A fatal outbreak of a rare strain of hantavirus that started on a cruise ship traveling around South America in April, followed by an even deadlier outbreak of Ebola virus in the Democratic Republic of Congo in May, has some in the U.S. wondering if they should be masking up and preparing for the ne xt epidemic or pandemic. Atlanta Black Star spoke to Tyler B. Evans, an infectious disease and public health physician who was formerly the Chief Medical Officer for New York City’s COVID-19 response, about which viral outbreaks he’s most concerned about and what Americans should know about the national and global public health response to them. Especially if they are considering going on a cruise or to the World Cup this summer.This interview has been edited for clarity and brevity. Infectious disease expert Tyler Evans, MD, during an interview with Atlanta Black Star on May 19, 2026. (Photo: Video screenshot of interview with Jill Jordan Sieder) ABS: So, we want to help our readers understand what people should know about this hantavirus outbreak, the nature of the virus, and what their risks of exposure are.  Tyler Evans: So, just kind of zooming out, it’s all very serious, right? This and the sort of the attacks on our public health systems, the dismantling of USAID globally, the dismantling of CDC’s [Center for Disease Control and Prevention] divisions on outbreak response, these are all really impacting our ability to manage these conditions both nationally and globally. Hantavirus is very serious. It could lead to something called hantavirus pulmonary syndrome or hantavirus hemorrhagic fever with renal complications or kidney complications. So it’s either kidneys or lungs, respectively. And the case fatality rate can be north of 20% for both.But the good news is it is incredibly rare. Hantavirus has very episodic outbreaks. There have been less than a thousand cases since the 1990s in the United States.Typically, the outbreaks are taking place in the western United States. It is spread almost exclusively through rodents. And it’s pretty much just droppings or excrement of certain rodents. So now, if folks do get infected, typically it’s leading to an upper respiratory infection, and folks are not getting too sick. Sometimes they could be asymptomatic. So very rarely does it progress into lung involvement, but if it does get to that, it is very serious. In this particular situation, [the outbreak among passengers on the MV Hondius cruise ship in the South Atlantic], it looked like it was. It is confirmed that it is the Andes strain of hantavirus, and it was probably through a bird-watching tour down in Patagonia. I personally did my honeymoon there, so I know it well. So it was where they boarded, and probably what they were exposed to there was a very specific type of rodent that could have gotten the [elderly] couple [who died] sick.  They boarded the boat and ultimately got each other sick, and then the third person was infected, and they ended up dying. And we have at least 11 cases confirmed or probable. So we know all that background and —ABS: The situation on the boat, it seems it was spread in the way that people usually get hantavirus, which is exposure to some kind of fecal particles in the air, and then between a married couple once they were back on the boat, in close quarters. But they don’t yet know how it transmitted to the other nine people —Tyler Evans: Right.ABS: And it was person-to-person most likely. So, I think that’s what’s worrying some folks.Tyler Evans: So, they’re still doing their contact tracing. This is what we do with any outbreak. And now, given the flight [of some passengers who disembarked and flew home before the outbreak was identified] that was impacted as well, there’s a lot more to unpack there. In terms of person-to-person spread of hantavirus, it’s super rare, and it’s pretty much only the strain that we know of that can do that is Andes. So this is like really a very bad bet that manifested here. But now we’re dealing with a situation where how does the spread actually take place? There’s a lot of theories, right? We have models that predict and determine what we should be focusing on in terms of mitigation and prevention, but this is a very, very unique setting. And then to your point, getting back into a congregate setting, I often describe cruise ships as being like the perfect recipe for an infectious disease disaster. It is typically norovirus that we’re dealing with on these ships. But it’s pretty much a floating petri dish. And a petri dish that’s sort of concentrated with all these folks living in very close quarters with one another. So whether it’s a respiratory infection, a GI or diarrheal illness, or hantavirus, the likelihood of spreading disease is very high. Now, just to zoom out again, I think the cruise ship industry represents one of the biggest threats. It’s probably, if I had to describe it in terms of bad ideas from an infectious disease standpoint, cruise