On 2 May 2026, a cluster of passengers with severe respiratory illness aboard a cruise ship was reported to the World Health Organization (WHO). At that time, according to the ship operator, 147 passengers and crew were onboard, and 34 passengers and crew had previously disembarked. Since the last Disease Outbreak News published on 4 May, three of the suspected cases were confirmed, and one additional confirmed case was reported. As of 8 May, a total of eight cases, including three deaths (case fatality ratio 38%), have been reported. Six cases have been laboratory-confirmed as hantavirus infections, with all identified as Andes virus (ANDV). Through the International Health Regulations (2005) (IHR) channel, National IHR Focal Points (NFPs) have all been informed and are supporting international contact tracing. WHO assesses the risk to the global population posed by this event as low and will continue to monitor the epidemiological situation and update the risk assessment. The risk for passengers and crew on the ship is considered moderate.
On 2 May 2026, WHO received notification from the National IHR Focal Point of the United Kingdom of Great Britain and Northern Ireland (hereafter referred to as the United Kingdom) regarding a cluster of severe acute respiratory illness, including two deaths and one critically ill passenger, aboard a Dutch-flagged cruise ship.
Since the last Disease Outbreak News was published on 4 May, three of the suspected cases were confirmed, and one additional confirmed case was reported. As of 8 May, a total of eight cases (six confirmed and two probable cases), including three deaths (two confirmed and one probable), case fatality ratio 38%, have been reported. All six laboratory-confirmed cases were identified as Andes virus through virus specific polymerase chain reaction (PCR) or sequencing.
Two medical evacuation flights, from Cabo Verde, carrying two symptomatic confirmed patients and one previously suspected case landed in the Netherlands on 6 and 7 May. As of 8 May, four patients are currently hospitalised, one in intensive care in Johannesburg, South Africa, two in different hospitals in the Netherlands and the other in Zurich, Switzerland. The previously suspected case was transferred directly to Germany, where she was tested, and both PCR and serology tests were negative for Andes virus, she is therefore no longer considered to be a case.
Contact tracing of passengers who disembarked in St Helena is ongoing; passengers have been contacted and advised to self-monitor for symptoms. Additionally, passengers who travelled on the same flight from St Helena to South Africa with one of the cases who was subsequently confirmed, have been contacted.
On 6 May, the ship left Cabo Verde, heading to the Canary Islands, Spain where disembarkation is planned.
Further investigations into the potential exposure of the first case and the source of the outbreak are ongoing in collaboration with authorities in Argentina and Chile. The outbreak is being managed through a coordinated international response, including in-depth epidemiological investigations, case isolation and clinical management, medical evacuations, laboratory testing and international contact tracing and monitoring.
Summary of confirmed and probable cases:
Case 1: An adult male who boarded the ship on 1 April, after more than three months of travel in Argentina, Chile, and Uruguay. Developed symptoms on 6 April and died onboard on 11 April. No microbiological tests were performed. He is considered a probable case.
Case 2: An adult female, who was a close contact of case 1, who travelled and boarded the ship with him, went ashore at Saint Helena on 24 April with gastrointestinal symptoms. She subsequently deteriorated on a flight to Johannesburg, South Africa, on 25 April. She died on 26 April in a Johannesburg clinic. On 4 May, she was subsequently confirmed by PCR testing with hantavirus infection.
Case 3: An adult male who developed symptoms on 24 April. He was disembarked and medically evacuated from Ascension Island on 27 April and is currently hospitalised in an Intensive Care Unit (ICU) in Johannesburg, South Africa. PCR testing confirmed hantavirus infection on 2 May, and Andes virus was confirmed through sequencing.
Case 4: An adult female, with onset of symptoms (fever and general malaise) on 28 April, later presenting with pneumonia, died on 2 May. A post-mortem sample was collected and sent to the Netherlands with the evacuated patients, where it was confirmed to be Andes virus.
Case 5: An adult male, working as the ship doctor, reported onset of symptoms on 30 April, including fever, fatigue, muscle pain, and mild respiratory symptoms. His samples confirmed PCR positivity for Andes virus on 6 May. The case was medically evacuated to the Netherlands on 6 May and is currently stable in isolation.
Case 6: An adult male, working as a ship guide. Onset of symptoms was reported on 27 April with mild respiratory and gastrointestinal symptoms. Laboratory samples confirmed PCR positivity for Andes virus on 6 May. The case was medically evacuated to the Netherlands on 7 May and is currently stable in isolation.
Case 7: An adult male, who disembarked in St Helena on 22 April and flew back to Switzerland on 27-28 April, through South Africa and Qatar. He started experiencing symptoms on 1 May after arrival in Switzerland, where he immediately self-isolated and reported to local public health authorities. He is currently hospitalised and in isolation in Switzerland. His samples confirmed PCR positivity for Andes virus on 5 May.[1]
Case 8: An adult male, who disembarked in Tristan da Cunha on 14 April. Onset of symptoms was reported on 28 April with diarrhoea and two days later with fever. He is currently stable and in isolation. He is currently a probable case until laboratory confirmation.
One case previously reported as suspected has now been reclassified as a non-case after testing negative for Andes virus through PCR and serology. Nevetheless, monitoring continues until the end of their incubation period from last exposure.
GNN
