Paul Hunter
Professor of Medicine at the University of East Anglia (United Kingdom)
Hantavirus is a viral infection that is acquired from contact with infected rodents (mice and rats). The virus is typically spread from rodents to humans through airborne aerosols of faeces and urine. There have been some suggestion that person-to-person spread may occur but there is still no agreement on this and others have concluded that evidence of person-to-person spread is not confirmed. If person-to-person spread happens at all it is rare.
There are several different types of Hantavirus each associated with a different rodent. The infection can present as hantavirus pulmonary syndrome (HPS) and haemorrhagic fever with renal syndrome (HFRS). The different types tend to cause one or other of the clinical syndromes. Mortality rate in diagnosed infections is high, in HPS this can be about 30% and in HFRS about 10%. Mortality rates are generally higher in older people, and often people on cruises tend to be older. There is no specific antiviral treatment available. Whilst some vaccines are available they do not affect all types of the virus.
It is too early to speculate on how the affected people became infected. But it is very unlikely that this outbreak would lead to an increased risk in the UK or elsewhere in Europe.