start anywhere from one to eight weeks after initial exposure to the hantavirus, according to the CDC. The symptoms can also come in two waves.

Early symptoms include fatigue, fever, and muscle aches, “especially in the large muscle groups like the thighs, hips, back, and sometimes shoulders,” the CDC notes.

Some patients also experience headaches, dizziness, chills, nausea, vomiting, diarrhea, or abdominal pain.

Late symptoms typically appear four to 10 days after the early symptoms and can include coughing, shortness of breath, chest tightness, and fluid in the lungs.

Hantaviruses can cause a disease known as hantavirus pulmonary syndrome (HPS), which the CDC says can kill about 38% of the people who come down with the condition.

Is there a risk to the wider public?

It’s possible, but experts think it’s unlikely. Most hantaviruses can only spread from animals, such as rats, to humans.

But the Andes strain, which is the strain that has infected some of the cruise passengers, can be transmitted from human to human.

Worse, the CDC says symptoms of infection may not appear for up to 42 days, and since the virus is believed to be most transmissible when symptoms are present, the affected passengers could be contagious for a long time.

However, in a May 8 notice, the CDC also stated that the “risk to the public’s health in the United States is considered extremely low at this time.” This is because the Andes strain of hantavirus does not spread easily from person to person.

As the HHS noted in a May 10 statement, “transmission is rare and limited to close-contact settings.”

In part because of its difficulty in transmitting between people, public health officials have stressed that the Andes hantavirus outbreak is not another COVID-19 situation.

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