Science
Californians were aboard hantavirus-stricken cruise ship. Is there a risk to the public?
Some California residents were among the 147 passengers and staff aboard a luxury cruise ship stricken by a suspected outbreak of hantavirus that has left three people dead and several others severely ill, officials confirmed Thursday.
California public health officials say they are monitoring the situation after being notified by the U.S. Centers for Disease Control and Prevention that some state residents were passengers on the MV Hondius. The precise status of those individuals, however, remains murky.
Hantavirus is a rare but deadly disease that attacks the lungs and is typically contracted by humans through inhalation of particles contaminated with the urine, feces or saliva of a wild rodent.
However, Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, confirmed Thursday that the Andes virus — a form of hantavirus that can spread from person to person — was involved in the outbreak.
Here’s what we know:
The MV Hondius cruise ship anchored at a port in Praia, Cape Verde, on Wednesday.
(Misper Apawu / Associated Press)
As its name suggests, the Andes virus is typically found in South America. The Dutch-flagged MV Hondius was on a 46-day journey that traveled from Antarctica with stops in Argentina.
In the case of human-to-human transmission, a person would first be infected by a wild rodent’s contaminated particles and then pass the infection to someone else, said Dr. Gaby Frank, director of the Johns Hopkins Special Pathogens Center.
“In previous outbreaks of Andes virus, transmission between people has been associated with close and prolonged contact, particularly among household members, intimate partners and people providing medical care,” Ghebreyesus said. “That appears to be the case in the current situation.”
None of the remaining passengers or crew members on the ship are symptomatic, he said.
The ship was not permitted to allow passengers to disembark at its original destination, Cape Verde, and is sailing for Spain’s Canary Islands.
“I want to be unequivocal here: This is not SARS-CoV-2. This is not the start of a COVID pandemic. This is an outbreak that we see on a ship. There’s a confined area,” Dr. Maria Van Kerkhove, who leads the WHO’s epidemic and pandemic management, said at a briefing. “This is not the same situation we were in six years ago. It doesn’t spread the same way like coronaviruses do.”
California passengers on the cruise
On April 1, 114 guests boarded the cruise ship in Ushuaia, Argentina. Twenty-three days later, 30 passengers — including six people from the United States — disembarked on a stop in St. Helena, a remote island about 1,100 miles off the coast of Africa, according to the cruise operator Oceanwide Expeditions.
Public health agencies in California, Georgia and Arizona were notified by the CDC that some of their residents were among the passengers on the cruise. It’s unclear whether these individuals disembarked on April 24, however.
The CDC is assisting local health authorities with monitoring California residents who were aboard the cruise, according to a statement by the California Department of Public Health on Friday.
As of Friday, one passenger has returned to their California residence and is in contact with local public health officials, and at least one other remains aboard the ship, according to the state agency.
“We understand that news of an unusual outbreak can be concerning,” said Dr. Erica Pan, director of the California Department of Public Health. “Unlike influenza and COVID-19, years of experience in South America have shown that this Andes hantavirus rarely spreads between people.”
Officials said the current public health protocol is to do daily symptom monitoring and reporting.
“As there are no known cases of Andes hantavirus infection from people without symptoms, and any spread has usually been limited to people with prolonged close contact with an ill person with this virus, the risk to the general public in California is extremely low,” the agency said in a statement.
In a statement earlier this week, the CDC also said that the risk to the American public “is extremely low” at this time.
“We urge all Americans aboard the ship to follow the guidance of health officials as we work to bring you home safely,” the agency said.
The others who exited the ship on April 24 were individuals from Canada, Denmark, Germany, the Netherlands, New Zealand, Switzerland, Sweden, Singapore, St. Kitts and Nevis, Turkey and the United Kingdom.
Of the remaining passengers still aboard the ship headed for Spain’s Canary Islands, California Department of Public Health said none were ill as of Friday.
How many people have been infected?
The number of lab-confirmed hantavirus cases has risen to five, according to the WHO. There are three additional suspected cases.
A timeline of reported cases of hantavirus aboard the cruise ship can be found here.
The WHO is monitoring reports of other people with symptoms “who may have had contact with one of the passengers. In each case, we are in close contact with the relevant authorities,” Tedros said.
The first passenger to have been infected, a Dutchman, became sick aboard the cruise ship on April 6 and died on April 11.
