1887
  1. Home
  2. Eurosurveillance
  3. Volume 31, Issue 22, 04/Jun/2026
  4. Article
Rapid communication Open Access
Like 0
Download

Abstract

A cruise ship-associated Andes hantavirus outbreak has raised questions usually associated with respiratory viruses, including transmissibility and pandemic risk. Although Andes virus may enter through the respiratory route, cause severe respiratory disease and under close contact spread between humans, it differs fundamentally from SARS-CoV-2. The ecology is rodent-borne, pathogenesis is vascular, diagnosis is centred on blood PCR and serology, and genetic diversity is mainly shaped by reservoir ecology and geography rather than by sustained human-to-human transmission and immune selection.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Closure
A corrected article has been published for this content:
Author’s correction for Euro Surveill. 2026;31(22)
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2026.31.22.2600428
2026-06-04
2026-07-18
/content/10.2807/1560-7917.ES.2026.31.22.2600428
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/31/22/eurosurv-31-22-1.html?itemId=/content/10.2807/1560-7917.ES.2026.31.22.2600428&mimeType=html&fmt=ahah

References

  1. World Health Organization (WHO). Hantavirus outbreak linked to cruise ship travel, multi-locations. Geneva: WHO; 28 May 2026. Available from: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON604
  2. European Centre for Disease Prevention and Control (ECDC). Threat assessment brief: Hantavirus-associated cluster of illness on cruise ship. Stockholm: ECDC; 6 May 2026. Available from: https://www.ecdc.europa.eu/en/publications-data/threat-assessment-brief-hantavirus-associated-cluster-illness-cruise-ship-ecdc
  3. Taylor SL, Schmaljohn CS, Williams EP, Jonsson CB. Pathogenicity and virulence of rodent-borne Orthohantaviruses. Virulence. 2025;16(1):2553784.  https://doi.org/10.1080/21505594.2025.2553784  PMID: 40878034 
  4. Jangra RK, Herbert AS, Li R, Jae LT, Kleinfelter LM, Slough MM, et al. Protocadherin-1 is essential for cell entry by New World hantaviruses. Nature. 2018;563(7732):559-63.  https://doi.org/10.1038/s41586-018-0702-1  PMID: 30464266 
  5. Rowe RK, Pekosz A. Bidirectional virus secretion and nonciliated cell tropism following Andes virus infection of primary airway epithelial cell cultures. J Virol. 2006;80(3):1087-97.  https://doi.org/10.1128/JVI.80.3.1087-1097.2006  PMID: 16414986 
  6. Sungnak W, Huang N, Bécavin C, Berg M, Queen R, Litvinukova M, et al. SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes. Nat Med. 2020;26(5):681-7.  https://doi.org/10.1038/s41591-020-0868-6  PMID: 32327758 
  7. Gavrilovskaya IN, Gorbunova EE, Mackow NA, Mackow ER. Hantaviruses direct endothelial cell permeability by sensitizing cells to the vascular permeability factor VEGF, while angiopoietin 1 and sphingosine 1-phosphate inhibit hantavirus-directed permeability. J Virol. 2008;82(12):5797-806.  https://doi.org/10.1128/JVI.02397-07  PMID: 18367532 
  8. Lamers MM, Haagmans BL. SARS-CoV-2 pathogenesis. Nat Rev Microbiol. 2022;20(5):270-84.  https://doi.org/10.1038/s41579-022-00713-0  PMID: 35354968 
  9. Vial PA, Ferrés M, Vial C, Klingström J, Ahlm C, López R, et al. Hantavirus in humans: a review of clinical aspects and management. Lancet Infect Dis. 2023;23(9):e371-82.  https://doi.org/10.1016/S1473-3099(23)00128-7  PMID: 37105214 
  10. Andrews JR, Bogoch II. Andes virus transmission dynamics. 16 May 2026. Available from: https://github.com/jasonandr/Andes-virus-epi
  11. Galmiche S, Cortier T, Charmet T, Schaeffer L, Chény O, von Platen C, et al. SARS-CoV-2 incubation period across variants of concern, individual factors, and circumstances of infection in France: a case series analysis from the ComCor study. Lancet Microbe. 2023;4(6):e409-17.  https://doi.org/10.1016/S2666-5247(23)00005-8  PMID: 37084751 
