'Very negligible' risk of hantavirus in Singapore, healthcare system well-prepared: Experts
"This is a virus that doesn't spread easily between people, usually only when there is close physical contact," says an infectious diseases expert.
Health workers in protective gear arrive to evacuate patients from the MV Hondius cruise ship at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (Photo: AP/Misper Apawu)
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SINGAPORE: The risk of a hantavirus outbreak in Singapore remains low, with experts stressing that the country is well equipped to deal with any potential cases, even as two residents who were on board a virus-hit cruise ship are being monitored.
The two Singapore residents who were on board the MV Hondius are currently isolated at the National Centre for Infectious Diseases (NCID), the Communicable Diseases Agency (CDA) said on Thursday (May 7).
Both men are well, with one experiencing a runny nose and the other asymptomatic, while they await test results.
Experts told CNA that the likelihood of the virus spreading in Singapore is minimal, given the nature of hantavirus transmission and Singapore’s strong public health response.
"I do not think that the general public should be concerned at all," said Professor Paul Tambyah, deputy chair of the infectious diseases translational research programme at the NUS Yong Loo Lin School of Medicine.
The virus is not efficiently spread between humans and is typically most contagious only when symptoms such as fever develop, he noted.
"So it is unlikely that these two largely asymptomatic individuals would spark off outbreaks in Singapore," Prof Tambyah added.
"This risk is reduced significantly by the fact that they are isolated during the incubation period, so they are less likely to spread the virus to anyone if they become febrile later on."
Hantavirus is a rare respiratory disease that is usually spread from infected rodents and can cause respiratory and cardiac distress as well as haemorrhagic fevers.
Only a few strains are known to cause human disease, including the Andes hantavirus found in several cases on the MV Hondius.
Transmission to humans happens when people breathe in dust contaminated with urine, droppings or saliva from infected rodents, especially when cleaning or disturbing areas with rodent activity, CDA said.
Professor Hsu Li Yang, director of the Asia Centre for Health Security at the Saw Swee Hock School of Public Health, similarly described the public health risk in Singapore as “very negligible”.
"This is a virus that doesn't spread easily between people, usually only when there is close physical contact or when a healthcare worker is caring for an infected individual without protection," he told CNA.
"But cruise ships are kind of a confined environment where the risk of transmission is higher."
Prof Hsu also noted that high hygiene standards and limited exposure to rodents - the primary carriers of hantaviruses - make infections uncommon in Singapore.
"Almost all of us are not exposed to rodents to the point where we easily contract pathogens from them, including the hantavirus," he said.
"So the concern is human to human, but ... this is only under circumstances of prolonged contact. And both of these individuals are now at the National Centre for Infectious Diseases."
Their prompt isolation further reduces any risk.
"As far as we know, asymptomatic or presymptomatic transmission … has not been reported," Prof Tambyah said.
WELL-PREPARED SYSTEM
Prof Tambyah said Singapore is "extremely well prepared" to handle any potential cases, pointing to its robust public health infrastructure and pandemic preparedness measures.
"We also have a well-developed laboratory infrastructure, well-trained clinicians and ample supplies of personal protective equipment, as well as a network of pandemic preparedness clinics across the island, which can spring into action in the unlikely event that we have a case or more than one case in Singapore," he said.
Experts added that, unlike respiratory viruses such as influenza or COVID-19, hantaviruses do not spread exponentially, making large outbreaks far less likely.
If the two Singapore residents test negative, they will still be quarantined for 30 days from their last exposure and monitored for up to 45 days.
Experts said the extended period reflects a cautious approach.
"There are rare case reports of incubation periods lasting as long as six weeks after exposure to the virus. Although those have predominantly been rat-to-human transmissions, I think that the CDA is not leaving anything to chance," said Prof Tambyah.
Professor Ooi Eng Eong from Duke-NUS Medical School noted that quarantine periods are typically set at twice the incubation period, which for Andes hantavirus is about two weeks.
TIMELINE OF CRUISE SHIP OUTBREAK
The two Singapore residents, aged 67 and 65, were on board the MV Hondius when it departed from the Argentinian port of Ushuaia on Apr 1.
On Apr 6, a 70-year-old Dutch man became sick on board with fever, headache and mild diarrhoea. Before boarding, the man and his wife, who is also Dutch, had gone sightseeing in Ushuaia, and travelled elsewhere in Argentina and Chile, according to the World Health Organization (WHO).
The man developed respiratory distress on Apr 11 and died on board.
His wife disembarked on Apr 24, along with more than two dozen other passengers, on the island of St Helena, a British overseas territory. The stop was the end of the cruise for some on board.
The next day, the Dutch woman, who has symptoms of illness, takes a commercial flight from St Helena to South Africa. The plane carried 88 passengers and crew members, according to the airline, although it is not clear how many other people who got off the MV Hondius took that flight.
The woman died in South Africa on Apr 26 after collapsing at an airport while trying to board another plane home.
Singapore's CDA said it was notified on May 4 and May 5 that the two Singapore residents were on the MV Hondius.
The first individual, a 67-year-old Singaporean, arrived in Singapore on May 2. The second, a 65-year-old Singapore permanent resident, arrived in Singapore on May 6.
Both men were on the same flight as a confirmed hantavirus case who travelled from St Helena to Johannesburg, South Africa on Apr 25. CNA has asked CDA for more information about the flight they were on.
Apart from Singapore, health authorities in Switzerland, Britain, the Netherlands, France and South Africa are also isolating people who previously left the cruise ship and tracing those who might have come into contact with cruise ship passengers.
In total, five people from the MV Hondius confirmed to have contracted the virus, with another three suspected cases.
NOT THE START OF PANDEMIC: WHO
Although the outbreak sparked international alarm, the WHO said it did not mark the beginning of a COVID-like crisis.
More hantavirus cases could emerge, but the WHO expects the outbreak to be "limited" if precautions are taken.
Associate Professor Sanjaya Senanayake, an infectious diseases specialist at the Australian National University's School of Medicine and Psychology, noted two key differences between the hantavirus outbreak and the COVID-19 pandemic.
"We've known about hantaviruses for decades, so it's not new. We know how it behaves. We know its natural history," he told CNA.
"And the other important thing, even with this particular strain of hantavirus, ... person-to-person spread is very limited, so it's not going to spread like wildfire," he added.
"This is not a situation in which we need to panic."
Symptoms of infection with the Andes virus typically include fever, body aches, fatigue, gastrointestinal symptoms and difficulty breathing, and progress rapidly to shock and death.
Treatment consists of supportive care and management in hospital if required.
There is no specific antiviral treatment or vaccination.
The Andes hantavirus, as its name suggests, is largely confined to South America, said Prof Tambyah.
Travellers to South America should thus avoid contact with rodents. If they accidentally stray into rat-infested areas, they should practise good hand hygiene and seek medical attention promptly if unwell, he added.
Otherwise, it should be business as usual, said Assoc Prof Sanjaya.
"Unless we determine that this hantavirus has changed its behaviour and mutated, I think we just proceed cautiously, but with life as usual."
Additional reporting by Daphne Yow
