Cruise ship deaths spark hantavirus outbreak fears: What to know about the rodent-borne virus

A luxury cruise ship is currently being held off the coast of West Africa after a suspected outbreak of hantavirus—a rare infectious disease typically carried by rodents—killed three passengers and infected three others.  

The World Health Organization (WHO) shared the news of the suspected outbreak in a post to X.

According to the organization, one case of hantavirus on the ship, MV Hondius, had been confirmed through laboratory testing, and there are five additional suspected cases.

Of those six affected individuals, three have died and one is currently in intensive care in South Africa.

According to an official update from Dutch company Oceanwide Expeditions, the operator of the ship, two crew members are still on board the ship with acute respiratory symptoms, both of whom require immediate care. As of Monday morning, medics were working to evacuate them.

Meanwhile, 149 passengers remain stuck on the ship as local medical teams and authorities work to determine how to proceed.

“Strict precautionary measures are in process on board, including isolation measures, hygiene protocols and medical monitoring,” Oceanwide’s statement reads. “All passengers have been informed and are being supported.”

Foster Mohale, a spokesman for the National Department of Health in South Africa, told The New York Times that “There is no need for the public to panic, because only two patients from the cruise ship have been within our borders.”

As the situation develops, here’s what to know about the hantavirus:

What is hantavirus?

Hantaviruses are a family of viruses that can cause serious illness and, in some cases, death. 

According to the Centers for Disease Control and Prevention (CDC), hantavirus infection can lead to two main syndromes:

• hantavirus pulmonary syndrome (HPS), which is typically found in the Western hemisphere
• hemorrhagic fever with renal syndrome (HFRS), which is typically found in Europe and Asia

As of the end of 2023, the CDC reported 890 total confirmed cases of hantavirus disease in the U.S. since surveillance began in 1993. 

How does it spread?

All hantaviruses spread primarily through contact with rodents.

Typically, the Mayo Clinic notes, infection is caused by “inhaling hantaviruses that have become airborne from rodent urine, droppings, or saliva.”

Hantaviruses can also spread through contact with infected people, though the WHO says these cases are extremely rare. 

What are the symptoms?

While HPS and HFRS are both diseases caused by hantavirus strains, their symptoms and impacts are different. 

HPS is a disease that affects the lungs. Symptoms typically start to show between one and eight weeks after contact with an infected rodent and, in early stages, include markers like fatigue, fever, and muscle aches.

As the disease progresses, late-stage symptoms look like coughing and shortness of breath. Per the CDC, 38% of people who develop respiratory symptoms die from the disease. 

Unlike HPS, HFRS primarily impacts the kidneys. Symptoms usually develop between one to two weeks after contact with an infected rodent, and include intense headaches, back and abdominal pain, fever, blurred vision, and nausea.

Later symptoms include low blood pressure, internal bleeding, and acute kidney failure.

The severity of the disease depends on which strain of hantavirus infected the patient, as some (Hantaan and Dobrava, for example) lead to more severe illness, while others (Seoul, Saaremaa, and Puumala) are typically less harmful.

How to prevent hantavirus from spreading

Given that hantavirus is primarily carried and spread by rodents, both the CDC and the Mayo Clinic say that eliminating contact with rodents is the best way to avoid infection.

That means sealing holes or gaps in your home or garage, cleaning up any easy-to-access food, setting traps, and taking precautions (like a mask, gloves, and disinfectant) while cleaning up any rodent droppings.

In regard to the MV Hondius outbreak, Hans Kluge, the WHO’s regional director for Europe, told Reuters, “The risk to the wider public remains low,” adding that there’s no need for panic or travel restrictions.

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