US 42-day monitoring period ends: all 18 American MV Hondius passengers have completed their monitoring period at the National Quarantine Unit (UNMC, Nebraska). No cases of hantavirus disease were detected. CDC confirms no further public-health follow-up is required for the American passengers.
MV Hondius decontamination completed in Rotterdam (29–30 May): EWS Group's 13 biosecurity experts cleared all 8 decks and confirmed rodent-free status. Ship cleared for operations by Dutch authorities. MV Hondius departs Rotterdam for Longyearbyen, Svalbard on 6 June; first post-outbreak Arctic expedition remains scheduled to depart Longyearbyen on 13 June 2026.
ECDC updates to 13 total cases (11 confirmed + 2 probable), 3 deaths, CFR 23% — reflecting Spain's new confirmed case. Case definition revised to align with WHO: confirmed now requires laboratory confirmation of ANDV by PCR and/or serology. WHO DG Tedros: 'Spain reported a new case among the passengers who are in quarantine, which brings the total number of cases to 13. The situation remains stable.' HantaCount headline updates to 18 cases; Spain total rises to 3.
Spain confirms third hantavirus case: a second Spanish national among the 14 MV Hondius passengers quarantined at Gómez Ulla Central Defence Hospital (Madrid) tests PCR-positive during routine periodic diagnostic screening. Patient transferred to High-Level Isolation Unit. Detected within the activated surveillance and control system; Spain's Health Ministry states the case does not change the public health risk assessment.
Tristan da Cunha government update: the one suspected hantavirus case on the island is now well enough to recuperate at home. Still classified as probable pending final laboratory confirmation. Community-wide GeneXpert screening has not revealed additional cases.
ECDC publishes 21 May 2026 surveillance update: no new cases or deaths reported since 16 May. Official ECDC count: 9 laboratory-confirmed + 2 probable = 11 total cases, 3 deaths, CFR 27%. Risk to the EU/EEA general population remains very low. All repatriated passengers continue 42-day home monitoring (ending late June). No new WHO DON published since DON-601 (13 May).
Spain update: the 70-year-old Spanish male MV Hondius passenger at Gómez Ulla Central Defence Hospital (Madrid) is 'progressing well.' The 13 high-risk contacts on the same ward — all testing negative — are allowed to move around shared areas wearing PPE and to receive staggered, safe visits. No cross-contamination confirmed among hospital contacts.
CDC issues formal quarantine orders for 2 US passengers at the National Quarantine Unit (UNMC, Nebraska) who sought to leave before the monitoring period ended. Orders signed by CDC's Acting Director under the Public Health Service Act (42 CFR parts 70–71). All 18 US passengers requested to remain at the facility through 31 May — the 21-day monitoring mark. The initial stay had been described by officials as voluntary; the shift to mandatory orders follows three new post-repatriation international cases (France, Spain, Canada).
MV Hondius docks in Rotterdam (18 May, 19:30 CET). Ship carried 25 crew + 2 Dutch health workers. The 20 non-Dutch crew (17 Filipino, 3 Ukrainian) entered 6-week quarantine in separate shipping-container cabins at the port; Dutch crew returned home under monitoring. Body of the passenger who died on 2 May removed from the ship for cremation. Oceanwide Expeditions contracted EWS Group to perform ship-wide decontamination (estimated 3–4 days). Return to service: departure from Longyearbyen, Svalbard on 13 June 2026.
Canada confirms first case: a returned MV Hondius passenger in British Columbia tests presumptively positive for Andes hantavirus — ECDC classifies as confirmed. Patient has mild symptoms and is quarantined at home. HantaCount headline updates to 16 cases, 15 countries, CFR 19%.
WHO and UKHSA jointly convene Emergency Scientific Consultation on Andes Virus Medical Countermeasures (MCM) in Geneva — experts, researchers and public health authorities from affected countries prioritise the vaccine and antiviral R&D pipeline for Andes hantavirus. First dedicated ANDV MCM workshop at WHO level, triggered by the MV Hondius outbreak.
France Health Minister Stéphanie Rist: all 26 close contacts of the two confirmed French cases PCR-tested negative for Andes hantavirus. The 27 French nationals under highest surveillance (2 confirmed cases + 25 contacts/household) continue weekly testing under France's 45-day quarantine protocol. Case 1 remains critically ill on ECMO at Hôpital Bichat-Claude-Bernard; no further deterioration reported.
Italy: all 4 persons quarantined following exposure on the KLM Johannesburg–Amsterdam flight (25 April) — including a 25-year-old Calabrian man who developed hantavirus-compatible symptoms — test negative for Andes hantavirus at Spallanzani Institute (Rome) and a Milan laboratory. Italy not added to HantaCount country list.
US inconclusive case (Nebraska Biocontainment Unit) retested NEGATIVE: CDC and UNMC confirm the result resolves to negative. Patient (Dr. Stephen Kornfeld, 69, Bend OR — retired oncologist who voluntarily cared for ill passengers onboard) released from biocontainment unit to Davis Global Center standard quarantine facility. HantaCount US total: 0 confirmed cases. Headline total drops from 16 to 15.
