Journal of Pediatric and Neonatal Sciences

ABSTRACT

The 2026 Andes virus (ANDV) outbreak aboard the MV Hondius cruise ship, with 13 confirmed or probable cases and three deaths, brought hantaviruses back to global attention and exposed a persistent gap in the literature: the paediatric perspective. Hantaviruses cause two major syndromes, haemorrhagic fever with renal syndrome (HFRS) in Europe and Asia, and hantavirus cardiopulmonary syndrome (HCPS) in the Americas, both potentially severe across all age groups. In children, reported incidence is lower than in adults, but this likely reflects diagnostic underrecognition rather than biological resistance: clinical features are frequently atypical, overlapping with gastroenteritis, nephritis, or viral respiratory illness, and thrombocytopenia with acute organ involvement may be the only laboratory signal. No confirmed paediatric cases emerged from the Hondius outbreak, a finding that reflects the demographics of this expedition cruise rather than any reassuring epidemiological pattern. ANDV's capacity for human-to-human transmission via respiratory secretions during close contact, combined with an incubation period of up to 42 days, makes family exposure scenarios, and delayed paediatric diagnosis, entirely plausible.

Keywords: Hantavirus; Pediatric Hantavirus Infection; Children, Hantavirus Pulmonary Syndrome (HPS); Hemorrhagic Fever with Renal Syndrome (HFRS); Zoonotic Viral Infection; Rodent-Borne Disease; Orthohantavirus