Hantavirus Town Hall: What Frontline Healthcare Staff Need to Know About Andes Hantavirus Preparedness

The National Quarantine Unit at UNMC where 18 U.S. citizens exposed to Andes hantavirus were monitored. Credit: UNMC/Nebraska Medicine

This post summarizes key points from NETEC’s Hantavirus Town Hall: Updates for Frontline Staff, recorded on May 19, 2026. Because guidance and case information continue to evolve, readers should consult current public health guidance and NETEC resources for the latest updates.

Situation Update

At the time of the town hall, public health partners were monitoring individuals who may have been exposed to Andes hantavirus during an international cruise ship outbreak. Some passengers were monitored at the National Quarantine Unit at the University of Nebraska Medical Center, while others were followed by state and local public health authorities.

Since the town hall, passengers monitored at the Nebraska National Quarantine Unit have completed or departed quarantine, and no additional cases have been reported. This update is reassuring, and panelists emphasized that healthcare providers are unlikely to encounter an unexpected Andes hantavirus patient. However, the event remains an important reminder for frontline healthcare facilities to maintain strong screening, isolation, PPE, laboratory safety, and communication practices.

Featured speakers included:

Dr. Vikram Mukherjee (NYC Health + Hospitals Bellevue, NETEC Co-Principal Investigator)
Vicki Herrera (University of Nebraska Medical Center, NETEC Laboratory Workgroup Co-Lead)
Dr. Alex Isakov (Emory University, NETEC EMS Workgroup Co-Lead)
Jill Morgan (Emory University, NETEC PPE Workgroup Co-Lead)

Understanding Andes Hantavirus

Hantaviruses are a family of viruses carried primarily by rodents. Most hantaviruses found in North America do not spread from person to person. Andes hantavirus is unique because person-to-person transmission has been documented.

Despite this capability, available evidence suggests that transmission remains relatively uncommon. Studies from South America have shown that fewer than 3% of exposed individuals developed infection, even after high-risk exposures.

Current evidence suggests transmission is most likely to occur during prolonged, close contact with an infected person, such as among household members or intimate partners.

PPE and Infection Prevention Recommendations

Because important questions remain about transmission dynamics, NETEC recommends a precautionary approach to protecting healthcare personnel caring for suspected or confirmed Andes hantavirus patients.

Recommended PPE for the care of suspected or confirmed Andes hantavirus patients includes the PPE ensemble recommended for dry or stable viral hemorrhagic fever (VHF), with required respiratory protection:

Eye protection: Full face shield, shield of powered air purifying respirator (PAPR), or tight-fitting goggles
Nose and mouth protection: Respiratory protection with an NIOSH-approved N95, elastomeric, or powered air-purifying respirator (PAPR)
Torso/Body coverage: AAMI Level 3 or 4 fluid-resistant gown
Gloves: Double gloves (with an extended-cuff outer pair) are preferred if consistent with institutional training and protocols.
Shoe covers: Optional

Patients should be placed in an Airborne Infection Isolation Room (AIIR) whenever possible. If an AIIR is unavailable, a private room with a closed door should be used.

The panel emphasized that source control remains important. Patients presenting with fever or respiratory symptoms should be masked as early as possible while additional screening is performed.

Laboratory Safety Considerations

Laboratory staff should approach suspected Andes hantavirus specimens with enhanced precautions.

Current recommendations include:

BSL-2 laboratory operations with BSL-3 precautions
Use a biosafety cabinet to process samples whenever possible
Aerosol-generating procedures and cultures should be avoided
Enhanced PPE including gown, gloves, eye protection, and N95 respirators
Facility-specific risk assessments for specimen handling and testing

Diagnostic testing currently includes:

IgM and IgG serology testing through CDC
Molecular testing (PCR) through the Nebraska Public Health Laboratory

Healthcare facilities should coordinate closely with public health authorities regarding testing requirements and specimen submission procedures.

The Importance of “Identify, Isolate, Inform”

A recurring theme throughout the town hall was NETEC’s core preparedness framework:

Identify

Screen for:

Compatible symptoms
Recent travel history
Potential exposure to known cases

Isolate

Promptly separate potentially infectious patients and implement appropriate PPE and infection prevention measures.

Inform

Notify:

Infection prevention teams
Public health authorities
EMS partners
Regional Emerging Special Pathogens Treatment Centers (RESPTCs) when appropriate

The “Identify, Isolate, Inform” framework supports a focus on recognizing potential risk factors, implementing appropriate infection prevention measures, and engaging public health and healthcare partners early when concerns arise.