ECDC publishes new technical guidance: 'Advice on laboratory testing of Andes virus (ANDV) for high-risk contacts under the MV Hondius outbreak'. Aligns serology + PCR testing protocols across receiving countries; addresses discordant-result handling (relevant to the inconclusive US case).
MV Hondius repatriation flights #2 and #3 — all passengers tested negative for hantavirus. Combined with the 1 inconclusive on flight #1, this leaves the only ongoing confirmed/probable cases as those previously reported. No new repatriation-discovered cases.
Radboud UMC update: all 12 quarantined Nijmegen hospital staff blood tests negative — no ANDV transmission confirmed. Dutch healthcare union CNV publicly condemns the protocol breach; Radboud admits the latest international ANDV-specific guideline was not yet available to staff at the time of exposure. Staff to remain in 6-week observational quarantine as precaution.
Spain Case 2 (Madrid, Gómez Ulla hospital) develops low-grade fever and mild respiratory symptoms — previously asymptomatic. Stable but progressing under close monitoring. ANDV onset window matches WHO timeline (1–8 weeks post-exposure).
ECDC urges quarantine for high-risk contacts on the LIFT St. Helena–Johannesburg (24 April) and KLM Johannesburg–Amsterdam (25 April) flights — specifically passengers in the same row or two rows in front/behind a confirmed case. Italy reports a 25-year-old man who travelled on the KLM flight has developed hantavirus-compatible symptoms; 4 Italian passengers placed under quarantine. First reported off-ship exposure under active investigation. Italy is not yet added to the HantaCount country list pending Italian health authority case classification.
France Case 1 critically ill: French repatriated passenger at Hôpital Bichat-Claude-Bernard (Paris) is placed on ECMO (extracorporeal membrane oxygenation) for life-threatening cardiopulmonary failure consistent with hantavirus pulmonary syndrome (HCPS). Patient is the in-flight symptomatic case from 11 May; condition has rapidly deteriorated.
Illinois IDPH investigates potential hantavirus case in Winnebago County — explicitly NOT linked to MV Hondius. Strain identified as Sin Nombre virus (SNV), a North American rodent-borne hantavirus unrelated to Andes virus (ANDV). SNV is not person-to-person transmissible; patient is recovering with mild symptoms and did not require hospitalisation. This case is not included in HantaCount headline total.
ECDC updates official count: one previously confirmed case reclassified as 'inconclusive' after further laboratory review. New ECDC tally aligns with WHO DON-601: 8 lab-confirmed + 2 probable + 1 inconclusive = 11, 3 deaths. HantaCount headline remains 16 (no change in national health agency confirmations). No new countries report cases.
WHO publishes DON-601: third Disease Outbreak News on the cluster. Confirms 11 cases (8 lab-confirmed ANDV + 2 probable + 1 inconclusive), 3 deaths (2 confirmed + 1 probable), CFR 27%. Inconclusive case is a US passenger with discordant results between two labs (one positive, one negative) — retesting under way. WHO risk assessment: low globally, moderate for those on board. Preliminary sequencing: cases differ by ≤1 SNP, indicating a single (or very small number of) zoonotic spillover event(s). Working hypothesis remains that index case was infected on land in Argentina/Chile (likely during bird-watching activity) before boarding the ship.
US update: 16 Americans at Nebraska Biocontainment Unit (1 confirmed, 15 monitoring); 2 at Emory University Hospital Atlanta — 1 symptomatic, PCR negative (hantavirus ruled out); 1 monitoring. Tristan da Cunha community PCR screening results from GeneXpert rig still pending.
ECDC updates official count to 11 (9 lab-confirmed + 2 probable), 3 deaths. MV Hondius departs Tenerife for Rotterdam for crew offload and ship-wide hantavirus decontamination (4–6 weeks). WHO Director-General: 'There is no sign that we're seeing the start of a larger outbreak.'
WHO Director-General Tedros Adhanom Ghebreyesus, briefing reporters in Tenerife, said: "This is not another COVID. The risk to the public is low." Tedros reiterated that human-to-human Andes virus transmission is limited to close-contact settings and that the multi-country evacuation should not change the overall WHO public-risk assessment, which remains very low.
CDC activates Level 3 emergency response for the MV Hondius outbreak — the agency's mid-tier activation that mobilises an Emergency Operations Center team and deploys epidemiologists and medical staff to the affected region. The CDC team is conducting per-passenger exposure risk assessments for the 18 repatriated US nationals and is coordinating with HHS on the Nebraska Biocontainment Unit transfer.
France confirms second case: a French woman evacuated from MV Hondius tests PCR-positive — the second of 5 repatriated French nationals to test positive. France total: 2 cases. HantaCount headline updates to 16 cases, CFR 19%.
