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An Arizona resident has died from Sin Nombre Hantavirus Pulmonary Syndrome, the first fatality in the state this year. Sin Nombre, spread primarily by deer mice through inhalation of dried urine and droppings, carries a 36% case-fatality rate historically in the U.S. The case is contextualized against the recent 2026 Andes virus outbreak aboard cruise ship MV Hondius near Antarctica, which killed an elderly Dutch couple and infected approximately a dozen others through person-to-person transmission—a rare feature of the Andes strain (38% mortality). Sin Nombre remains the most common hantavirus in the Western Hemisphere, with 890 cases reported across the U.S. from 1993–2023, concentrated in Colorado, New Mexico, Arizona, Washington, and California.