AI-Generated Summary: This article identifies essential facts pharmacists should know about hantavirus, including transmission through rodent exposure (mostly), the risk for severe cardiopulmonary disease, and the importance of early recognition and supportive care. It notes emerging concerns surrounding the Andes virus strain which can spread person-to-person and is associated with an ongoing cruise ship-realted outbreak that has prompted international monitoring, quarantine efforts, and public health response measures.
Authored By: Timothy P. Gauthier, Pharm.D., BCPS, BCIDP
Article posted 12 May 2026
As an infectious diseases and antimicrobial stewardship pharmacist who has been professionally engaged in the field for 15 years, I have read about hantaviruses sporadically, but they have never really been relevant to my clinical practice. With the recent serious hantavirus cluster linked to cruise ship travel making international headlines, the topic has become nearly unavoidable in daily conversation for those of us in infectious diseases.
I find it interesting because norovirus is the first thing I think of when it comes to infections on cruise ships, but nobody really ever asks about that, even though it’s in the news all the time. Now hantavirus is in the news and interest is over the top. Hantavirus has recently gained renewed public attention following reports of a cruise ship-associated outbreak on the MV Hondius involving the Andes virus strain in South America. While infections remain rare, pharmacists should understand the basics of transmission, clinical presentation, prevention, and public concern surrounding the virus. Needless to say, I have to learn about hantavirus and maybe you do too. I figured, what better way to learn about it than to write a blog post? As they say, the best way to learn is to teach!
I hope this topic quickly becomes irrelevant and no further illnesses are reported. However I also hope this might help other pharmacists who are getting questions and want a relatively quick 411. Information in this post are drawn from journal articles, CDC webpages, and WHO resources. Here are 5 things that stood out to me that pharmacists should know about hantavirus.
1. Not all hantaviruses are the same
Hantaviruses are negative-sense single-stranded RNA viruses, including more than 20 viral species that have the potential to cause life-threatening illness. It is not just one hantavirus.
Some hantaviruses can cause hantavirus pulmonary syndrome (HPS). Most hantaviruses in the United States can cause HPS. There is a type of hantavirus called Andes virus (ANDV) which can cause HPS. ANDV can spread person-to-person (more on that below). This is unique because other hantaviruses are not known to spread person-to-person. According to WHO reports, the 2026 hantavirus cluster linked to cruise ship travel has involved ANDV.
Some hantaviruses can cause hemorrhagic fever with renal syndrome (HFRS). In the United States, Seoul virus is the only hantavirus that causes HFRS.
CDC provides HPS-specific hantavirus information here: https://www.cdc.gov/hantavirus/hcp/clinical-overview/hps.html
CDC provides HFRS-specific hantavirus information here: https://www.cdc.gov/hantavirus/hcp/clinical-overview/hfrs.html
While illness progression of HPS and HFRS are different, diagnostic methods used are the same for both.
Hantavirus infectious are generally uncommon globally. The prevalence of a given hantavirus can vary geographically. For example In the Americas, Sin Nombre virus is the predominant cause of HPS in North America, while Orthohantavirus andesense is responsible for most cases in South America. There is a map from CDC with various statistics on reported hantavirus cases here.
2. Most hantavirus cases are spread through infected rodents, not person-to-person
Hantaviruses infect many species of rodents, shrews, moles and bats. Hantaviruses are often spread by infected rodents through their urine, feces, and saliva. The most common hantavirus that causes HPS in the United States is spread by the deer mouse. Anyone who has had contact with hantavirus-carrying rodents, or their droppings, or urine, saliva, or nesting material are at risk of HPS. Rodent infestation in and around a home are the primary hantavirus risk factor.
Exposure may occur when breathing hantavirus-contaminated air during cleaning, touching a contaminated object followed by touching your mouth, being bitten or scratched by an infected rodent, or by eating food contaminate with hantavirus.
Hantavirus infection is more common in rural areas where there may be habitat for rodents. Dogs and cats are not known to become infected in the US, but may incidentally deliver infected animals to their owners.
3. The hantavirus called Andes virus (ANDV) is the only type of hantavirus that is known to spread person-to-person
CDC provides information specifically about ANDV here. CDC provides a detailed guidance document about ANDV here, which includes sections of:
- Definitions
- Exposure risk stratification
- Risk-based management of contacts
- Laboratory diagnostics
- Infection prevention and control in healthcare settings
- An Andes virus exposure questionnaire
CDC provides an FAQ on the recent ANDV cruise ship outbreak here.
ANDV does not spread easily from person-to-person, it is associated with close contact. This can include direct physical contact, prolonged time spent in inclosed spaces, and exposure to a sick person’s body fluids. Signs and symptoms of ANDV appear between 4-42 days (median 18 days) after exposure.
According to CDC, up to 38% of people who get Andes virus and develop HPS may die from the disease. A truly concerning statistic.
4. Early diagnosis and isolation precautions are critical for andes virus, but still risk of a pandemic is extremely low
Identification and mitigation potential spread are critical.
Early symptoms of HPS can resemble other respiratory illnesses (e.g., fatigue, fever, muscle aches) making it difficult to diagnose. CDC advises healthcare providers should test patients for hantavirus if the patient has HPS-comparable symptoms and have had contact with rodents.
CDC provides recommendations for isolation precautions here. They also provide a phone number for the CDC Emergency Operations Center where an on call epidemiologist with the Viral Specialist Pathogens Branch (VSPB) can be requested for consultation or for diagnostic testing.
CDC states that the risk of the current outbreak to the American public is extremely low.
5. There are no FDA-approved antiviral treatments or vaccines for hantavirus
Patients with symptomatic hantavirus infection can be categorized by HPS and HFRS.
For HPS medical care should be initiated immediately. ICU-level care is required even before diagnosis because there is a risk for rapid decompensation. Care includes cardiac monitoring, fluid support, supplemental oxygen, and potentially intubation for respiratory support. Antipyretics and analgesics may be indicated. Broad-spectrum antibiotics should also be considered even if still waiting on the diagnosis. Without treatment HPS-related death occurs quickly, within 24-48 hours of cardiopulmonary phase onset.
Ribavirin has been tested for HPS but has not been shown to be effective.
Since HFRS is not relevant to the current ANDV-related discussion, I will defer to other resource for how it is clinically managed. Notably though, there are no approved vaccines or antiviral treatments.
Closing comments
While hantaviruses are an interesting group of clinically important microbial pathogens, I truly hope that their relevance to the general public quickly subsides. In the meantime, I hope that this may be a helpful resource for pharmacists who need to know about hantaviruses and the Andes virus.
Additional References & Readings
Hantavirus-Associated Acute Respiratory Failure (NEJM 1993)
Uncovering the mysteries of hantavirus infections (Nature Reviews Microbiology 2013)
“Super-Spreaders” and Person-to-Person Transmission of Andes Virus in Argentina (NEJM 2020)
Hantavirus cluster linked to cruise ship travel, Multi-country (WHO 2026)
Hantavirus outbreak toolbox (WHO 2026)
Reported Cases of Hantavirus Disease (CDC 2026)
Disclosure: The views and opinions in this article represent those of the author and may not reflect the policy or position of any previous, current, or potential future employer. ChatGPT has been used to enhance readability and identify helpful resources.
Disclaimer: Information on this topic is evolving. This post may be updated periodically and if it is the date above will be adjusted accordingly. Beware that as information changes it is possible that some content on this webpage may become inaccurate/ out-dated, but the links provided here are likely to continue to be extremely helpful.
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