As hantavirus infections have been reported in succession on the Atlantic-cruising ship MV Hondius, health authorities worldwide are on alert. While some say the likelihood of a large outbreak is low, experts say Korea should reexamine domestic surveillance, early diagnosis, and vaccine technology.
According to the World Health Organization (WHO), as of the 4th, seven people on the MV Hondius—2 confirmed and 5 suspected among 147 passengers and crew—were identified with hantavirus infection, and 3 of them died. The Netherlands National Institute for Public Health and the Environment (RIVM) said the virus on board is the Andes virus, a type of hantavirus mainly found in South America.
Hantaviruses are mainly transmitted to humans through rodents such as mice. Virus shed in the urine, feces, and saliva of infected rodents can become airborne with dry dust and enter the respiratory tract to cause infection. The risk increases in environments where exposure to rodent excreta is possible, such as grasslands, farmland, warehouses, and military training grounds.
The reason this cruise ship incident is drawing attention is that the Andes virus is one of the few hantaviruses for which possible human-to-human transmission has been reported. Still, the WHO assessed the risk to the general population worldwide as low, and the European Centre for Disease Prevention and Control (ECDC) also said that if infection control measures are applied, the likelihood of large-scale community spread is low.
However, in Korea, several hundred cases of hemorrhagic fever with renal syndrome (hantavirus infection) occur every year. According to the Korea Disease Control and Prevention Agency, 373 cases of hemorrhagic fever with renal syndrome were reported in 2024, and around 400 to 500 cases have occurred annually since the 2000s. The agency classifies hemorrhagic fever with renal syndrome as a tier 3 notifiable infectious disease under the statutory infectious disease classification system revised in 2019.
Song Jin-won, a professor in the Department of Microbiology at the Korea University College of Medicine, said, "Hantaviruses are endemic infectious diseases that occur in many regions around the world," adding, "Currently in Korea, there are four types—Hantaan virus, Seoul virus, Imjin virus, and Jeju virus—and among them, Hantaan and Seoul viruses mainly cause disease in humans."
Hantaan virus was first isolated worldwide in 1976 by Lee Ho-wang, a Korea University professor, from striped field mice near the Hantan River. As viruses similar to Hantaan virus were later identified in many parts of the world, the umbrella term "hantavirus" came into use. Seoul virus is a hantavirus transmitted by urban brown and black rats.
Jung Jae-hoon, a professor in the Department of Preventive Medicine and the Interdisciplinary Program in Public Health at the Korea University College of Medicine, said, "In Korea, hantavirus is not someone else's problem," adding, "The fatality rate of hemorrhagic fever with renal syndrome caused by Hantaan and Seoul viruses is over 5%, with deaths continuing to occur, and it often begins with nonspecific fever, leading to delayed diagnosis."
Experts say the cruise incident should prompt continued strengthening of domestic hantavirus surveillance and research. Jung said, "Both hantavirus pulmonary syndrome and hemorrhagic fever with renal syndrome lack specific antiviral treatments, so early diagnosis and supportive care determine outcomes," adding, "Because cases can rapidly progress within hours from fever and myalgia to acute respiratory distress syndrome or multiple organ failure, early diagnosis and intensive care capabilities—such as oxygen supply, fluid and electrolyte balance, and renal replacement therapy—are crucial."
Song said, "In Korea, preventive vaccines and diagnostic kits have been developed, and new hantaviruses continue to be discovered," adding, "However, because the vaccine was developed long ago, it needs to be improved with more modern methods, and support for early diagnostic methods and vaccine research should continue."