Spain confirms second case: a Spanish male passenger in Madrid hospital tested PCR-positive on arrival screening; asymptomatic and in good health. This is distinct from the May 8 Alicante case (South African woman). Spain total: 2 cases.
Radboud UMC (Nijmegen, Netherlands): 12 hospital staff placed in 6-week preventive quarantine after protocol breaches in handling an MV Hondius patient. Blood samples were processed under standard rather than ANDV-strict protocol; urine disposal did not follow latest international guidelines. Hospital states the probability of actual infection is very small.
First US case confirmed: HHS announced one of the 18 repatriated American passengers tested PCR-positive for Andes hantavirus on the trans-Atlantic flight (asymptomatic at testing). Patient transported in a biocontainment unit to the Nebraska Biocontainment Unit at University of Nebraska Medical Center for follow-up. A second American with mild symptoms is being routed to a separate ASPR RESPTC. HantaCount headline updates to 14 cases (13 + 1 US PCR-positive), CFR 21%.
Methodology lock-in: HantaCount headline aligned to the sum of national health agency reports (NL 2 + ZA 1 + GB 3 + CH 1 + ES 1 + DE 1 + FR 1 + TR 1 + CV 1 + SH 1 = 13 cases, 3 deaths, CFR 23%). Each country count now carries an explicit source. WHO DON-600 baseline (8 cases, 6 lab-confirmed + 2 probable, CFR 38%) shown separately for direct comparison.
Updated disembarkation count: 94 of the 147 onboard passengers disembarked on the first day (10 May), representing 19 different nationalities. Beyond the 13 countries with cases, additional passenger nationalities include Australia, Belgium, Greece, Guatemala, India, Japan, Montenegro, New Zealand, Poland, Portugal, Russia and Ukraine — these countries are conducting precautionary contact monitoring even though no cases have been confirmed among their nationals.
WHO coordinates shipment of 2,500 Andes virus diagnostic kits from Instituto Malbrán (Argentina) to reference laboratories in Spain, France, Netherlands, United Kingdom and South Africa. Tristan da Cunha team installs Cepheid GeneXpert PCR rig at Camogli Hospital — first community screening results expected within 48 hours.
Tenerife disembarkation operation completes. UK Health Security Agency confirms a third British national positive for Andes virus on the repatriation flight. One French passenger develops symptoms in-flight to Paris and is isolated on arrival at Bichat. WHO updated Tristan da Cunha case timeline: probable case is an adult male resident who disembarked at Saint Helena on 14 April, symptom onset 28 April (diarrhoea, then fever); currently stable in isolation. One previously suspected case has been reclassified as non-case after PCR and serology negative.
WHO confirms 46 passengers disembarked at Tenerife in the first wave; first Spanish charter (14 passengers) reached Madrid. France evacuates 5 nationals to Paris under 72-hour hospital observation + 45-day home quarantine protocol. UK military paratroopers airdrop medical clinicians and equipment to Tristan da Cunha. After full disembarkation MV Hondius will continue to Rotterdam for crew offload and ship-wide disinfection.
Spanish health authorities confirm disembarkation order: Spanish nationals first, flown to Madrid Gomez-Ulla military hospital for quarantine; followed by Netherlands, Canada, Türkiye, France, United Kingdom, Ireland and United States. Spain's health minister states remaining passengers are asymptomatic.
Passenger disembarkation begins at Tenerife under strict medical supervision. UK Health Security Agency confirms second British case.
Tristan da Cunha government reports suspected hantavirus case in a resident who disembarked April 24. Flight attendant who left Hondius by air tests negative for Andes virus.
WHO issues DON-600: 8 cases (6 confirmed, 2 probable), 3 deaths, CFR 38%. Ship docked at Tenerife; passenger disembarkation planned for May 10. 17 Americans to be repatriated to Offutt AFB; no mandatory quarantine.
MV Hondius arrives at Tenerife (Granadilla de Abona port); WHO Director-General travels to Canary Islands to coordinate disembarkation of 147 on board. France and Singapore added to contact-tracing network; 7 US states monitoring passengers.
CDC announces repatriation flight; Spain confirms case in Alicante; US monitoring across 5 states.
Switzerland confirms first European case; 40 passengers evacuated.
Argentina opens investigation into pre-cruise exposure source.
WHO Disease Outbreak News (DON-599) issued — Andes virus confirmed.
A female passenger dies on board MV Hondius after developing pneumonia — third death (still being stored on the ship). PCR samples sent to Lisbon.
First-death body removed from MV Hondius at Saint Helena port. The deceased's wife disembarks at Saint Helena and is later hospitalised; she dies in Johannesburg on April 26 — second death.
First passenger dies on board MV Hondius (later identified as Andes virus). Body remains on the ship until Saint Helena.
First passengers report flu-like symptoms.
Several dozen passengers disembark at Saint Helena; later identified for contact tracing.
MV Hondius departs Argentina with 240+ passengers.