Global hantavirus outbreak and the lessons to be learnt for India: epidemiology, clinical manifestations, investigations, surveillance and way forward

Abstract

Hantaviruses are emerging zoonotic pathogens of the family Hantaviridae that are present in rodent and insectivore reservoirs. They are transmitted primarily through inhalation of contaminated aerosols. Globally, it causes two major clinical syndromes: hemorrhagic fever with renal syndrome (HFRS), predominantly in Asia and Europe and Hantavirus cardiopulmonary syndrome (HCS), primarily seen in the Americas. The 2026 multinational Andes virus Outbreak linked to the expedition cruise ship MV Hondius demonstrated the potential for rapid international dissemination of Hantavirus through global travel, resulting in multiple cases, deaths, and large-scale cross-border public health responses. The outbreak highlighted the importance of genomic surveillance, international collaboration, contact tracing, and preparedness for emerging zoonotic threats. India possesses ecological conditions favorable for hantavirus circulation and has documented evidence of hantavirus-related viruses. The apparent absence of major hantavirus outbreaks in India may reflect surveillance and diagnostic gaps rather than the true absence of disease. Strengthening one health surveillance, laboratory capacity, rodent monitoring, genomic sequencing, and clinician awareness is essential to enhance preparedness against emerging hantavirus threats.