  12. Pizarro E, Navarrete M, Mendez C, Zaror L, Mansilla C, Tapia M, et al. Immunocytochemical and ultrastructural evidence supporting that Andes hantavirus (ANDV) is transmitted person-to-person through respiratory and/or salivary pathways. Front Microbiol. 2020;10:2992.  https://doi.org/10.3389/fmicb.2019.02992  PMID: 31998273 
  13. Ferrés M, Martínez-Valdebenito C, Henriquez C, Marco C, Angulo J, Barrera A, et al. Viral shedding and viraemia of Andes virus during acute hantavirus infection: a prospective study. Lancet Infect Dis. 2024;24(7):775-82.  https://doi.org/10.1016/S1473-3099(24)00142-7  PMID: 38582089 
  14. Züst R, Ackermann-Gäumann R, Liechti N, Siegrist D, Ryter S, Portmann J, et al. Presence and persistence of Andes virus RNA in human semen. Viruses. 2023;15(11):2266.  https://doi.org/10.3390/v15112266  PMID: 38005942 
  15. Wu Y, Guo Z, Yuan J, Cao G, Wang Y, Gao P, et al. Duration of viable virus shedding and polymerase chain reaction positivity of the SARS-CoV-2 Omicron variant in the upper respiratory tract: a systematic review and meta-analysis. Int J Infect Dis. 2023;129:228-35.  https://doi.org/10.1016/j.ijid.2023.02.011  PMID: 36804640 
  16. Bwire GM, Majigo MV, Njiro BJ, Mawazo A. Detection profile of SARS-CoV-2 using RT-PCR in different types of clinical specimens: A systematic review and meta-analysis. J Med Virol. 2021;93(2):719-25.  https://doi.org/10.1002/jmv.26349  PMID: 32706393 
  17. Wölfel R, Corman VM, Guggemos W, Seilmaier M, Zange S, Müller MA, et al. Virological assessment of hospitalized patients with COVID-2019. Nature. 2020;581(7809):465-9.  https://doi.org/10.1038/s41586-020-2196-x  PMID: 32235945 
  18. Zhao S, Cao P, Gao D, Zhuang Z, Wang W, Ran J, et al. Modelling COVID-19 outbreak on the Diamond Princess ship using the public surveillance data. Infect Dis Model. 2022;7(2):189-95.  https://doi.org/10.1016/j.idm.2022.05.005  PMID: 35637656 
  19. Yamagishi T, Kamiya H, Kakimoto K, Suzuki M, Wakita T. Descriptive study of COVID-19 outbreak among passengers and crew on Diamond Princess cruise ship, Yokohama Port, Japan, 20 January to 9 February 2020. Euro Surveill. 2020;25(23):2000272.  https://doi.org/10.2807/1560-7917.ES.2020.25.23.2000272  PMID: 32553062 
  20. Jimi H, Hashimoto G. Challenges of COVID-19 outbreak on the cruise ship Diamond Princess docked at Yokohama, Japan: a real-world story. Glob Health Med. 2020;2(2):63-5.  https://doi.org/10.35772/ghm.2020.01038  PMID: 33330779 
  21. Maes P, Tischler N. Statement from the International Hantavirus Society and members of the international hantavirus research and clinical community regarding Andes virus transmission and the current outbreak investigation. Version 5. 19 May 2026. Available from: https://zenodo.org/records/20095475
  22. Liu Y, Rocklöv J. The effective reproductive number of the Omicron variant of SARS-CoV-2 is several times relative to Delta. J Travel Med. 2022;29(3):taac037.  https://doi.org/10.1093/jtm/taac037  PMID: 35262737 
  23. Andronico A, Tran Kiem C, Bosetti P, Paireau J, Consortium Emergen, Fontanet A, et al. Impact du variant Omicron sur l'epidemie COVID-19 et son controle en France metropolitaine durant l'hiver 2021-2022. [Impact of the Omicron variant on the COVID-19 epidemic and its control in metropolitan France during the winter of 2021-2022]. Paris: Institut Pasteur; 27 Dec 2021. French. Available from: https://modelisation-covid19.pasteur.fr/variant/Institut_Pasteur_Impact_dOmicron_sur_lepidemie_francaise_20211227.pdf
  24. Perez-Guzman PN, Knock E, Imai N, Rawson T, Santoni CN, Alcada J, et al. Epidemiological drivers of transmissibility and severity of SARS-CoV-2 in England. Nat Commun. 2023;14(1):4279.  https://doi.org/10.1038/s41467-023-39661-5  PMID: 37460537 
