By Ana Espino | Published on June 08, 2026 | 4 min readLong considered a rare infection confined to certain regions
of South America, Andes hantavirus (ANDV) is now attracting increasing
attention from the medical community. Like other hantaviruses, it is primarily
transmitted through the inhalation of contaminated particles originating from
the excreta of infected rodents. However, it possesses a particularly
concerning feature: it is the only hantavirus for which person-to-person
transmission has been clearly demonstrated.
Although infections remain uncommon, their consequences can
be devastating. In its most severe forms, the virus causes hantavirus
cardiopulmonary syndrome (HCPS), a disease characterized by acute
respiratory distress, shock, and multiple organ failure. Despite advances in
intensive care medicine, no specific antiviral treatment or vaccine is
currently available.
The recent outbreak aboard the cruise ship MV Hondius,
involving travelers from 23 different countries, highlighted how even a
pathogen with limited transmissibility can rapidly cross borders in an era of
global travel. In response, Italian researchers conducted an updated review of
the available evidence on Andes hantavirus to better understand its epidemic
potential and the challenges it poses to clinicians.
Behind the Scenes of a Virus Capable of Spreading from
Animals to Humans... and Then Between Humans
The authors reviewed the latest data on the epidemiology,
transmission routes, clinical manifestations, and management of Andes
hantavirus infection.
The review confirms that the virus is primarily carried by a
rodent species found in Argentina and Chile. Infection generally occurs
through the inhalation of dust contaminated with viral particles from the urine
or feces of infected animals. However, unlike other hantaviruses, ANDV can also
spread between humans following close and prolonged contact with a
symptomatic individual.
After an incubation period that can last up to 40 days,
the infection often begins with nonspecific symptoms such as fever, fatigue,
headache, muscle pain, and gastrointestinal disturbances. This initial phase
may rapidly progress to severe pulmonary involvement associated with acute
respiratory failure, marked hypotension, and potentially fatal shock.
The researchers also identified several biological markers
associated with severe disease. Elevated white blood cell counts, pronounced
neutrophilia, reduced lymphocyte and platelet counts, and increased lactate
dehydrogenase (LDH) levels are frequently observed in the most critically ill
patients. These abnormalities reflect an excessive inflammatory response that
may evolve into a true cytokine storm.
The reviewed data also underscore the seriousness of the
disease. During a major outbreak in Argentina between 2018 and 2019,
nearly one-third of infected patients died, often within less than a week after
the onset of symptoms.
Read next : Hantavirus: Why Does This Rare Virus Continue to Concern Intensive Care Specialists?
What If Prevention Remains the Best Weapon?
This review confirms that Andes hantavirus remains a rare
but potentially severe infectious threat. Its most significant challenge lies
in its unusual ability to spread from person to person, a characteristic that
is exceptional among known hantaviruses.
In the absence of a validated antiviral therapy or an
available vaccine, management relies primarily on intensive supportive care,
including oxygen therapy, respiratory support, hemodynamic stabilization, and,
in the most severe cases, renal replacement therapy.
The authors also emphasize several gaps in current
knowledge. Available evidence comes mainly from localized outbreaks, and the
total number of studied cases remains relatively small. Important questions
remain regarding the precise mechanisms of transmission, the factors underlying
severe disease, and the development of targeted therapeutic strategies.
Looking ahead, the development of vaccines, specific
antiviral treatments, and enhanced surveillance systems could improve the
management of future outbreaks. Above all, the MV Hondius episode serves as a
reminder that in an increasingly interconnected world, even pathogens
considered rare can quickly become an international public health concern.
Read next : How can hantaviruses be stopped?
About the author – Ana Espino
PhD in Immunology, specialized in Virology
As a scientific writer, Ana is passionate about bridging the gap between research and real-world impact. With expertise in immunology, virology, oncology, and clinical studies, she makes complex science clear and accessible. Her mission: to accelerate knowledge sharing and empower evidence-based decisions.
