Special report: Andes Hantavirus risk assessment | EMS One-Stop

In this special EMS One-Stop update, Rob Lawrence is joined by returning guest Dr. Alex Isakov to break down the rapidly developing Andes Hantavirus outbreak linked to the expedition cruise ship MV Hondius. What began as a handful of unexplained respiratory illnesses aboard a South Atlantic voyage has evolved into an internationally monitored infectious disease event involving multiple countries, quarantine operations, public health investigations and the repatriation of exposed passengers to specialized containment facilities in the United States. Dr. Isakov is professor of emergency medicine at Emory University School of Medicine and executive director of the Emory Office of Critical Event Preparedness and Response (CEPAR). He also serves as EMS lead for the National Emerging Special Pathogens Training and Education Center (NETEC), where he helps lead national preparedness efforts for high-consequence infectious diseases. In the episode, he explains how Andes Hantavirus differs from other hantaviruses already present in North America because it is capable of person-to-person transmission in limited circumstances. The discussion covers transmission dynamics, incubation periods, PPE recommendations, public health monitoring and why experts continue to assess the overall public risk as low. Listeners are also directed toward the excellent educational resource hub on preparedness and response available through NETEC Hantavirus Resources. Hantavirus outbreak timeline May 3, 2026 — Initial WHO alert. The World Health Organization reported a cluster of hantavirus cases aboard the MV Hondius, traveling from Argentina toward Cape Verde. One laboratory-confirmed case and five suspected cases were identified. Three patients had died and one patient was admitted to intensive care in South Africa. May 6, 2026 — Andes Virus Confirmed. WHO confirmed the virus involved was Andes Virus (ANDV), the only hantavirus known to demonstrate human-to-human transmission in select environments. Case numbers rose to eight, including three confirmed laboratory cases and three deaths. One patient remained critically ill in South Africa while several governments began evacuation planning for exposed passengers. May 8, 2026 — U.S. quarantine operations activated. Nebraska Medicine and the University of Nebraska Medical Center announced that exposed U.S. passengers would be transported to the National Quarantine Unit following disembarkation in the Canary Islands. Officials reported all arriving passengers were asymptomatic at the time of transfer. May 8, 2026 — International Contact Tracing Expanded. WHO reported eight confirmed or suspected cases linked to the outbreak, including three deaths. Spanish authorities and WHO personnel prepared health screening and epidemiologic investigation operations as the vessel approached the Canary Islands. May 11, 2026 — Emory activated serious communicable disease unit. Emory University Hospital confirmed receipt of two passengers from the MV Hondius. One symptomatic patient was admitted to the hospital’s serious communicable diseases unit while one asymptomatic close contact underwent evaluation and monitoring under biocontainment protocols. May 12, 2026 — WHO maintained “Low Risk” assessment. WHO reported a total of 11 outbreak-associated cases, including three deaths. Nine cases were laboratory-confirmed Andes Virus infections, with two additional probable cases under investigation. Officials stated no new deaths had occurred since May 2 and continued to assess the global public health risk as low. Episode timeline 00:00 – Introduction to the Special Edition. Rob Lawrence introduces the emergency update format and welcomes Dr. Alex Isakov to discuss the emerging Andes Hantavirus outbreak. 00:50 – Understanding hantaviruses. Dr. Isakov explains the difference between common North American hantaviruses and Andes Virus, emphasizing the rare person-to-person transmission capability. 03:13 – The cruise ship incident. Discussion of the outbreak aboard the MV Hondius, including onboard transmission concerns, severe illness development and international evacuation efforts. 05:16 – U.S. monitoring and quarantine. Review of quarantine operations in Nebraska and ongoing public health monitoring of exposed American passengers. 07:21 – Incubation and EMS risk assessment. Dr. Isakov outlines the prolonged incubation period and explains why frontline EMS encounters remain unlikely. 11:17 – PPE guidance for EMS personnel. Specific PPE recommendations are reviewed, including standard, contact and airborne precautions with eye protection. 13:17 – Looking ahead to World Cup 2026. The discussion turns to international travel, mass gatherings and why clinicians must maintain awareness of rare infectious diseases tied to travel history. 14:32 – EMS and public health resources. Dr. Isakov directs listeners to CDC, WHO and NETEC resources for ongoing guidance and EMS-specific updates.