Preparedness Matters

Although the current risk to most healthcare facilities remains low, the town hall reinforced an important preparedness lesson: emerging infectious diseases can appear unexpectedly, and healthcare organizations benefit from maintaining strong screening, isolation, communication, and PPE practices.

The same preparedness principles that support responses to Ebola, viral hemorrhagic fevers, and other special pathogens remain valuable for Andes hantavirus and future emerging threats.

Healthcare facilities are encouraged to review NETEC’s preparedness resources, PPE guidance, laboratory recommendations, and educational materials available through the NETEC Resource Repository.

Additional Resources

Healthcare facilities can access the NETEC Hantavirus Resource Collection for the latest guidance, training materials, PPE recommendations, laboratory resources, and preparedness tools:

Frequently Asked Questions

Transmission & Infectious Risk

Can asymptomatic individuals transmit hantavirus?

At this time, person-to-person transmission of Andes hantavirus appears to occur primarily among individuals with close, prolonged contact with someone who is infected. Evidence regarding transmission from asymptomatic individuals remains limited, and ongoing investigations continue to improve understanding of transmission dynamics. Healthcare facilities should continue following public health guidance and use appropriate precautions when evaluating potential cases.

Does masking reduce the risk of hantavirus transmission?

Yes. Source control remains an important infection prevention strategy. Patients with fever, respiratory symptoms, or suspected infection should be masked as early as possible. Healthcare personnel should wear recommended respiratory protection, including a fit-tested N95 respirator or higher-level respiratory protection when caring for suspected or confirmed Andes hantavirus patients.

PPE & Infection Control Practices

What PPE is recommended for suspected or confirmed Andes virus hantavirus patients?

CDC guidance currently recommends:

Fluid-resistant gown
Gloves
Eye protection
NIOSH-approved, fit-tested N95 respirator or higher-level respiratory protection

Because important questions remain about Andes hantavirus transmission—including the potential role of aerosols, viral shedding, and infectious dose—NETEC recommends a more protective approach for suspected or confirmed cases.

The NETEC PPE Work Group recommends the PPE ensemble for Andes hantavirus, including:

Full face shield (or PAPR hood/shield)
NIOSH-approved, fit-tested N95 respirator, elastomeric respirator, or PAPR
Fluid-resistant or fluid-impermeable gown
Double gloves, including extended-cuff outer gloves
Shoe or boot covers, based on facility policy and risk assessment

This recommendation reflects a precautionary approach that prioritizes healthcare worker safety while scientific understanding of Andes hantavirus transmission continues to evolve.

Should hantavirus be managed with standard precautions, droplet precautions, or higher-level isolation?

Standard precautions should be used for all patients. For suspected or confirmed Andes hantavirus patients, NETEC recommends airborne infection isolation, including placement in an AIIR when available, and the use of the Andes hantavirus PPE ensemble.

What environmental cleaning and disinfection practices are appropriate?

Andes virus is classified as a Tier 1 virus, meaning it is among the easiest viruses to inactivate with disinfectants. Facilities should use EPA-approved hospital disinfectants that are effective against Tier 1 pathogens. Most healthcare facilities are likely already using products that meet this requirement. When a disinfectant does not make a specific claim against Andes virus, infection preventionists can refer to EPA guidance on pathogen tiers and select products effective against pathogens in the same category. The EPA Disinfectants for Emerging Viral Pathogens (EVPs): List Q provides guidance on disinfectants effective against Andes hantavirus.

What infection prevention measures should be implemented when a potentially infectious patient is present in a waiting room before screening?

Facilities should focus on early recognition and source control. Patients with fever or respiratory symptoms should be masked promptly. Staff conducting screening should have access to appropriate PPE, including respiratory protection and eye protection. If concern for Andes hantavirus exists, the patient should be moved to an isolation area as quickly as possible.

How likely is it that a patient with Andes hantavirus will present unexpectedly to a healthcare facility?

The likelihood is considered low. During the 2026 cruise ship response, exposed individuals were identified and monitored by public health authorities. Individuals under monitoring were instructed to contact public health officials if symptoms developed so evaluation and transport could occur through established response pathways. However, healthcare facilities should maintain readiness to identify, isolate, and inform if a patient with compatible symptoms and exposure history presents for care.

Laboratory Testing & Specimen Handling

What diagnostic tests are currently available for Andes hantavirus?

