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Abstract

In May 2026, an outbreak of hantavirus pulmonary syndrome (HPS) caused by Andes virus (ANDV) was detected aboard the cruise ship MV Hondius, sparking public health measures in multiple countries. ANDV infections in humans are mostly sporadic, most often linked to exposure to infected rodents in South America, although small clusters of human cases, like the 2026 outbreak on the MV Hondius occur as well. It is not known whether virological factors may contribute to this distinct epidemiology, and no phenotypic characterisation of the newly emerged ANDV (ANDV2026) has been carried out to date. Here, using an ANDV isolate from a presymptomatic patient from the MV Hondius, we studied pathogenesis, identified sites of viral replication, characterized innate and adaptive immune responses, and quantified shedding in golden Syrian hamsters. ANDV2026 proved to be highly pathogenic in hamsters, causing severe pulmonary disease reminiscent of HPS. ANDV2026 triggered a delayed type-I IFN response and inflammatory response in the lungs consistent with the key pathological features of HPS, and we detected viral replication in both respiratory and extra-respiratory tissues, including the brain. Infected animals mounted neutralising antibodies and T cell responses, the latter directed predominantly against the L and N proteins. Importantly, ANDV2026-infected animals shed virus through multiple routes, and we detected infectious virus in air samplers connected to cages housing ANDV2026-infected hamsters. In contrast, control hamsters infected with a rodent-derived ANDV isolate (ANDV9717869) shed little virus and air samples were consistently negative. These findings consolidate established features of ANDV pathogenesis, while revealing properties not previously described. Phenotypic characterisation of patient-derived ANDV isolates in animal models can strengthen outbreak preparedness, identify markers of disease severity, and support the development of medical countermeasures.

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