All eyes are on passengers of a cruise ship battling an outbreak of Andes virus, an infectious disease that has so far left three people dead and several others sick.

On Monday, a group of Americans on the ship were flown from the Canary Islands in Spain to Nebraska for monitoring, with at least two later flown to Atlanta for treatment. Their arrival comes just days after the U.S.’s top health agency issued a nationwide advisory urging doctors to be on the lookout, as a precaution, for potential “imported cases,” while noting “the risk of broad spread to the United States is considered extremely unlikely at this time.”

The infectious disease is commonly being referred to simply as “hantavirus,” the family name for the Andes virus and other viruses that are primarily transmitted by contact with rodents.

The Andes virus, a species within the Orthohantavirus genus, is a rare disease known to cause severe, and often fatal, respiratory illness. So far, there are at least 11 reported cases linked to the Netherlands-based MV Hondius cruise ship and at least three deaths, according to CBS News. As of now, there are no reported cases in Florida, which has not seen a confirmed hantavirus-related case in over 30 years, according to data from the state health department.

No antiviral drugs or vaccines currently exist to prevent or reduce symptoms. But public health experts say this isn’t like the early days of COVID, when cruise ships were ground zero for outbreaks and hospitals were overwhelmed with sick patients doctors weren’t sure how to treat.

“This is not going to be another pandemic,” Dr. Nicole Iovine, chief hospital epidemiologist and infectious disease physician at UF Health Shands hospital in Gainesville, told the Miami Herald on Monday, explaining that public health experts for years have studied and handled similar outbreaks of the Andes virus.

Here’s what to know:

How does the Andes virus spread?

The cruise ship outbreak is linked to the Andes virus, the only member of the hantavirus family that can spread from person to person, according to Dr. Aileen Marty, an infectious disease expert at Florida International University. It’s not known which subtype of the Andes virus is fueling the cruise ship outbreak, a key piece of information Marty said could be useful to determine treatment and public health measures.

Marty and Iovine said the Andes virus often spreads by contact with certain rodents found in South America — usually by breathing in virus particles that are in the air and come from rodents’ dried saliva, feces or urine — and can lead to severe, and sometimes fatal, respiratory illness, including fluid in the lungs.

People can also get infected by “touching an object with the virus on it, or, rarely, through contact with a sick person who has the virus,” through direct physical contact, prolonged time spent in close or enclosed spaces, and exposure to bodily fluids, according to the CDC.

“Every other Orthohantavirus virus, you can only get it by breathing in air contaminated with the virus from a rodent, but the Andes virus, you can get by breathing in Andes virus from a person,” Marty said.

Remember, there are many different hantaviruses in the world.

“Some, like those in Europe and Asia, tend to cause problems with the kidneys and bleeding. And then there are strains within the Americas, North and South America, and they are more likely to cause problems with the lungs, pulmonary syndrome. So that’s what these people on the ship experienced,” Dr. Mary Jo Trepka, an infectious disease expert at Florida International University, told FIU News.

The good news is that the Andes-virus-carrying rodents are not found in the United States. Health experts say the virus also doesn’t spread as easily as COVID, the flu, measles and other infectious diseases. Unlike COVID, people sick with the Andes virus are not infectious before symptoms start to appear, the health experts say.

How common is this virus?

Health officials say the virus is rare and is not considered to be easily transmissible. State data, for example, shows that Florida has not seen a confirmed case of hantavirus since at least 1992, according to Trepka.

However, there was an uptick of hantavirus cases reported last year in endemic countries, according to The Pan American Health Organization (PAHO), which functions as the Americas’ regional office for the World Health Organization.

“In the Americas, hantaviruses can cause hantavirus cardiopulmonary syndrome (HCPS), a severe respiratory illness, with a case fatality rate up to 50%,” according to PAHO.

In December, the health agency published an alert noting that eight countries in 2025 had reported a total of 229 cases of hantavirus pulmonary syndrome, with 59 deaths, including Argentina, Brazil, Bolivia, Chile, Panama, Paraguay, the U.S. and Uruguay. About 26% of the people infected died.

It’s worth noting that the fatality rate varies by outbreak, with previous outbreaks seeing fatality rates ranging from about 20% to 50%, according to Marty, who noted that the earlier a person receives appropriate treatment, the higher their chances of recovery.

Andes virus symptoms and treatment

It can take four to 42 days for symptoms to appear after exposure to the virus, according to the CDC.

The most common symptoms people initially experience include fatigue, fever and aching muscles, particularly in areas like the thighs, hips, back and sometimes shoulders, according to the federal health agency. Nearly half of all Andes virus-infected patients will also experience headaches, dizziness, chills, diarrhea, vomiting, nausea and abdominal pain.

However, there are no antiviral drugs or vaccines to help prevent infection or reduce symptoms, according to Marty and Iovine. Instead, doctors will turn to “supportive” treatment options based on symptoms. If a person is severely ill and hospitalized and is struggling to breathe, doctors put them on a ventilator, for example, said Iovine. Recovery time varies on symptoms.

Doctors may also turn to convalescent serum, “the watery part of the blood that has antibodies from somebody who recovered” from a previous Andes virus infection, according to Marty.

“A person who recovers from having had Andes virus has antibodies against Andes virus. ... So we can use their serum, the watery part of their blood that has antibodies to treat somebody else, just like we used that serum from people that had COVID and recovered to help people who were very sick with COVID before we had good antiviral [medication].”

Marty and Iovine say the best way to help combat the disease spread is to effectively use contact tracing, quarantine and isolation to reduce the risk of transmission. Marty said people who were exposed or potentially exposed to the virus and don’t have symptoms should be in quarantine for up to 45 days. People who have symptoms should stay in isolation until symptoms are gone and they test negative.

“We know about this. We have tools in place. Yes, we don’t have a treatment, but we know how to contain it,” Marty said.

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