  25. Martínez VP, Di Paola N, Alonso DO, Pérez-Sautu U, Bellomo CM, Iglesias AA, et al. “Super-spreaders” and person-to-person transmission of Andes virus in Argentina. N Engl J Med. 2020;383(23):2230-41.  https://doi.org/10.1056/NEJMoa2009040  PMID: 33264545 
  26. Ferres M, Vial P, Marco C, Yanez L, Godoy P, Castillo C, et al. Prospective evaluation of household contacts of persons with hantavirus cardiopulmonary syndrome in chile. J Infect Dis. 2007;195(11):1563-71.  https://doi.org/10.1086/516786  PMID: 17471425 
  27. Manica M, De Bellis A, Guzzetta G, Mancuso P, Vicentini M, Venturelli F, et al. Intrinsic generation time of the SARS-CoV-2 Omicron variant: An observational study of household transmission. Lancet Reg Health Eur. 2022;19(39):100446.  https://doi.org/10.1016/j.lanepe.2022.100446  PMID: 35791373 
  28. Frediani JK, Parsons R, McLendon KB, Westbrook AL, Lam W, Martin G, et al. The new normal: delayed peak SARS-CoV-2 viral loads relative to symptom onset and implications for COVID-19 testing programs. Clin Infect Dis. 2024;78(2):301-7.  https://doi.org/10.1093/cid/ciad582  PMID: 37768707 
  29. Long QX, Liu BZ, Deng HJ, Wu GC, Deng K, Chen YK, et al. Antibody responses to SARS-CoV-2 in patients with COVID-19. Nat Med. 2020;26(6):845-8.  https://doi.org/10.1038/s41591-020-0897-1  PMID: 32350462 
  30. Kallio-Kokko H, Vapalahti O, Lundkvist A, Vaheri A. Evaluation of Puumala virus IgG and IgM enzyme immunoassays based on recombinant baculovirus-expressed nucleocapsid protein for early nephropathia epidemica diagnosis. Clin Diagn Virol. 1998;10(1):83-90.  https://doi.org/10.1016/S0928-0197(97)10019-8  PMID: 9646005 
  31. Plante JA, Liu Y, Liu J, Xia H, Johnson BA, Lokugamage KG, et al. Spike mutation D614G alters SARS-CoV-2 fitness. Nature. 2021;592(7852):116-21.  https://doi.org/10.1038/s41586-020-2895-3  PMID: 33106671 
  32. Twohig KA, Nyberg T, Zaidi A, Thelwall S, Sinnathamby MA, Aliabadi S, et al. Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study. Lancet Infect Dis. 2022;22(1):35-42.  https://doi.org/10.1016/S1473-3099(21)00475-8  PMID: 34461056 
  33. Ramsden C, Melo FL, Figueiredo LM, Holmes EC, Zanotto PM, VGDN Consortium. High rates of molecular evolution in hantaviruses. Mol Biol Evol. 2008;25(7):1488-92.  https://doi.org/10.1093/molbev/msn093  PMID: 18417484 
  34. Tay JH, Porter AF, Wirth W, Duchene S. The emergence of SARS-CoV-2 variants of concern is driven by acceleration of the substitution rate. Mol Biol Evol. 2022;39(2):msac013.  https://doi.org/10.1093/molbev/msac013  PMID: 35038741 
  35. Laubscher F. Complete sequence of Orthohantavirus andesense virus: Swiss resident 2026. Virological.org. 8 May 2026. Available from: https://virological.org/t/complete-sequence-of-orthohantavirus-andesense-virus-swiss-resident-2026/1023
  36. Palacios G. Preliminary analysis of Orthohantavirus andesense virus sequences from a cruise-ship related cluster, May 2026. Virological.org. 10 May 2026. Available from: https://virological.org/t/preliminary-analysis-of-orthohantavirus-andesense-virus-sequences-from-a-cruise-ship-related-cluster-may-2026/1029
  37. Bellomo CM, Alonso DO, Pérez-Sautu U, Prieto K, Kehl S, Coelho RM, et al. Andes virus genome mutations that are likely associated with animal model attenuation and human person-to-person transmission. MSphere. 2023;8(3):e0001823.  https://doi.org/10.1128/msphere.00018-23  PMID: 37097182 
  38. Warner BM, Prévost J, Tailor N, Deschambault Y, Sloan A, Allarie J, et al. High genomic stability of Andes virus following successive passage in vivo in Syrian hamsters. J Virol. 2025;99(8):e0051225.  https://doi.org/10.1128/jvi.00512-25  PMID: 40704892 
Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error