Singapore steps up public health surveillance amid international hantavirus cruise outbreak

Singapore health authorities have activated public health measures for two residents who were onboard the cruise ship MV Hondius, which has been linked to a multi-country outbreak of Andes hantavirus infections.

In a statement issued on May 7, the Communicable Diseases Agency said the two men are currently isolated at the National Centre for Infectious Diseases and are undergoing testing for hantavirus. Results are still pending.

One of the individuals, a 67-year-old Singaporean male, arrived in Singapore on May 2, while the second, a 65-year-old Singapore Permanent Resident, returned on May 6. Both had travelled onboard the MV Hondius after it departed Ushuaia, Argentina, on April 1.

Authorities said both individuals had also been on the same flight from St Helena to Johannesburg on April 25 as a confirmed hantavirus case who later died in South Africa. The infected passenger did not travel to Singapore.

The CDA said one of the Singapore residents has a runny nose but is otherwise well, while the other remains asymptomatic. “The risk to the general public in Singapore is currently low,” the agency stated.

The outbreak linked to the cruise ship has so far resulted in eight reported cases and three deaths globally as of May 8, according to the World Health Organization. Six cases have been laboratory-confirmed as Andes virus infections, while investigations continue into the remaining cases.

WHO said the outbreak may involve limited human-to-human transmission, which has previously been associated with Andes virus in South America. The organisation currently assesses the global public health risk as low, but considers the risk for passengers and crew onboard the ship to be moderate.

Singapore authorities said if the two residents test negative, they will still undergo quarantine for 30 days from their last exposure, followed by phone surveillance until the end of the 45-day incubation monitoring period. If they test positive, they will remain hospitalised for treatment and contact tracing will be initiated.

The MV Hondius outbreak has triggered an international public health response involving multiple countries, including Argentina, South Africa, the Netherlands, Switzerland, Spain and the United Kingdom. WHO said investigations are ongoing into whether the first case may have contracted the virus through rodent exposure during travel activities in South America before boarding the ship.

Hantaviruses are typically spread through exposure to infected rodents or contaminated dust. Symptoms can include fever, fatigue, muscle aches, gastrointestinal illness and breathing difficulties, with severe cases progressing rapidly to respiratory failure and death. There is currently no approved antiviral treatment or vaccine for Andes hantavirus infection.

Singapore’s health advisory urged travellers visiting rural or rodent-prone areas to avoid contact with rodents and contaminated surfaces, maintain good hygiene, and seek medical attention promptly if symptoms develop after travel.