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A hantavirus outbreak aboard the Dutch cruise ship MV Hondius has resulted in 3 deaths and 3 additional suspected cases among approximately 150 passengers and crew. One case is laboratory-confirmed; one patient remains in ICU in South Africa. The ship departed Ushuaia, Argentina three weeks prior and is now anchored near Cape Verde. Experts believe the outbreak involves the Andes virus strain, given respiratory symptom presentation and South American voyage origin. The Andes strain, found primarily in South America, has a ~38% fatality rate and rarely enables person-to-person transmission. Transmission likely occurred via inhalation of rodent excreta, though direct person-to-person spread cannot be excluded. This represents the first known hantavirus outbreak associated with cruise ships. Passengers are quarantined to cabins while the vessel undergoes sanitization.