No samples were taken, because his symptoms were similar to other respiratory diseases. His widow left the ship with his body on April 24 during the scheduled stop at St. Helena.
“She deteriorated during a flight to Johannesburg on the 25th of April and died the next day,” Tedros said.
Before boarding the cruise ship, the Dutch couple had traveled through Argentina, Chile and Uruguay on a bird-watching trip, “which included visits to sites where the species of rat that is known to carry Andes virus was present,” Tedros said.
After leaving the ship, the woman was briefly aboard a KLM aircraft in Johannesburg bound for Amsterdam but was barred from the flight due to her medical condition, the airline said in a statement.
Dutch news outlets reported that a flight attendant on a KLM airplane — who briefly had contact with the widow — started feeling sick and had mild symptoms and was in isolation at a hospital in Amsterdam.
The flight attendant has since tested negative for the Andes virus, Dr. Jeremy Faust, an emergency medicine physician, wrote on his Substack blog, Inside Medicine, citing a text message sent to him by Tedros.
“It is still possible that the flight attendant contracted the Andes virus. However, given our understanding of the virus, this information means that the flight attendant’s symptoms are not caused by the Andes hantavirus, but by some other medical illness,” Faust wrote.
More cases may be reported, because the incubation period — the time it takes between exposure to the virus and the onset of illness — for the Andes strain of the hantavirus is up to six weeks.
What we know about hantavirus
There are roughly 50 identified species of hantavirus. The virus that’s found in the Americas tends to cause a cardiopulmonary syndrome, a condition that affects the heart and the lungs, according to Frank.
There have been 890 laboratory-confirmed cases of hantavirus disease reported in the U.S. since surveillance began in 1993, according to the most recent data from the CDC.
From 1980 to 2025, 99 California residents have been diagnosed with a hantavirus infection, according to the California Department of Public Health.
CDC officials said 38% of people who develop respiratory symptoms may die from the disease.
Still, the data suggest that contracting hantavirus is rare, said Dr. Afif El-Hasan, member of the American Lung Assn.’s national board of directors.
There is no vaccine or specific antiviral medicine for hantavirius.
Intensive-care treatment may include intubation and oxygen therapy, fluid replacement and use of medications to lower blood pressure, according to the American Lung Assn.
The signs of hantavirus
Early symptoms of hantavirus are similar to the flu and include fatigue, fever and muscle aches, according to the CDC. Symptoms start to develop within one to eight weeks after contact with an infected rodent.
Half of those who contract the virus also experience headaches, dizziness, chills, nausea, vomiting, diarrhea and abdominal pain.
Four to 10 days after the initial phase of the illness, another round of symptoms can develop, which include coughing, shortness of breath and possible tightness in the chest as the lungs fill with fluid.
Even though contracting hantavirus in the U.S. continues to be a rare event, El-Hasan said, people should take these initial symptoms seriously and promptly seek medical care.
How to protect yourself
Hantavirus cases can occur year-round, but the peak seasons in the United States are the spring and summer, which coincide with the reproductive seasons for deer mice.
To lessen your risk of infection, keep wild rodents out of your home and other enclosed spaces by sealing any holes and placing snap traps.
If you find evidence of mice, wear personal protective equipment and disinfect the area. When you’re done, put everything, including cleaning materials, in a bag and toss it in your trash bin.
Medical workers in protective suits. Contact tracing. P.C.R. tests and World Health Organization briefings.
Just when much of the public had presumed to have left those ominous images and turns of phrase intertwined with the Covid-19 pandemic in the rearview mirror, a deadly hantavirus outbreak aboard a Dutch cruise ship has dredged up familiar anxieties.
Health experts, aware of the scars Covid left on people, including those who are still dealing with it, have sought to dispel comparisons between hantavirus and coronavirus. They said this week that the viruses spread quite differently and were not close in magnitude.
Still, those reassurances have not quelled the public’s anxiety or its appetite for medical advice from some of the same doctors who commanded attention on television as Covid-19 marched across the globe.
“I have Covid P.T.S.D.,” Dr. Celine R. Gounder, editor at large for public health at KFF Health News and an infectious disease expert, said in an interview on Thursday. “There are parts of New York City I cannot walk by without seeing the refrigerated mortuary trucks. I had to get rid of certain things I was using during the pandemic, clothing or otherwise, because it was triggering. So I completely get where people are coming from.”