Diagnostic testing currently includes both serology and molecular testing. Serum specimens can be tested for Andes virus IgM and IgG antibodies, while EDTA (purple-top) whole blood can be used for molecular (PCR) testing. Clinicians should also evaluate patients for more common causes of fever and respiratory illness as part of the diagnostic workup.

Where is testing performed and how is it accessed?

At the time of the town hall, Andes hantavirus IgM and IgG serology testing was available through CDC. Molecular (RT-PCR) testing was available through the Nebraska Public Health Laboratory, and additional public health laboratories were working to develop testing capability. Facilities should coordinate with their state or local public health department to arrange testing and determine specimen requirements.

What precautions should laboratory personnel take when handling specimens from suspected Andes hantavirus patients?

Laboratories should perform a facility-specific risk assessment and implement BSL-3 precautions when handling specimens from suspected or confirmed Andes hantavirus patients. Recommended measures include the use of biosafety cabinets, enhanced PPE, minimizing aerosol-generating procedures and unnecessary specimen handling, and limiting staff exposure whenever possible. If aerosol risks cannot be adequately mitigated through engineering controls, work practices, or PPE, alternative testing approaches should be considered.

How should laboratory waste from suspected or confirmed Andes hantavirus patients be managed?

DOT/PHMSA has determined that waste generated from the care of suspected or confirmed Andes hantavirus patients should be classified as a Division 6.2, Category B infectious substance when offered for transport. No DOT special permit is required, provided applicable packaging and Hazardous Materials Regulations requirements are met.

Healthcare facilities should follow applicable packaging, transport, and disposal requirements and work closely with waste management vendors, infection prevention teams, and public health partners to ensure compliance with local, state, and federal regulations.

Editor’s note: At the time of the May 19, 2026, town hall, DOT had not yet issued final guidance. Facilities were advised to manage waste as Category B regulated medical waste while awaiting formal determination. DOT has since clarified that waste should be managed as a Division 6.2, Category B infectious substance for transport.

Is there a point-of-care test available for Andes virus?

At the time of the town hall, no widely available point-of-care test existed. Diagnostic testing relied on CDC serology (IgM and IgG) and RT-PCR testing performed through the Nebraska Public Health Laboratory.

Should isolation precautions be discontinued if a patient tests negative?

Clinical context and timing of testing are important. Serologic testing performed within the first 72 hours of symptom onset may be falsely negative. If testing occurs early in illness, repeat testing may be necessary. Decisions regarding discontinuation of precautions should be made in consultation with infection prevention and public health partners and should follow current CDC guidance (CDC, https://www.cdc.gov/hantavirus/php/emergency-guidance/index.html, Accessed 6/2026).

What PPE should healthcare workers wear when collecting blood or respiratory specimens from suspected Andes virus patients?

Healthcare workers collecting specimens should wear a respirator, eye protection, gloves, and a fluid-resistant gown. Blood collection and respiratory specimen collection require close contact with the patient, increasing the potential for exposure. Particular caution should be exercised during collection of respiratory specimens, such as nasal or nasopharyngeal swabs, which may induce coughing or sneezing. Facilities should ensure staff are fit-tested for N95 respirators or have access to alternatives such as PAPRs when appropriate.

Treatment & Care

Is there a vaccine for Andes hantavirus?

Currently, there is no approved vaccine for Andes hantavirus. Prevention efforts focus on early recognition, infection prevention measures, public health monitoring, and supportive clinical care.

What treatments are available for Andes hantavirus?

There are currently no approved antiviral therapies for Andes hantavirus infection in the United States. Treatment is supportive and should be escalated early because hantavirus cardiopulmonary syndrome can progress rapidly.

Patient management may include close cardiac monitoring, careful fluid administration, supplemental oxygen, mechanical ventilation if respiratory failure develops, vasopressors rather than repeated fluid boluses for hypotension, and early transfer to a facility with ECMO capability when indicated.

Preparedness & Response

What is the Nebraska Quarantine Unit (NQU), and how is it being used?

The Nebraska Quarantine Unit is a federal quarantine facility that can house approximately 20 individuals who have been exposed to a communicable disease but are not currently ill. During the 2026 cruise ship response, the facility was used to monitor exposed individuals who were not ill. As of June 2026, those monitoring activities have concluded.

What is the difference between quarantine and isolation?

Quarantine refers to monitoring and restricting movement of individuals who have been exposed to a disease but are not currently sick.

Isolation refers to separating individuals who are ill or suspected to be infected in order to prevent transmission to others.

For Andes hantavirus, exposed individuals may be monitored for up to 42 days, although most infections would be expected to develop within the first two to three weeks following exposure.

Share this article