The Andes hantavirus is a rare but highly dangerous rodent-borne virus found primarily in South America. Unlike most hantaviruses, Andes virus has been associated with limited person-to-person transmission, making it a particular concern for healthcare workers and first responders. While infections remain uncommon, the virus can cause severe respiratory illness with a high fatality rate.
For EMS providers, firefighters and law enforcement personnel, understanding how Andes hantavirus spreads, what symptoms look like and how to protect crews during patient encounters is important for operational safety.
| WATCH: Special report — Rob Lawrence and Dr. Alex Isakov on the Andes Hantavirus risk assessment
What is the Andes hantavirus?
Andes virus is a rare strain of hantavirus that causes Hantavirus Pulmonary Syndrome (HPS), also known as Hantavirus Cardiopulmonary Syndrome (HCPS), a severe respiratory disease that can rapidly progress to respiratory failure.
Note: The virus is called HPS by the Centers for Disease Control but identified by the World Health Organization as HCPS.
How is the Andes hantavirus spread?
The virus is primarily carried by rodents and can spread to humans through airborne virus particles from rodent urine, saliva or droppings; or touching something contaminated by the virus.
What makes the Andes virus different from other hantaviruses is its documented ability to spread between people through close contact. While transmission is still considered uncommon, cases involving household contacts and healthcare exposures have been reported.
Most infections occur in rural or wilderness settings where people encounter infected rodents or contaminated environments. Activities linked to exposure include:
- Camping
- Hiking
- Cleaning cabins or storage buildings
- Agricultural work
- Exposure to rodent-infested structures
Where did Andes hantavirus originate?
Andes hantavirus was first identified in Argentina in 1995 after outbreaks of severe respiratory illness in the Andes mountain region of South America.
The virus is still mainly associated with Argentina and Chile, though international travel can spread the virus beyond those regions.
Travel history may be important during patient assessment, particularly for patients recently returning from South America.
How is Andes hantavirus different from other hantaviruses?
Most hantaviruses found in North America, including the Sin Nombre virus stemming from deer mice in the Four Corners region of the U.S., are spread only through rodent exposure. Person-to-person transmission is not considered a significant risk with those strains.
The Andes virus is different because limited human-to-human transmission has been documented, particularly among close contacts exposed to respiratory secretions during the patient’s early symptomatic phase.
Insert table comparing hantavirus differences
Because of this transmission potential, responders should treat suspected Andes virus patients with heightened respiratory precautions.
Symptoms of Andes hantavirus
Symptoms usually develop one to six weeks after exposure.
Early symptoms may include:
- Fever
- Muscle aches
- Fatigue
- Headache
- Chills
- Nausea and vomiting
- Abdominal pain
As the disease progresses, patients may develop:
- Cough
- Shortness of breath
- Chest tightness
- Rapid respiratory decline
- Pulmonary edema
- Respiratory failure
Patients can deteriorate rapidly over a short period of time. If Andes hantavirus symptoms are present, check if the patient has:
- Recently traveled to Argentina or Chile;
- Frequent exposure to rodents or rodent-infested structures; or
- Interacted with international travelers
What to do if you encounter a suspected Andes hantavirus patient
Though the virus is rare, international travel can quickly turn an isolated outbreak into a global concern. Here’s how responders should proceed if they suspect their patient may have contracted the Andes strain.
| RESOURCE: Rethinking respiratory safety for modern threats
Use respiratory precautions
Because Andes virus may spread through close contact, responders should use:
- Gloves
- Eye protection
- N95 respirator or higher-level respiratory protection
- Gown if significant exposure to bodily fluids is possible
Use caution during aerosol-generating procedures such as:
- Intubation
- Nebulizer treatments
- Suctioning
- CPAP or BiPAP
Limit unnecessary exposure
Reduce the number of personnel involved in patient care when possible. Isolate the patient from others during transport if operationally feasible.
Gather exposure and travel history
Ask about:
- Recent travel to South America
- Rodent exposure
- Camping or wilderness activities
- Contact with sick household members
Travel history may be critical in helping hospitals identify possible Andes virus cases.
Provide supportive care
There is no specific antiviral treatment for Andes hantavirus. EMS care focuses on:
- Oxygenation
- Airway management
- Hemodynamic support
- Rapid transport to an appropriate facility
Monitor closely for rapid respiratory deterioration.
Notify the receiving facility early
Advance notification allows hospitals to implement infection-control precautions and prepare for possible respiratory isolation.
Follow exposure-reporting procedures
If responders believe they had unprotected exposure to respiratory secretions or aerosol-generating procedures involving a suspected patient, they should follow agency occupational exposure protocols immediately.
| WATCH NOW: Turning over a clean rig. MCHD’s Sean Simmonds shares decontamination best practices.
Don’t panic; calmly prepare
Andes hantavirus remains rare, but its potential for severe respiratory illness and limited person-to-person transmission makes it important for first responders to understand.
Maintaining strong respiratory precautions, identifying relevant travel and exposure histories and recognizing rapidly worsening respiratory symptoms can help protect responders and improve patient care outcomes.
Timeline: 2026 Andes strain outbreak
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.
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