International risk of secondary hantavirus clusters following MV Hondius outbreak

Abstract

As countries monitor contacts exposed during the ongoing multinational hantavirus outbreak linked to the MV Hondius cruise ship, the current absence of additional confirmed cases remains difficult to interpret given the long incubation period of Andes virus. Contacts exposed before coordinated medical repatriation, including during commercial flights, are currently managed under markedly different isolation and follow-up protocols across countries, while uncertainty persists regarding possible pre-symptomatic transmission. Here, we estimate the probability that additional transmission clusters may still emerge under these heterogeneous response conditions, using country-specific indicators of tracing and isolation capacity from two scores of the Global Health Security Index together with transmission patterns observed in previous Andes virus outbreaks, as well as more conservative assumptions.