All Your Hantavirus Questions, Answered by an Infectious Disease Expert

Now that more than 100 passengers aboard a hantavirus-stricken luxury cruise ship have been evacuated, with 18 Americans in biocontainment units in Nebraska and Georgia, health officials around the world are working to monitor more than two dozen individuals who left the cruise and anyone with whom they might have come in close contact.

So far, all of the 11 reported hantavirus cases are among passengers or crew on the ship, the World Health Organization’s director-general, Tedros Adhanom Ghebreyesus, said at a press conference in Madrid on Tuesday. That includes three deaths resulting from the virus.

Typically, hantaviruses are spread when contaminated rodent droppings and urine are stirred up in the air and breathed in. The strain identified on board the cruise ship, the MV Hondius, is known as the Andes virus, and is the only type known to transmit from person to person. While the virus can cause serious disease and carries a high mortality rate, health officials say the hantavirus outbreak is unlikely to become a global crisis like the Covid-19 pandemic.

“At the moment, there is no sign that we are seeing the start of a larger outbreak,” Ghebreyesus said, “but of course the situation could change, and given the long incubation period of the virus, it’s possible we might see more cases in the coming weeks.”

WIRED spoke with Nicole Iovine, an infectious disease expert and hospital epidemiologist at the University of Florida Health, about how the Andes virus spreads and whether it’s likely to spark another pandemic.

This interview has been edited for brevity and clarity.

WIRED: One of the things that is probably top of mind for most people is how similar is the Andes virus to SARS-Cov-2, and how infectious is it?

Nicole Iovine: It is not similar at all to SARS-Cov-2. This outbreak on the cruise ship is not going to translate into a worldwide pandemic like Covid for a number of reasons. One of the reasons is that it is just not as infectious as Covid was. Covid infected our upper airways and also deep in our lungs. But the fact that it infected our upper airways meant that when we talked or sneezed or coughed, it was easily put out into the air, and so it was easy to transmit. With the Andes virus, this virus actually infects very deep in the lungs. It doesn’t typically infect the upper airways, so it’s a lot harder for it to transmit from one person to another.

How would you know if you had the Andes virus? It seems like the symptoms are pretty nonspecific at first but progress quickly to serious disease.

People can start to get symptoms anywhere from about five days or so after exposure to as long as six weeks, which is again very different from Covid and another reason why hantavirus is of some concern but is not likely to cause a pandemic. It starts out with very generalized symptoms. You can develop a fever, headache, fatigue, muscle aches and pains. Those sorts of symptoms are what you would get if you had the flu or many other sorts of infections.

Is the Andes virus airborne?

Not exactly, because the way that it transmits into your lungs is if you have really close contact with someone for an appreciable amount of time. It’s not something like measles, where if you’re in a room and you have measles, somebody could come into that room two hours later and still contract measles. That’s airborne, but hantavirus is not like that.