As hantavirus infections have been reported in succession on the cruise ship MV Hondius sailing across the Atlantic, health authorities worldwide are on edge. While some expect the likelihood of a large outbreak is low, experts say Korea should reexamine domestic surveillance, early diagnosis, and vaccine technologies.
According to the World Health Organization (WHO), as of the 4th, seven people aboard the MV Hondius—two confirmed and five suspected among 147 passengers and crew—were identified with hantavirus infection, and three of them died. The National Institute for Public Health and the Environment (RIVM) of the Netherlands said the virus on the vessel is the Andes virus, a type of hantavirus mainly found in South America.
Hantaviruses are mainly transmitted to humans through rodents such as mice. The virus shed in the urine, feces, and saliva of infected rodents becomes airborne with dry dust and enters the respiratory tract to cause infection. The risk increases in environments where people can be exposed to rodent excreta, such as grasslands, farmland, warehouses, and military training grounds.
This cruise-ship incident is drawing attention because the Andes virus is a rare hantavirus type for which human-to-human transmission has been reported. Still, the WHO assessed the risk to the general global population as low, and the European Centre for Disease Prevention and Control (ECDC) also said the likelihood of large-scale community spread is low if infection-control measures are applied.
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 Category 3 infectious disease under the statutory infectious disease classification system revised in 2019.
Song Jin-won, a professor in the Department of Microbiology at the College of Medicine at Korea University, said, "Hantaviruses are endemic infections that occur in many regions around the world," and noted, "Currently in Korea, there are four types—Hantan virus, Seoul virus, Imjin virus, and Jeju virus—and among these, Hantan and Seoul viruses mainly cause disease in humans."
Hantan virus is a virus first isolated worldwide in 1976 by Korea University Professor Lee Ho-wang from striped field mice near the Hantan River. As viruses similar to Hantan virus were later identified in many parts of the world, the term "hantavirus" came to be used as an umbrella name. Seoul virus is a hantavirus transmitted by urban house rats and brown rats.
Jung Jae-hoon, a professor in the Department of Preventive Medicine and the Interdisciplinary Program in Public Health at the College of Medicine at Korea University, said, "In Korea, hantavirus is not someone else's problem," and explained, "The fatality rate of hemorrhagic fever with renal syndrome caused by Hantan and Seoul viruses is over 5%, with deaths occurring continuously, and because it begins with nonspecific fever, diagnosis is often delayed."
Experts say the cruise incident should prompt continued strengthening of domestic hantavirus surveillance and research. Professor Jung said, "There are no specific antiviral treatments for both hantavirus pulmonary syndrome and hemorrhagic fever with renal syndrome, so early diagnosis and supportive care determine outcomes," and added, "Because the illness can progress rapidly within hours from fever and myalgia to acute respiratory distress syndrome or multiple organ failure, capabilities in early diagnosis and critical care—such as oxygen delivery, fluid and electrolyte balance, and renal replacement therapy—are crucial."
Professor 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 a long time ago, it needs to be improved with more modern approaches, and support for early diagnostic methods and vaccine research should continue."