Could Hantavirus become the next Covid?

KATHMANDU: A growing international health alert has emerged after an outbreak of the Andes strain of hantavirus aboard the Dutch-operated cruise ship MV Hondius, raising concerns over the rare possibility of human-to-human transmission.

The vessel, operated by Oceanwide Expeditions, departed Argentina on April 1 carrying more than 150 passengers from 28 countries, including the United Kingdom, the United States and Spain.

According to reports, three people — including two Dutch nationals — have died following the outbreak, while at least five laboratory-confirmed infections have been identified.

Around 150 passengers were later allowed to disembark safely, but international contact tracing efforts are still underway for passengers who had already traveled onward to different countries.

Governments in several countries have urged former passengers and their close contacts to seek medical attention and remain in quarantine.

The World Health Organization has reportedly activated international monitoring and control mechanisms under global health regulations while assessing the overall risk as low but requiring heightened vigilance.

Health alerts have reportedly been issued to 12 countries, including the United Kingdom, the United States, Canada, Germany, the Netherlands, Switzerland, Singapore and Turkey.

Symptoms among passengers reportedly began appearing on April 6, while the first death was recorded on April 11. The illness was initially believed to be a common respiratory infection before hantavirus infection was confirmed following further testing.

Oceanwide Expeditions stated that 30 passengers disembarked at Saint Helena on April 24, including a Dutch couple. The husband reportedly died aboard the vessel, while the wife later also died.

Subsequent infections identified in Johannesburg and Switzerland reportedly helped confirm the outbreak as hantavirus-related. Authorities in Canada’s British Columbia province have also confirmed infection in a cruise passenger who remains in isolation, while close contacts are being monitored.

What is hantavirus?

Hantavirus refers to a group of more than 20 viruses belonging to the Hantaviridae family. The virus was first identified in 1978 near the Hantan River in South Korea, from which its name is derived.

The virus usually spreads to humans through contact with urine, saliva or droppings from infected rodents, or by inhaling contaminated airborne particles. Human-to-human transmission is considered extremely rare.

However, experts say the Andes strain — mainly found in Argentina and Chile — is the only known hantavirus variant capable of spreading between people through prolonged close contact, especially in enclosed spaces or through exposure to bodily fluids.

Unlike COVID-19, hantavirus is not considered highly airborne or rapidly transmissible.

Global infection trends

According to health data cited in the report:

• Europe recorded 1,885 cases of hantavirus-related hemorrhagic fever with renal syndrome (HFRS) in 2023.
• Eight countries in the Americas reported 229 hantavirus cases and 59 deaths in 2025.
• The United States recorded only 890 confirmed cases between 1993 and 2023.
• Human-to-human transmission has previously been documented only in South America, including a 2018–2019 outbreak in which 34 people were infected and 11 died.

Symptoms and risks

Symptoms generally appear between two and four weeks after infection, though the incubation period can range from one to eight weeks.

Early symptoms include:

• Fever
• Chills
• Headache
• Muscle pain
• Fatigue
• Dizziness
• Nausea and vomiting
• Diarrhea
• Abdominal pain

Severe cases can later develop into breathing difficulties, fluid buildup in the lungs, falling blood pressure and respiratory failure.

Hantavirus can lead to two major syndromes:

• Hantavirus Pulmonary Syndrome (HPS), which severely affects the lungs
• Hemorrhagic Fever with Renal Syndrome (HFRS), which primarily damages the kidneys

Older adults and people with chronic illnesses are considered more vulnerable to severe complications.

Diagnosis and treatment

Health experts classify cases into four categories:

• Suspected case: Individuals with symptoms who recently traveled to affected areas or had contact with infected persons.
• Probable case: Symptomatic individuals epidemiologically linked to confirmed cases but not yet laboratory tested.
• Confirmed case: Infection verified through RT-PCR or serological testing.
• Negative case: Individuals who test negative or complete the incubation period without symptoms.

There is currently no specific cure, vaccine or approved antiviral treatment for hantavirus infection. Patients receive supportive and symptomatic care only.

Experts have also warned against misinformation and unnecessary panic circulating on social media, urging the public to rely solely on official health authorities for accurate information.

Prevention measures

Health specialists emphasize that personal and environmental hygiene remain the most effective preventive measures.

Recommended precautions include:

• Controlling rodent populations
• Keeping homes and surroundings clean
• Sealing possible rodent entry points
• Wearing gloves, masks and protective gear while cleaning rodent waste
• Washing hands regularly with soap and water
• Avoiding crowded areas when symptomatic
• Maintaining physical distance from suspected cases
• Using face masks when necessary

People experiencing fever, respiratory problems or unusual symptoms are advised to seek immediate medical attention.

Nepal’s preparedness

Nepal has not officially confirmed any hantavirus infections so far.

However, a report by the US Centers for Disease Control and Prevention (CDC) previously documented a Spanish traveler who tested positive for hantavirus after returning from Nepal in 2017. The traveler reportedly had exposure to rodents while staying in local lodges.

Although the Andes strain’s rodent carriers are not known to exist in Nepal and no infected cruise passengers are believed to have entered the country, experts warn that international travel, weak surveillance systems and limited testing capacity mean the risk cannot be entirely dismissed.

Nepal currently lacks domestic laboratory facilities capable of diagnosing hantavirus infections. Authorities have yet to clarify whether testing kits will be imported or whether suspected samples would be sent abroad for examination.

Health experts say the government should move beyond public reassurance alone and strengthen preparedness through improved surveillance, testing capacity, diagnosis systems, treatment readiness and public awareness campaigns.