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Pandemics and Biosecurity
12MAY

WHO upgrades Hondius Andes risk to MODERATE

3 min read
16:29UTC

WHO revised Disease Outbreak News 600 on 9 May, upgrading the ship-level risk for the MV Hondius Andes hantavirus cluster from LOW to MODERATE and confirming all six laboratory-tested cases as Andes virus by PCR and sequencing, with a 38% case-fatality rate across 8 cases and 3 deaths.

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Key takeaway

WHO's MODERATE upgrade on 9 May confirmed Andes virus in all six lab cases, with a 38% case-fatality rate.

WHO revised DON 600 on 9 May, upgrading the ship-level risk for the MV Hondius cluster from LOW to MODERATE and confirming that all six laboratory-tested cases were Andes virus by PCR and full genome sequencing. 1 The revision supersedes the original DON 599 assessment, which logged 7 cases, 3 deaths, and applied standard hantavirus droplet precautions rather than the Andes-specific airborne isolation tier. The Swiss case , confirmed days after DON 599 was published, is the event that forced the upgrade: the Andes strain identification changed both the transmission model and the infection-control calculus.

At the point of revision, the WHO case count stood at 8 cases (6 confirmed, 2 probable) and 3 deaths, producing a 38% case-fatality rate. That CFR is consistent with the baseline for Andes hantavirus in laboratory-confirmed cases, which historically runs 30-40%. The six reporting countries at the time of revision were the Netherlands, South Africa, Switzerland, Germany, the United Kingdom, and Spain. A MODERATE ship-level risk assessment indicates that transmission from the MV Hondius environment to passengers is considered plausible, though person-to-person secondary transmission ashore had not been confirmed.

PAHO's December 2025 epidemiological alert had already placed Southern Cone health authorities on notice about rising hantavirus case-fatality figures before the voyage , and the pre-voyage birding expedition traversed Oligoryzomys longicaudatus habitat in Chile, Uruguay, and Argentina, according to WHO's Maria Van Kerkhove, establishing the most plausible rodent-exposure window. 2 The vessel completed disembarkation at Tenerife on 11 May, closing the primary exposure environment. The MODERATE designation remains in force while contact tracing and 45-day incubation monitoring continue across all six countries.

Deep Analysis

In plain English

Most viruses spread through large droplets, which means a surgical mask and keeping your distance from the patient is enough protection for nurses and doctors. A smaller number of viruses spread through tiny airborne particles that can drift across a room, and those require a different kind of mask (called an N95 or FFP3 respirator) and a room designed to stop air flowing outward. **Andes hantavirus** is the only type of hantavirus known to spread between people, so on 8 May the **US Centers for Disease Control** issued guidance requiring hospitals to treat suspected cases as airborne until proved otherwise. The guidance also had a practical message for doctors: a life-support machine called **ECMO** (which does the work of the heart and lungs for a patient) raises survival to about 80% if started early. US patients suspected of having Andes virus are being sent to a specialist hospital in **Nebraska** that has both the ECMO capacity and the bio-containment rooms needed.

What could happen next?
  • Consequence

    Community hospitals receiving suspected Andes cases will need to transfer them to negative-pressure facilities, creating a transfer-delay risk during which nosocomial exposure can occur if precautions are not escalated at the referring hospital.

  • Precedent

    HAN00528 is the first CDC guidance to require airborne precautions for a hantavirus; it will be cited in future guidance for other hantaviruses with potential person-to-person transmission should new evidence emerge.

First Reported In

Update #2 · B3.13 gets better at humans as testing ends

CDC· 12 May 2026
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Causes and effects
This Event
WHO upgrades Hondius Andes risk to MODERATE
The LOW-to-MODERATE upgrade is the first formal threshold crossing since the Swiss Andes confirmation, and it triggers more demanding case-management guidance for the six countries now reporting cases.
Different Perspectives
NTI Bio and Resolve to Save Lives
NTI Bio and Resolve to Save Lives
NTI Bio and Resolve to Save Lives have consistently argued that the WHA Pandemic Agreement's Pathogen Access and Benefit-Sharing annex is its operational core. A failed PABS outcome at WHA79 in late May leaves the treaty without a legal mechanism for rapid vaccine sharing.
UK Health Security Agency
UK Health Security Agency
UKHSA confirmed on 6 May that British nationals are among MV Hondius cases and placed the UK in the European secondary-monitoring picture. UKHSA's active monitoring obligation covers Andes-specific person-to-person transmission risk, not generic hantavirus protocol.
Africa CDC and ASLM
Africa CDC and ASLM
Africa CDC and ASLM launched ARILAC in Addis Ababa on 6 May alongside the EU, targeting AMR laboratory capacity in 8 AU states where 1.3% of assessed labs currently conduct routine resistance testing.
CEPI (Coalition for Epidemic Preparedness Innovations)
CEPI (Coalition for Epidemic Preparedness Innovations)
CEPI announced on 22 April that Moderna's mRNA H5N1 vaccine candidate entered Phase 3 trial. CEPI's position is that pre-pandemic efficacy data collected now is the only credible path to a 100 Days Mission authorisation if H5N1 achieves sustained human-to-human spread.
World Health Organization
World Health Organization
WHO Disease Outbreak News 599, published 2 May, assessed the MV Hondius cluster as low global risk under standard hantavirus protocol. The Swiss Andes confirmation, released after DON 599 closed, makes that rodent-only framing outdated before the bulletin was indexed.
Africa CDC
Africa CDC
Africa CDC lifted the mpox PHECS on 22 January 2026 after clade I CFR dropped from 2.6% to 0.6% and confirmed cases fell roughly 60% from peak. Clade Ib community transmission continues in 11 countries and WHO standing recommendations remain in force through 20 August 2026, so the lift tracks improved trends, not containment.