“That said,” Dr. Gounder was swift to emphasize, “not all infectious diseases are created equal.”
In Spain, the president of the Canary Islands lodged a protest against allowing the cruise ship to dock there, while a flurry of threads have begun to appear on social media sites pondering whether it was safe to travel at all.
The mention of masks particularly reverberated on the far right politically, where some have begun using the outbreak to warn against the prospect of new restrictions or government mandates.
Three passengers who were traveling on the Dutch cruise ship MV Hondius died during the hantavirus outbreak, which has sickened at least five other people aboard the vessel with symptoms of the rare disease. On Sunday, the ship is expected to approach the island of Tenerife, where passengers will be brought by boats for evacuation flights to their home countries.
Most strains of the virus, which is primarily carried by rodents, cannot be spread from person to person. But the one identified in the ship outbreak, the Andes strain, can move between people, according to medical experts, who underscored that it requires repeated close contact.
“This is not coronavirus,” Dr. Maria Van Kerkhove, the W.H.O.’s head of epidemic and pandemic preparedness, said at a news conference in Geneva on Thursday. “This is a very different virus.”
Dr. Van Kerkhove said she could understand the intense demand for answers about the cluster of infections.
“I want to be unequivocal here: This is not SARS-CoV-2,” she said, referring to the virus that causes Covid. “This is not the start of a Covid pandemic.”
Around the world, health authorities monitored suspected cases of hantavirus infection. A number of these potential patients tested negative. But the concerns were a reminder of how every allergy season sneeze or wheeze could prompt existential dread in the early months of the Covid pandemic.
In an appearance on the “Today” show on Thursday, Dr. Ashish Jha, who oversaw the Biden administration’s pandemic response as it wound down, said he was confident that public health authorities could contain the spread of the hantavirus if they followed longstanding contact tracing protocols.
“We’ve got to track down everybody who left the cruise ship and figure out where they are, make sure that we’re monitoring them,” he said. “If they develop any symptoms, then they’ve got to get isolated.”
Such attempts at reassurance may be interpreted differently by some critics of the Trump and Biden administration’s responses to the Covid pandemic.
The far-right commentator Glenn Beck on Thursday signaled the need to resist a return to Covid-era measures on his show.
“They’ll do exactly the same thing they did last time, and then our kids won’t go to school, and we’ll have masks,” Mr. Beck said.
Plenty of others on social media sought to introduce levity in the moment, harking back to quirky rituals and skills they honed during the pandemic.
“Practicing my dancing for when the hantavirus becomes the new covid,” one young woman wrote in a post.
The heinously polluted Tijuana River, which has sickened residents and even researchers with its hydrogen sulfide fumes, is gaining attention, and now a coalition of politicians, activists, physicians and economists are pushing California Gov. Gavin Newsom to declare the fetid and toxic river valley a public health emergency.
They’ve also put together a plan to clean it up and are pleading with state lawmakers to fund it, even as the state faces a multibillion-dollar deficit.
“We’re only starting to understand the full reach of the environmental and health impacts and they’re getting worse every day,” Sarah Davidson, clean border water manager for the ocean protection group Surfrider, said at a news conference Thursday. “There’s no saying how far-reaching they are or how far-reaching they will be. So every lawmaker and resident in California should be concerned.”
In 2024, Newsom said in an interview that a state emergency declaration “would not have availed us to any real benefit except symbolism and then ultimately frustration that it didn’t mean anything.”
Four of the gubernatorial candidates — Katie Porter, Antonio Villaraigosa, Tom Steyer and Xavier Becerra — have pledged to treat the issue as a top priority.
Despite his resistance, Newsom has secured funding for the river and region, including $38 million for water quality improvements in 2019 and an additional $100 million in federal funds for the area’s infrastructure in 2025.
Among the elements in the package announced Thursday: state Senate Bill 58, which would establish air quality standards for hydrogen sulfide, a toxic pollutant emitted from the river, and Senate Bill 1046, which would set standards and guidelines for workers employed near the river.
They’re also pushing for $23 million in state transportation funds to upgrade the Saturn Boulevard crossing near San Ysidro, where the river cascades through a small channel and is considered a hot spot for spewing toxic air pollutants. Other items include $5 million for air purifiers for people in heavily affected ZIP Codes, and $2 million to update a boom on the river that collects trash moving downstream.
