The European Centre for Disease Prevention and Control recommends a quarantine of up to six weeks for passengers of the MV Hondius.

The European Centre for Disease Prevention and Control has published rapid recommendations for managing passengers and crew exposed to the Andes virus, following an outbreak associated with eight cases, three deaths, and one critically ill patient. All individuals on board are considered, for disembarkation and repatriation, high-risk contacts. ECDC has published recommendations for managing passengers of the MV Hondius ship, following an outbreak of the Andes virus with eight cases, including three deaths. In brief

ECDC reported, on May 9, 2026, eight cases of Andes virus infection related to the MV Hondius ship, including three deaths and one critically ill patient. All individuals on board are considered, for disembarkation and repatriation, high-risk contacts. ECDC recommends self-quarantine and daily symptom monitoring for up to six weeks, with day 0 set on May 6, 2026. Asymptomatic passengers will not use regular commercial flights for repatriation but will be transported by special arrangements organized by states and the EU Civil Protection Mechanism. Symptomatic individuals must be prioritized for medical evaluation and testing upon arrival. The European Centre for Disease Prevention and Control has published a rapid scientific recommendation for managing passengers and crew of the MV Hondius ship, in the context of an outbreak of Andes virus infection identified on the cruise ship. On May 9, 2026, ECDC reported eight cases of Andes virus infection related to the MV Hondius ship, including three deaths and one critically ill patient. Six of the cases were laboratory confirmed as Andes virus infections. The outbreak was identified on the MV Hondius ship, which departed from Argentina on April 1, 2026, and traveled through the South Atlantic towards Cape Verde. On board were 149 passengers and crew members from 23 nationalities, and another 30 passengers disembarked on April 24 in Saint Helena. ECDC classified all individuals on board, for the purpose of disembarkation and repatriation, as high-risk contacts. Exceptions are made for public health and infectious disease experts who boarded in Cape Verde on May 6, after the medical evacuation of all symptomatic cases and with protective measures applied. For high-risk contacts, ECDC recommends self-quarantine for six weeks, daily symptom monitoring, and testing if symptoms compatible with the infection appear. Day 0 for calculating the monitoring period is set, for individuals remaining on the ship, at May 6, 2026, provided no other symptomatic individuals appear in the meantime. Self-quarantine involves using a separate room, maintaining a distance of at least one to two meters from household members, avoiding the use of the same utensils, and ventilating rooms. ECDC notes that outings may be allowed for maintaining mental health and well-being, with a medical mask and avoiding crowds. Asymptomatic passengers are currently considered high-risk contacts as a precautionary measure. They are to be repatriated to their countries of origin for self-quarantine, through special transport organized by their respective states and the EU Civil Protection Mechanism. They will not use regular commercial flights. ECDC specifies that, upon disembarkation, passengers are still treated as high-risk contacts. However, after interviews conducted by the public health team on board, not all passengers will necessarily be considered high-risk upon returning to their countries and may have less strict quarantine measures. Symptomatic passengers must be prioritized for medical evaluation and testing upon arrival. Depending on their condition and operational decisions, they may be isolated in Tenerife or medically evacuated for isolation in their country of origin. If the test is positive, medical care and isolation must continue. If the test is negative, quarantine and monitoring may remain in effect for up to six weeks as a precautionary measure. ECDC recommends prioritizing testing for symptomatic individuals, especially those with symptoms compatible with hantavirus cardiopulmonary syndrome. Testing during the incubation period may frequently be negative and may provide a false sense of security. For flights, ECDC recommends contact tracing only in the case of probable or confirmed individuals. In the case of flights longer than six hours, contact identification should be limited to passengers seated in the same row, two rows in front, and two rows behind the case, as well as crew members who served that section or had close contact with the case. In the case of special transport for repatriation, ECDC recommends that passengers and crew wear fluid-resistant medical masks or respiratory masks, such as FFP2. In transport vehicles, at least one seat should remain empty in all directions around each passenger or crew member. ECDC recommends physical distancing of about one to two meters, reducing crowding, and improving ventilation in reception areas. Reception and transport staff should be attentive to the appearance of symptoms such as cough, fever, gastrointestinal disturbances, or other flu-like signs. For medical interactions, ECDC recommends using personal protective equipment, including FFP2 respirators, gloves, gowns, and eye protection. For procedures that may generate aerosols, ECDC recommends considering an FFP3 respirator and, where possible, managing the patient in a negative pressure room. ECDC also recommends strict cleaning and disinfection measures for the ship, as handling waste, textiles, and surfaces can aerosolize dry biological material. Cleaning staff must use airborne protection measures, and procedures should avoid dry sweeping. The Centre warns that outbreak management must be accompanied by clear risk communication, community engagement, and combating misinformation. ECDC recommends communication tailored to different audiences, in their languages, without medical jargon, specifying what is known, what remains unknown, and the level of risk to the general population. ECDC notes that residents of the Canary Islands are considered at low risk for the Andes virus, but recommends consultation and engagement with local communities to address fears and concerns. The Centre warns that misinformation can contribute to the stigmatization of passengers and crew. ECDC has also announced operational support for Spain. Along with the ECDC expert already on board the ship, Spain has requested assistance through the EU Health Task Force, which has led to the sending of an additional ECDC expert and two fellows from the European Programme for Intervention Epidemiology Training. The additional expert will support coordination with national and regional authorities in Spain and the Canary Islands. Hantaviruses are zoonotic viruses transmitted to humans primarily through contact with rodent-contaminated excreta, usually through inhalation. The Andes virus is considered of special interest because very limited cases of human-to-human transmission have been reported, primarily after close and prolonged contact with symptomatic individuals. The incubation period is from one to six weeks. Infection may begin with fever, respiratory, and gastrointestinal symptoms and can rapidly progress to severe illness or death. The ECDC document was developed based on data reported through the EU Early Warning and Response System, EWRS, and through the European Infectious Disease Surveillance Portal, EpiPulse, based on available epidemiological information, scientific literature, and consultations with the World Health Organization and the European reference laboratory for emerging pathogens and zoonotic agents transmitted by rodents. The epidemiological, microbiological, and environmental investigation is still ongoing. ECDC specifies that there is limited information regarding the travel history of the cases, exposures prior to boarding, and contacts between passengers and crew on board. The search for rodent reservoirs and environmental sampling on the ship is to be conducted in Spain. The outbreak on the MV Hondius has triggered a European public health response due to the number of severe cases, deaths, and the movement of passengers and crew between multiple jurisdictions. For EU/EEA authorities, the main difficulty is the coordinated management of repatriation, quarantine, monitoring, and potential testing of exposed individuals. ECDC applies the precautionary principle as the Andes virus has documented but very limited potential for person-to-person transmission. The recommendations do not treat the entire population as exposed to the same risk but differentiate between high-risk and low-risk contacts, depending on the proximity and duration of exposure. For ECDC, medical measures must be accompanied by careful public communication. The Centre emphasizes that the perceived risk by the population may differ from the scientifically assessed risk and that misinformation can complicate the outbreak response, especially in areas receiving passengers or participating in disembarkation and transport operations.