Transmission timing and containment risk in human Andes virus outbreaks

The 2026 multinational Andes virus (ANDV) outbreak linked to cruise-ship travel from Argentina triggered extensive contact tracing and quarantine. Whether intervention on this scale was necessary or sufficient depends on the risk of onward transmission, which can be difficult to estimate early in an outbreak. Using transmission-pair data from the 2018--2019 outbreak in Epuyen, Argentina, and a mechanistic model linking viral growth, symptom onset, and transmission, we estimated that 42.4% (95% CrI: 18.2-69.7%) of transmission occurs before symptom onset and that the median incubation period is

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