PRETORIA – Recent international reports of hantavirus cases linked to an outbreak on a cruise ship have raised questions about the virus, how it spreads and what level of risk it may pose to the public. According to Professor Veronica Ueckermann, Head of Infectious Diseases in the Department of Internal Medicine at the University of Pretoria (UP), hantavirus is a rare but potentially serious infection that should be understood in context.
“Hantavirus is a rare zoonotic virus, which means it’s carried by animals – in this case, rodents,” she explains. “Humans typically become infected when they breathe in particles from the urine, faeces or saliva of infected rodents.” Rare cases of human-to-human spread have been reported.
The virus isn’t new and does not spread in the same way as more familiar respiratory infections such as influenza or COVID-19. Most hantavirus infections occur after environmental exposure (in endemic regions), particularly in enclosed spaces where rodent droppings, urine or saliva have contaminated dust. Activities such as sweeping dry droppings in garages, sheds, storage rooms or other poorly ventilated areas may increase the risk of inhaling contaminated particles.
The current outbreak has drawn attention because it’s been confirmed as the Andes variant of hantavirus. The Andes virus is unusual because it is the only hantavirus variant documented to spread between people. However, Prof Ueckermann emphasises that this form of transmission remains rare and appears to require prolonged, close contact.
“To date, human-to-human spread of hantavirus is extremely rare, and has been described only with the Andes variant and with prolonged close contact, such as people sharing a household,” she says. “There is no evidence of community-wide spread of hantavirus of the kind seen with COVID-19.”
Previous cases of the Andes virus suggest that transmission is associated with close, sustained exposure rather than brief or casual contact. Reported situations include household exposure, being in contact with an intimate partner, caregiving activities or spending extended periods in enclosed spaces in close proximity to an infected person. This distinction is important in interpreting public concern about travel and shared public spaces.
“Based on what we currently know about the Andes virus, the risk to fellow passengers on a flight appears to be low,” Prof Ueckermann says. “Simply being on the same aircraft, walking past an infected person or sitting at a distance would be considered very low risk. Sitting next to a sick person on a long-haul flight may plausibly carry a low risk, while the highest risk would be repeated close contact, such as caring for someone, touching or sharing cups.”
Prof Ueckermann adds that the public health response to the recent outbreak has been appropriate and reassuring. This has included early sequencing of the virus to confirm that it is the Andes variant, monitoring of close contacts and a coordinated approach to managing those affected.
In South Africa, hantavirus is not considered a major public health concern. Confirmed human cases are extremely rare, and the current cases being managed in the country are linked to exposure outside South Africa, not local transmission. Prof Ueckermann stresses that South Africa is not experiencing a hantavirus outbreak.
Symptoms may initially resemble influenza and can include fever, body aches, headache and abdominal pain. In most cases, especially during winter in South Africa, such symptoms are far more likely to be caused by common seasonal infections. However, anyone with a known exposure to rodent-contaminated environments or having had close contact with a confirmed case should seek medical advice if symptoms develop. Urgent care is needed if symptoms progress to shortness of breath, tightness in the chest, rapid breathing, dizziness, confusion, bluish lips or sudden worsening after a flu-like illness.
Practical prevention remains important. People should avoid sweeping rodent droppings, and instead spray the droppings with disinfectant or diluted bleach, allow the area to soak, wipe it up with paper towels and wash their hands thoroughly afterwards. They should also ventilate enclosed spaces before cleaning, wear gloves and a mask. Food and waste should be stored securely, and rodent entry points should be sealed.
“Hantavirus is a rare but potentially serious rodent-borne infection, with very rare person-to-person spread,” Prof Ueckermann says. “The appropriate response is evidence-based awareness, sensible hygiene and rodent control – not panic.”
