Europe has a complicated relationship with hantavirus. Long before MV Hondius brought Andes virus to Amsterdam, Paris, and Munich, thousands of Europeans were being infected every year by a hantavirus that most of them had never heard of: Puumala virus, carried by the common bank vole (Myodes glareolus) and endemic across Scandinavia, the Baltic states, Belgium, Germany, and much of central Europe.
In 2026, European hantavirus surveillance is now tracking two completely different threats simultaneously — and they could not be more different in their severity, geography, and transmission dynamics.
Europe’s Native Hantavirus: Puumala
Puumala virus (PUUV) has circulated in Europe for millennia. It causes Nephropathia Epidemica (NE) — a mild-to-moderate haemorrhagic fever with renal syndrome (HFRS) that rarely kills but frequently hospitalises.
Key facts about Puumala:
- Reservoir: Bank vole (Myodes glareolus), found across most of Europe
- Disease: Nephropathia Epidemica — fever, back/abdominal pain, kidney impairment
- Mortality: Less than 1% (usually 0.1–0.5%)
- Transmission: Aerosol from vole excreta; no person-to-person spread
- Seasonality: Autumn and winter peaks, correlating with bank vole population cycles
- Endemic countries: Finland, Sweden, Belgium, Germany, France, Estonia, Latvia, Lithuania, Russia (European portion), Czech Republic, Slovakia
In Finland alone, Puumala causes 1,000–3,000 hospitalised cases in high-transmission years. The country records more hantavirus cases per capita than anywhere outside South America.
In Germany, the RKI (Robert Koch Institute) records several hundred to several thousand Puumala cases per year depending on the vole population cycle. The states of Baden-Württemberg and Bavaria are particularly affected.
ECDC estimates approximately 10,000–15,000 symptomatic European hantavirus cases per year, almost entirely Puumala, with a small number of Dobrava-Belgrade virus cases in southeastern Europe (former Yugoslavia, Balkans).
European Hantavirus Cases in 2026 — The Puumala Baseline
The 2025–26 bank vole cycle has been elevated in several countries following mild winters and good mast production in 2024 (beech mast drives vole population booms). ECDC data as of May 2026:
| Country | 2026 YTD cases | Dominant strain | Source |
|---|---|---|---|
| Finland | ~1,800 | Puumala | THL |
| Sweden | ~420 | Puumala | FoHM |
| Germany | ~310 + 13* | Puumala + Andes* | RKI |
| Belgium | ~85 | Puumala | Sciensano |
| France | ~90 + 7* | Puumala + Andes* | ANRS |
| Netherlands | ~30 + 6* | Puumala + Andes* | RIVM |
| Czech Republic | ~65 | Puumala | NIPH |
| Russia (European) | ~500 | Puumala + Hantaan | Rospotrebnadzor |
*Andes virus cases are the MV Hondius Hondius-linked imported cases; these are counted separately from endemic Puumala surveillance.
The Andes Invasion: MV Hondius Cases in European Countries
The five European countries with confirmed MV Hondius Andes virus cases as of May 13, 2026:
Netherlands — 6 cases confirmed
The Netherlands has the highest Hondius case count among European nations, reflecting both the country’s high expedition travel participation and the Amsterdam UMC role as a primary receiving hospital for repatriated cases. RIVM has confirmed 6 cases; 2 are in isolation at Amsterdam UMC in stable condition.
France — 7 Hondius cases
Santé publique France has confirmed 7 Andes virus cases linked to the vessel. The Lyon cluster (two cases in one household) has prompted investigation into possible P2P transmission within France — results pending.
Germany — 2 Hondius cases (as of May 13)
Germany’s RKI confirmed the 11th global case today — a Munich passenger who was one of three contacts under active observation. Two of Germany’s 13 total 2026 hantavirus cases are Andes virus; the remainder are Puumala.
United Kingdom — 4 Hondius cases
UKHSA confirmed 4 UK-linked Hondius cases. Scotland reported no additional domestic spread. 12 contacts are on the extended 45-day monitoring programme.
Switzerland — under investigation
Swiss public health authorities are tracking multiple Hondius contacts; no confirmed cases as of May 13 but monitoring ongoing.
Why Andes Virus Is Far More Dangerous Than Puumala
European clinicians are accustomed to hantavirus presenting as a kidney problem — manageable, rarely fatal. Andes virus presents as a lung catastrophe, and the contrast could not be sharper.
| Puumala (HFRS/NE) | Andes (HPS) | |
|---|---|---|
| Target organ | Kidneys | Lungs |
| Case fatality rate | 0.1–0.5% | 35–50% |
| ICU admission rate | ~15% | >50% |
| ECMO sometimes required | No | Yes |
| Specific treatment | Supportive, dialysis if needed | Supportive; no antiviral |
| Person-to-person spread | No | Yes (only hantavirus to do so) |
| Vaccine | No | No |
A European physician who has managed Puumala cases for years would still be encountering an entirely different clinical entity with Andes virus. The ECDC has issued explicit clinical guidance to EU/EEA member states emphasising this distinction.
ECDC’s Response: Moderate Risk, Enhanced Surveillance
ECDC maintains a ‘moderate’ EU/EEA risk level for the Hondius cluster as of May 13. This level reflects:
- Limited community spread risk (transmission requires specific exposures)
- Ongoing incubation window for Hondius contacts (new cases still possible through late June)
- France household cluster under investigation
ECDC’s current recommendations to member states:
- Any febrile illness with myalgia in a returned Hondius passenger should trigger RT-PCR hantavirus testing
- Healthcare facilities should implement contact and droplet precautions for suspected cases
- National surveillance systems should differentiate Puumala/Dobrava and Andes virus cases in reporting
What European Travellers to South America Should Know
The Hondius outbreak has implications beyond cruise passengers. Any European travelling to rural or wilderness areas of Argentina, Chile, Bolivia, Paraguay, or Uruguay is entering Andes virus territory.
Key risk reduction steps:
- Avoid enclosed rural spaces (barns, mountain refuges, huts) that may have rodent activity
- Do not sleep directly on the ground in endemic areas
- Report fever and myalgia to a physician within 6 weeks of returning from South America — and specifically mention the travel history
- Standard travel medical insurance does not typically cover medical evacuation costs for hantavirus HPS; specialist policies may be warranted
For the latest European and global case counts, visit our live map →.
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