ships and buffets are up there in the top five. So, really what we have to be concerned about are the folks that go on the cruise ships. Your average age of cruise ship passengers is over the age of 50. And a lot of them are over the age of 65. When we look at the folks that did pass away as a result of this, they were older adults. And so that is going to increase your risk of not just infection because your immunity has waned, but also in terms of advancing the seriousness of the disease.I was the only infectious disease doctor working on the Grand Princess back in early 2020 with the COVID-19 pandemic. And that Grand Princess was the last cruise ship on Earth, I like to say for theatrical purposes. The Grand Princess was docked in Oakland [California], and we had to demobilize the crew and the passengers. So it was a little bit south of a thousand folks that we were both isolating and quarantining. We were using hotels for the first time, and a lot of folks just didn’t know what to do. They were scared. There weren’t any precautions for the folks that got onto this boat, and they were almost definitely sick with it prior to boarding the boat. Had we had some screening precautions, we could have potentially caught this [hantavirus] outbreak. But screening for hantavirus would have been very rare. Again, it’s very unusual that this [outbreak] happened. So, we probably would have missed it. But there could be increased surveillance that we can have on these cruise ships. Now, this was only 150 people on the Hondius, but typically on your cruise ships are thousands, you know, six, seven, eight thousand people.ABS: Is there anything you would advise people who are going on a cruise?Tyler Evans: I don’t want to be an alarmist and tell folks not to get on the cruise ship this summer. It’s summertime. But I would say again, check with your doctor. Look at your own medical history. If you’re dealing with chronic lung disease, chronic kidney disease, etc., ask your doctor, get the itinerary, determine, is this really a good decision for me? Once they make a decision to board, what they can do is ensure that they know exactly where the boat is going to be disembarking. And see if there’s any connections between the U.S. and that country. There typically are, but now given the challenges with CDC right now, a lot of those coordination pieces, because we seceded from the WHO [World Health Organization], are challenged. So that’s a little bit harder to control.ABS: What is the readiness of the CDC and the public health system in this country to deal with a large outbreak, not necessarily of hantavirus, but of a more easily transmittable virus? This is something that the historically well-founded lack of trust some Black Americans have in the US health system brings to the fore. Tyler Evans: I mean, as they should. I wrote a book called Pandemics, Poverty, and Politics. And with a lot of our diseases, our chronic diseases as well as our infections, I wrote on how infectious disease outbreaks like hanta or Ebola led to epidemics, which then led to pandemics, a lot of which were socially and politically determined.And a lot of the underlying components are that lack of trust with systems, whether it’s in the U.S. or abroad. For example, there were a number of influenza outbreaks and pandemics that took place in Asia, which were the result of basically the Chinese not playing in the sandbox with the Singaporeans and the Taiwanese and others, and they weren’t connected to the WHO. So, we’ve seen this movie reel a number of times play out, and again it’s often a lack of systems, and now, given the political dismantling of our public health systems, it’s getting worse.And the Ebola outbreak is serious. I mean, I am pretty risk-tolerant, but I’ve worked on Ebola twice, both in Sierra Leone and in the Congo. Those are the only two, prior to this, established public health emergencies of international concern. So, it’s not quite a pandemic, but it’s only the third time the WHO has identified Ebola, which is different from hantavirus, which is relatively dull and mild, as a serious outbreak. Almost all of Ebola will manifest in really serious disease, and the case fatality rate for the 2014-2016 outbreak in West Africa was around 26 percent. And so the spread is highly infectious, and once it gets into a city, which it now has — it’s gotten into Kampala and Kinshasa; these are two large central African cities, highly concentrated, and USAID is no longer there for tracking. We don’t have point-of-care tests, molecular diagnostic tests — we could have, but we no longer have them as a result of USAID being disbanded. So you have basically just local African centers; they call it African CDC, with very limited resources. There are now over 100 people [139, per the WHO] that have died as a result [of Ebola]. And I’m really concerned that there might be Americans that are impacted, and CDC is not commenting on whether or not there are