A plain-language review of what is known about hantavirus exposure, infection and severe disease during pregnancy, written against current CDC, WHO and obstetric-infectious-disease guidance and updated during the 2026 MV Hondius outbreak.
Hantavirus pulmonary syndrome (HPS) is a severe respiratory illness with an overall case-fatality rate of roughly 35 to 50 percent in the Americas. The cardiopulmonary phase of the illness produces capillary leak in the lungs and depression of cardiac function, both of which directly limit oxygen delivery to the rest of the body, including the placenta. Even when the mother survives, the fetus can be harmed by maternal hypoxia and shock during the most severe phase of illness.
Published case reports of pregnant women with Andes virus HPS in Argentina and Chile describe rapid maternal deterioration, frequent need for ICU-level support, preterm delivery, and in a minority of published cases, fetal demise. The North American Sin Nombre virus literature is smaller but consistent: severe HPS in pregnancy carries a meaningfully higher risk than HPS in non-pregnant adults of the same age.
Almost all hantavirus exposures in the Americas occur in one of three settings: cleaning a cabin, garage, shed or storage area that has been closed up with rodents present; entering an attic or crawl space with rodent droppings; or living or working in agricultural settings where deer mice or long-tailed pygmy rice rats are abundant. The virus is shed in rodent urine, droppings and saliva, and becomes airborne as a fine aerosol when dry material is disturbed by sweeping, vacuuming or even foot traffic.
Person-to-person transmission has been documented only for the Andes virus strain, in South America, and only in settings of very close, prolonged contact such as caregiving or household exposure. The MV Hondius cluster — at 11 cases, 9 PCR-confirmed Andes virus, 2 probable, and 3 deaths as of May 13, 2026 — is being managed with the assumption that limited human-to-human spread is possible, but WHO\'s overall risk assessment for people not on the ship and not in close contact with a confirmed case remains low.
The clearest CDC recommendation for any pregnant person facing a rodent-cleanup task is to delegate it. If another adult can perform the cleanup using full PPE while the pregnant person stays outside the contaminated space, that is the lowest-risk option.
The minimum PPE for rodent cleanup is a NIOSH-approved N95 respirator (or higher — P100 or PAPR for heavy contamination), nitrile gloves, eye protection, and ideally disposable coveralls. Pregnant cleaners should pay particular attention to a proper user seal check on the respirator: cup both hands gently over the mask, inhale sharply, and feel for any leak around the edges.
Open doors and windows for at least 30 minutes before entering. When you re-enter, wet-disinfect any visible droppings, urine staining or nesting material with a 1:10 bleach solution or an EPA-registered disinfectant. Allow at least five minutes of contact time before any wiping. Never dry-sweep or dry-vacuum a contaminated space.
Place contaminated material in a kitchen-sized bag, wipe the outside of that bag with disinfectant, and place the sealed inner bag inside a heavy contractor bag. Wash hands and forearms thoroughly with soap and water after removing PPE, and launder any reusable outer clothing on a hot cycle.
The hantavirus incubation period is roughly one to eight weeks, with most cases declaring themselves at two to four weeks. The earliest symptoms — fever, severe muscle aches, headache, fatigue, gastrointestinal upset — overlap with many common pregnancy complaints, which is why telling your obstetric provider about a rodent exposure matters: it changes the level of suspicion and the speed of escalation if you do go on to develop respiratory symptoms.
The red-flag transition is to the cardiopulmonary phase: new shortness of breath, cough, low blood pressure, or rapidly worsening fatigue. These are emergency-department symptoms in this context, regardless of pregnancy. Survival in hantavirus pulmonary syndrome is strongly time-dependent — earlier ICU admission and earlier escalation to mechanical ventilation or ECMO are the best predictors of recovery.
There is no specific antiviral approved for hantavirus pulmonary syndrome. Ribavirin, which has shown some benefit for hemorrhagic fever with renal syndrome (HFRS) caused by Old World hantaviruses, is teratogenic and contraindicated in pregnancy. The mainstay of treatment is supportive care: ICU monitoring, oxygen, mechanical ventilation when needed, and extracorporeal membrane oxygenation (ECMO) for the most severe cases. Each of these modalities can be used in pregnancy with multidisciplinary obstetric input, and several published case reports describe successful ECMO management of pregnant women with severe HPS, including some who delivered viable infants during the ECMO course.
Pregnant travellers to Andes virus-endemic regions of Argentina and Chile, or to Sin Nombre virus-endemic regions of the US Southwest (the Four Corners area in particular), should follow the same precautions recommended for all travellers, with an extra margin for delegation. That means avoiding rural cabins with signs of rodent activity, sleeping in well-sealed accommodation, never disturbing rodent droppings or nesting material, and asking accommodation staff to handle any rodent issues that arise. There is no travel restriction for pregnant people to these regions; the standard rodent-avoidance precautions are considered sufficient.
As of May 13, 2026, the MV Hondius cluster total stands at 11 cases (9 PCR-confirmed Andes virus, 2 probable) and 3 deaths. None of the publicly reported cases to date is a pregnant patient. All approximately 122 repatriated passengers and crew are now in WHO-recommended 42-day active monitoring across roughly 20 countries. WHO and ECDC continue to assess the risk to the general public — including pregnant travellers who were not on the ship and are not in close contact with a confirmed case — as low. There are no travel restrictions related to the cluster.
→ See the live MV Hondius tracker, full timeline and global news sourcesYes. Pregnant people who develop hantavirus pulmonary syndrome (HPS) are at significant risk because the cardiopulmonary phase can severely reduce oxygen delivery to the fetus. Published Andes virus case reports from Argentina and Chile have documented maternal critical illness, preterm delivery, and in some cases fetal demise even when the mother survives. There is no specific antiviral treatment, so the priority is prevention and rapid hospital escalation.
Vertical transmission of hantavirus from mother to fetus has been documented for Andes virus in a small number of published cases in South America. It has not been clearly documented for the North American Sin Nombre virus. Even when vertical transmission does not occur, severe maternal HPS frequently causes adverse fetal outcomes through hypoxia and shock rather than the virus itself.
CDC and public-health authorities recommend that pregnant people avoid cleaning rodent-infested areas entirely and ask another adult to perform the cleanup using the standard CDC protocol (ventilation, wet-disinfection with 1:10 bleach, N95 respirator, gloves, eye protection, double-bagging). When that is not possible, the same PPE and protocol apply, with extra care to ventilate the space for at least 30 minutes before entry and to never dry-sweep contaminated areas.
Ribavirin has shown some benefit for hemorrhagic fever with renal syndrome (HFRS) in clinical trials, but it is teratogenic and is contraindicated in pregnancy. For hantavirus pulmonary syndrome (HPS) the standard of care is supportive — ICU-level monitoring, oxygen, mechanical ventilation, and ECMO in severe cases — and these supportive measures are used in pregnancy when needed, with multidisciplinary obstetric input.
WHO and ECDC continue to assess the risk to the general public, including pregnant travellers who were not on the MV Hondius or in close contact with a confirmed case, as low. Pregnant travellers to Andes virus-endemic regions of Argentina and Chile should follow the same rodent-avoidance precautions recommended for all travellers — avoid rural cabins with signs of rodent activity, sleep in well-sealed accommodation, and never disturb rodent droppings or nesting material.