Support for addressing the Tijuana River crisis has been bipartisan.
Last summer, Environmental Protection Agency Administrator Lee Zeldin committed the Trump administration to “a permanent, 100% solution to the decades-old Tijuana River sewage crisis,” signing a memorandum of understanding with Mexico.
“I smelled for myself that foul smell that so many residents of Southern California have been complaining about for so long,” Zeldin said, adding that President Trump was highly motivated after hearing from Navy SEALs who must train in the polluted waters of the Pacific Ocean where the Tijuana River meets the sea.
A recent Department of Defense report showed 1,100 reported cases of illness among Navy SEALs and other service members exposed to high levels of bacteria when they trained in and around the mouth of the river near the border.
In 2024, California voters also approved Proposition 4, which allocated nearly $50 million for projects addressing water quality problems along the Mexico border and coastal areas. But most of that money has yet to be released, waiting for various agency reviews and approvals.
Trump also took an interest in the river during his first administration, committing $300 million in federal funding to the San Diego region for a new U.S. facility to capture Tijuana sewage spills before they foul shorelines.
Advocates for an emergency declaration, including those representing local communities, say an emergency declaration could help release those funds and prompt interagency action. For example, funds could be used for road and tunnel construction to improve the flow of the river, addressing several public health issues plaguing the region.
Nearly three-quarters of the Tijuana River watershed is in Mexico, with the last five miles flowing into the U.S. before emptying into the Pacific Ocean at Imperial Beach.
Pollution in the 120-mile-long river has been so egregious that recent studies have shown that even the air above the river, or the spray where it reaches the surf, is dangerous.
Using an air quality monitor nearly half a mile from the river in the community of Nestor, Calif., last year, scientists found extremely high levels of hydrogen sulfide, a gas linked to sewage that smells like rotten eggs. Their paper was published in the journal Science.
Last year, American Rivers, an environmental group, declared the Tijuana River the second-most endangered river in the nation.
A couple of years ago, in the middle of the night, I crept downstairs to find my father sitting at the kitchen table, sobbing like a child.
My mother was beside him, trying to comfort him, an activity that took up more and more of her time. He was 87 and had dementia. It wasn’t unusual to find him upset or confused. But on this night, something seemed to be happening to him in real time — in 1941.
He was 6 years old, and was leaving Pittsburgh, the only home he had ever known, for an Air Force base in San Antonio, where his father had been ordered for duty. He and his parents were traveling there by train, transferring in Chicago.
It was the beginning of a lonely, difficult time for my father’s family, moving between Air Force bases in the South, where landlords sometimes turned them away because they were Catholic. An only child, he had been allowed to take one pet with him, a canary he was carrying in a birdcage.
As they were changing trains in Chicago, the bottom fell out of the cage. The canary flew out, up into the vaulted atrium of the station’s Great Hall. There was no way to get the bird — there was no time, they had to board a train to Texas. So my 6-year-old father shuffled after his parents, holding an empty cage.
In the years that had elapsed, he had negotiated arms treaties with the Soviets, had advised presidents, had served as a U.S. ambassador, all with the same watchful, wisecracking reserve. I thought I knew who he was. I could count on one hand the times I had seen him cry. Now here he was, sobbing over the canary as if it were yesterday.
This was all, it seemed, because of his brain. He had fallen hard in their house in Washington, D.C., smacking his head on the hardwood floor. Blood rushed into spaces in his brain, and cells starved of oxygen began to die. Eventually, he was diagnosed with vascular dementia, which is most often caused by strokes.
For five years after that, my parents lived with my family outside Boston, and we learned firsthand how brain injury affects behavior. My father recovered in some ways, but he became chaotic, his thoughts broken into mirror shards.
The biggest problem was that he had no idea where he was. Specifically, he did not know why he was living with us in Massachusetts, and no matter how many times we tried to remind him, over and over, he tried to leave. We would catch him packing the car, and gently — or not so gently — guide him back into the house.
This child-father was full of surprises. He bought surprising things: Five laptops! A cruise on the Norwegian fjords! Recurring $2 donations to every Democrat running for any office, anywhere! Once, in a weeklong cascade of Amazon deliveries, we received seven identical birdbaths from China.
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