Andes Virus: From Transmission Dynamics to Pandemic Potential

Andes virus (ANDV) has recently emerged as a significant public health concern following a multi-country outbreak aboard the MV Hondius cruise ship in April 2026, with 13 identified cases and three deaths among passengers and crew.

We reviewed available literature from PubMed and Google Scholar databases and searched international health agencies, including the World Health Organisation and national public health authorities, for current outbreak information and up-to-date epidemiological data.

ANDV is a zoonotic orthohantavirus endemic in southern Chile and Argentina, with Oligoryzomys longicaudatus as its principal reservoir. Approximately 300 cases of hantavirus cardiopulmonary syndrome occur annually in the Americas. The virus causes severe disease through endothelial dysfunction and vascular leakage, resulting in rapidly progressive pulmonary edema and shock. Human-to-human transmission is characteristic of ANDV and occurs through respiratory and salivary routes during prolonged close contact. Clinical presentation includes nonspecific prodromal symptoms followed by rapid cardiopulmonary deterioration. Diagnosis relies on serological assays and RT-qPCR. Management is predominantly supportive, emphasising hemodynamic monitoring and early consideration of extracorporeal membrane oxygenation in severe cases.

Despite ANDV's severity and high mortality, its epidemic potential seems to be low. However, the recent outbreak underscores the importance of international surveillance coordination and rapid diagnostic capabilities for emerging zoonotic infections.