Journal of Travel Medicine
Hantaviruses are a globally distributed group of rodent- and small mammal–associated negative-sense RNA viruses in the family Hantaviridae. Human transmission is primarily through inhalation of aerosolized excreta (urine, faeces or saliva) from infected reservoir hosts.1,2 Clinical presentation and severity differ by species, but severe disease overlaps between haemorrhagic fever with renal syndrome in Europe and Asia (Old World) and hantavirus pulmonary syndrome in the Americas (New World). Historically, hantavirus infections are seen in those with rural occupational or recreational exposures and are rarely diagnosed among travellers. However, an international outbreak of New World Orthohantavirus Andes virus (ANDV) linked to a cruise voyage that departed Argentina occurred in April 2026. ANDV is uniquely well documented for its capacity for person-to-person transmission.3,4 At the time of submission, there were 13 confirmed cases, 2 suspected cases and 3 deaths associated with the outbreak.
We evaluated cases reported through the GeoSentinel network (GeoSentinel) for evidence of hantavirus infection in returned travellers and migrants (Table 1) to add context to the 2026 outbreak among travellers. Established in 1996, GeoSentinel is now comprised of 71 travel and tropical medicine clinics in 29 countries across 6 continents, and conducts passive global surveillance of the epidemiology, clinical manifestations and outcomes of illness in international travellers. Confirmed, probable and suspect cases were included in this review (Cases were classified in the following manner if they had a compatible clinical and exposure history: Confirmed cases were defined as having either virus isolation, positive nucleic acid testing, histopathologic confirmation or paired serology (a four-fold increase). Probable cases were defined as those with a single positive serologic result (IgM or IgG). Suspect status was used in the GeoSentinel database prior to 2016 and was defined as compatible clinical presentation and exposure. Prior to 2016, no evidence of testing was required in the database as diagnosis status was determined by the treating clinicians; therefore, some cases have missing details regarding diagnostic testing.). This activity was reviewed by CDC, deemed not research, and was conducted consistent with applicable federal law and CDC policy (See, e.g. 45 C.F.R. part 46.102(l)(2), 21 C.F.R. part 56; 42 U.S.C. §241(d); 5 U.S.C. §552a; 44 U.S.C. §3501 et seq.).
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Journal of Travel Medicine
DOI
https://doi.org/10.1093/jtm/taag062
Abstract
Hantaviruses are a globally distributed group of rodent- and small mammal–associated negative-sense RNA viruses in the family Hantaviridae. Human transmission is primarily through inhalation of aerosolized excreta (urine, faeces or saliva) from infected reservoir hosts.1,2 Clinical presentation and severity differ by species, but severe disease overlaps between haemorrhagic fever with renal syndrome in Europe and Asia (Old World) and hantavirus pulmonary syndrome in the Americas (New World). Historically, hantavirus infections are seen in those with rural occupational or recreational exposures and are rarely diagnosed among travellers. However, an international outbreak of New World Orthohantavirus Andes virus (ANDV) linked to a cruise voyage that departed Argentina occurred in April 2026. ANDV is uniquely well documented for its capacity for person-to-person transmission.3,4 At the time of submission, there were 13 confirmed cases, 2 suspected cases and 3 deaths associated with the outbreak.
We evaluated cases reported through the GeoSentinel network (GeoSentinel) for evidence of hantavirus infection in returned travellers and migrants (Table 1) to add context to the 2026 outbreak among travellers. Established in 1996, GeoSentinel is now comprised of 71 travel and tropical medicine clinics in 29 countries across 6 continents, and conducts passive global surveillance of the epidemiology, clinical manifestations and outcomes of illness in international travellers. Confirmed, probable and suspect cases were included in this review (Cases were classified in the following manner if they had a compatible clinical and exposure history: Confirmed cases were defined as having either virus isolation, positive nucleic acid testing, histopathologic confirmation or paired serology (a four-fold increase). Probable cases were defined as those with a single positive serologic result (IgM or IgG). Suspect status was used in the GeoSentinel database prior to 2016 and was defined as compatible clinical presentation and exposure. Prior to 2016, no evidence of testing was required in the database as diagnosis status was determined by the treating clinicians; therefore, some cases have missing details regarding diagnostic testing.). This activity was reviewed by CDC, deemed not research, and was conducted consistent with applicable federal law and CDC policy (See, e.g. 45 C.F.R. part 46.102(l)(2), 21 C.F.R. part 56; 42 U.S.C. §241(d); 5 U.S.C. §552a; 44 U.S.C. §3501 et seq.).