The situation aboard the MV Hondius is continuing to evolve, with three deaths linked to the outbreak. But what is hantavirus and how does it spread?
A rodent-borne disease is suspected of causing an outbreak aboard a cruise ship that has left three people dead and several others ill, with health authorities now investigating the possibility of rare human-to-human transmission.
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Studies indicate hantaviruses have been around for centuries, with outbreaks documented in Asia and Europe.
Here’s what you need to know about hantavirus, how it spreads, and why this outbreak is raising concern.
Cruise ship outbreak: What’s happening on the MV Hondius?
Three passengers have died and eight others have been sickened by hantavirus on board the Dutch-flagged MV Hondius cruise ship, which remains marooned off the coast of Cape Verde with nearly 150 people onboard.
The ship left Argentina on 1 April on an Atlantic cruise and was scheduled to include stops in Antarctica, the Falkland Islands and other locations, though its itinerary has since changed due to the outbreak.
The head of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, said three patients with suspected hantavirus cases have been evacuated and are on their way to the Netherlands.
“At this stage, the overall public health risk remains low,” he wrote on his X account.
Passengers remain isolated in their cabins while the ship awaits permission to dock in Spain’s Canary Islands following a request involving European health authorities.
"Our days have been close to normal, just waiting for authorities to find a solution," passenger Qasem Elhato said. "But morale on the ship is high and we’re keeping ourselves busy with reading, watching movies, having hot drinks and that kind of things."
Meanwhile, Maria Van Kerkhove of the WHO said officials are investigating possible human-to-human transmission - something considered extremely rare - and believe the first infected person likely contracted the virus before boarding. Authorities have also said there are no rats on board.
A case linked to the ship has also been confirmed in Switzerland, while health authorities in South Africa and Switzerland have identified a strain capable of spreading between humans in rare cases.
What is hantavirus?
Hantavirus refers to a group of viruses carried by rodents, primarily transmitted to humans through inhalation of airborne particles from dried rodent droppings.
According to the US Centers for Disease Control and Prevention, hantaviruses can cause two serious illnesses.
The first is hantavirus pulmonary syndrome, which affects the lungs and can lead to severe respiratory failure. The second is haemorrhagic fever with renal syndrome, which affects the kidneys and can cause serious complications.
How does it spread?
Contact with infected rodents or their urine, saliva, or droppings - especially when these materials are disturbed and become airborne - is the primary way that the hantavirus spreads.
People are typically exposed in enclosed or poorly ventilated spaces such as homes, cabins, or sheds where rodent activity is present.
Though rare, the World Health Organization says hantaviruses can also spread directly between people - which is now being investigated in the case of the MV Hondius outbreak.
Australian virus researcher Paul Griffin told the Australian News Agency that around 150,000 to 200,000 hantavirus infections are identified worldwide each year.
"It is very rare that it spreads from human to human," he said.
What are the symptoms?
Early detection of the virus is difficult, as it frequently starts with everyday flu-like symptoms.
“Early in the illness, you really may not be able to tell the difference between hantavirus and having the flu,” says Sonja Bartolome of UT Southwestern Medical Center in Dallas.
Symptoms early on can consist of fever, chills, muscle pain, and headache. But the virus does not take long to become more serious.
For the hantavirus pulmonary syndrome, the symptoms show up one to eight weeks after exposure to the virus and can develop into severe breathing problems when the lungs start filling up with fluid.
Hemorrhagic fever with renal syndrome primarily affects the kidneys and can lead to low blood pressure, internal bleeding, and acute kidney failure.
How dangerous is it?
Death rates vary depending on the strain.
According to the Centres for Disease Control and Prevention, hantavirus pulmonary syndrome is fatal in about 35% of cases, while hemorrhagic fever with renal syndrome has a rate ranging from 1% to 15%.
Is there a cure?
There is currently no specific treatment or cure for hantavirus infections.
Patients typically receive supportive care, which can include oxygen therapy, mechanical ventilation, and, in severe cases, dialysis. Early medical attention significantly improves survival chances.
Despite decades of research, many aspects of the disease remain unclear.
The best way to avoid the virus is to reduce contact with rodents and their droppings. When cleaning up rodent droppings, it's recommended to use protective gloves and bleach.
Public health experts also caution against sweeping or vacuuming droppings, as it can cause the virus to get into the air.
Have there been any other recent hantavirus cases?
While the most recent suspected outbreak has been aboard the MV Hondius, there was a high-profile last year involving Betsy Arakawa, the wife of Gene Hackman, who died in February 2025 at their home in Santa Fe, New Mexico.
An autopsy confirmed she died from hantavirus pulmonary syndrome. Reports indicated she had been searching for flu-like symptoms in the days before her death.
Evidence of rodent activity was later found on the property, which may have been the source of exposure.