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Epidemiological investigations are detective stories. There is a body (or bodies), the deaths are connected in some way, and there is a race to find out who did it, as well as to protect those who might be next, before the killer strikes again. The tale of the MV Hondius, a Dutch-flagged, ice-strengthened expedition ship travelling the Atlantic cruise route between Europe and the southern polar regions, is one such story. 

The Hondius left the southern Argentinian port of Ushuaia, the starting point for most Antarctic cruises, on April 1, for what was to be a 24-day return voyage to Europe. It carried around 160 passengers and crew from 23 countries. The return trip would cross the Atlantic, stopping at select ports along the way. Among the passengers was a Dutch couple in their sixties, avid bird-watchers who had traveled extensively in Chile and Argentina before boarding.

The 69-year-old Dutch man was the first to die. He had initially complained of a fever, headache and diarrhoea. Breathing difficulties and acute respiratory distress followed abruptly before his death on April 11. 

His body was taken off the ship at St. Helena almost two weeks later to be repatriated, accompanied by his wife. Altogether, 24 passengers disembarked there, including a number of Americans. His wife fell ill shortly after leaving the ship, collapsing at an airport in Johannesburg and dying shortly thereafter in a local health facility.

Meanwhile, on the ship, a British national began to experience breathing difficulties similar to those of the Dutch man and was evacuated to an intensive care unit (ICU) in South Africa. On May 2, a German woman died on board. She had been unwell for only 5 days. The same day, tests conducted in South Africa confirmed a  specific viral infection in the British man and on May 4, the same infection was confirm in the case of the German woman.

Whatever was sickening the patients did not respond to standard antibiotics carried by the high-end cruise ship’s doctor. The disease progressed similarly across patients, presenting initially like a flu. It was clearly infectious – the doctor who had treated the Dutch man and his wife was among those who fell ill early. Tests ultimately established that all those who died were infected by the same pathogen: a virus called the hantavirus, specifically the Andes strain. 

The hantavirus family is large, with around 28 members known to cause diseases in humans. Carried primarily by rodents, the virus causes fever, fatigue, nausea and breathing difficulties in infected humans. Transmission usually occurs through contact with, or inhalation of, rodent droppings and urine. 

There are two major disease-causing variants. The Asian hantaviruses result in a renal syndrome,  primarily affecting the kidneys and blood vessels. The American hantaviruses, such as the Sin Nombre virus in the American Southwest or the Andes virus found on the cruise ship, cause hantavirus pulmonary syndrome, a condition affecting both the lungs and heart.

Cleaning enclosed or poorly ventilated spaces where rodent droppings may be present, and thus can be inhaled, increases the risk of exposure, as does sleeping in dwellings frequented by rodents. Betsy Arakawa, the wife of the well-known actor Gene Hackman, is believed to have died of hantavirus pulmonary syndrome in their New Mexico home, where she may have been exposed to deer mouse droppings. Investigations following her death in early 2025 found rodent nests in several buildings on their property. Tragically, her husband, who died of natural causes just a week later, may not have known of her death, as he himself was in the late-stages of Alzheimer’s disease.

Although infections are relatively rare, the fatality rate ranges between 30% and 50%. The global burden of hantavirus infection is dominated by China and Korea, where the less........

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