Americans involved. Two of my team members from Wellness Equity Alliance are former CDC executives, and so they’re kind of giving us background on this. So we don’t know if Americans are or not involved with the current outbreak. They probably are. There definitely were some Europeans. But if some of these folks get on airplanes back to, you know, the US or other parts of Europe, I mean, this is really, really serious. ABS: Right. And we have the World Cup coming up.Tyler Evans: And a World Cup coming up. ABS: What are some practical things for people to know if they think they might have some exposure either to hantavirus or to Ebola?Tyler Evans: Well, let’s take away the Andes strain. Obviously, unless you were connected to the current contact tracing of the Andes strain connected to the Hondius, I wouldn’t tell your readers to be too concerned about hantavirus.  If you have been camping, for example, in the Western United States, if you’re having flu-like or upper respiratory infection symptoms, if you are over a certain age, typically over the age of 65, if you have a number of comorbidities, you’re definitely going to want to get checked out.   Right now, Ebola is concentrated in the Democratic Republic of Congo and Uganda. I have worked in the DRC for many years. I have a program out there. It’s in the Ituri province, which is basically a mineral province on the east coast of the DRC bordering Uganda. The DRC has been in conflict since 1994, since the genocide in Rwanda. So there are some serious risk factors there. Again, with socially and politically determined risk factors for disease emergence. So really serious challenges there. I think people just right now need to stay calm and continue to kind of watch where this goes. But if it does hit the U.S., then we have to take serious and cautious considerations. ABS: Say there’s a couple of reported cases of Ebola in the U.S. in the next week or two. How should people conduct themselves? Should they be wearing masks or distancing or anything like that? Tyler Evans: No, not yet. But when we think about infectious disease collisions —hantavirus, Ebola, and COVID hasn’t left us —all of these things are called syndemics. So they are epidemics that basically synergistically work with one another, and they explode. They multiply the risk factors and a lot of it is socially and politically driven, which could also include addiction and other social conditions. So we’re in very serious times. Again, I’m not an alarmist. Ebola has me concerned. Hantavirus was a near-miss, and it’s a call to action that we need to rethink our public health systems. But Ebola is very serious, and we don’t have it right now, given all of the dismantling of state, city, county health departments — we have a skeleton of what we once had a few years ago in terms of public health, and that wasn’t great. ABS: So given that lack of state-by-state public health surveillance and reporting, particularly by the CDC, where can people get the best, most up-to-date information about viruses and these kinds of outbreaks?Tyler Evans: That’s a great question. The best way that I can respond to that is to say to contact their primary care doctor right now.If we were talking about children, look at the American Academy of Pediatrics. There’s the American Academy of Family Practice. Certain state health departments are still in relatively good shape. The California Department of Public Health, New York State Department of Health are in relatively good shape. So you could look at their websites. We’re also dealing with a lot of historically marginalized, poorer populations. They lack digital literacy. They lack access to a lot of these different systems, health literacy. So it’s a challenge. And then saying go to your primary care doctor when a lot of them don’t have one, or did have one and recently lost their insurance, it is hard. So we’re in a tough place right now. I would say if people don’t have a primary care doctor look up local FQC’s, federally qualified health centers. Typically, we’ll take people without an appointment, without insurance, that’s another way to do it. Of course if there are serious manifestations of symptomatic illness go to the ER. The good news is, I think, the pendulum will swing with these with these situations and in addition to the measles outbreaks and everything else that’s been happening, we will see more of these kind of historically, almost arcane diseases, in the United States anyway. We will see manifestations of this and people will get hurt, which is terrible, but the silver lining — I’m always an optimist— will be that America will wake up and really understand the importance of investing in public health systems, particularly for the most historically marginalized communities. With Hantavirus Patients Quarantined In the U.S. and a Fast-Spreading Ebola Outbreak In Africa, What Should Americans Know? We Talked to an Infectious Disease Expert. ...read more read less