Social Support and Emotional Eating in Adults with Metabolic Dysfunction-Associated Fatty Liver Disease: The Chain Mediation Effects of Weight Self-Stigma and Depression.

Hantaviruses are enveloped, negative‑sense ribonucleic acid (RNA) viruses with a segmented genome, classified within the family Hantaviridae and the order Bunyavirales. Their public health importance reflects a paradox: although transmission typically occurs at restricted ecological interfaces involving persistently infected rodents, severe infections can demand advanced intensive care, generate considerable public concern, and be readily disseminated through modern travel. Old world hantaviruses, such as Hantaan virus and others, including Seoul, Puumala, and Dobrava-Belgrade viruses, are primarily associated with hemorrhagic fever with renal syndrome (HFRS), whereas new world hantaviruses, such as Sin Nombre virus (SNV) and Andes virus (ANDV), cause hantavirus pulmonary syndrome (HPS) or hantavirus cardiopulmonary syndrome (HCPS) [-]. Although these syndromic categories are essential for clinical detection, they should not obscure the common pathogenic theme of vascular dysfunction, immunological activation, thrombocytopenia, capillary leak, and sudden clinical deterioration after an apparently vague febrile illness [-]. The epidemiology of hantavirus infection is best viewed through a One Health lens. Each medically significant hantavirus is maintained in one or more reservoir hosts, whose abundance, infection prevalence, behavior, and proximity to humans are influenced by food availability, rainfall, temperature, land conversion, living conditions, occupational activity, and recreational exposure [,-]. Human infection is usually caused by inhaling aerosolized rat excreta; however, the risk is rarely evenly distributed throughout communities. Rural people, agricultural and forestry workers, cleaners of rodent-infested areas, military personnel, ecotourism professionals, and travelers accessing rodent habitats may be more exposed than the general population [,,]. These ecological and social variables make hantavirus disease environmental, occupational, clinical, and political. Among human‑pathogenic hantaviruses, ANDV remains unique as the only strain with repeatedly documented, albeit limited, person‑to‑person transmission. Epidemiological evidence from Argentina and Chile indicates that such transmission occurs predominantly in settings of close, sustained interpersonal contact, household, caregiving, or nosocomial, rather than casual community exposure [-]. This distinction is pivotal for public health policy: exaggerating interpersonal risk may prompt coercive measures, stigmatization, and erosion of trust, whereas underestimating it risks missed opportunities for prevention, contact monitoring, and early case recognition. The challenge is not merely to establish whether human transmission occurs, but to delineate its timing, frequency, routes, and contextual conditions of exposure. The 2026 outbreak linked to the expedition cruise ship MV Hondius exemplified how a rare zoonosis can be amplified through global travel networks. On May 2, 2026, the World Health Organization (WHO) issued an initial notification, followed by serial Disease Outbreak News updates; by May 13, WHO reported 11 cases, including three fatalities, with eight laboratory‑confirmed infections, two probable cases, and one inconclusive result pending further testing []. WHO assessed global public risk as low, prioritizing contact tracing, clinical care, dignified management of passengers and crew, diagnostic support, and International Health Regulations (IHR) coordination [-]. The episode was significant not because it suggested pandemic‑level transmissibility, but because it combined a severe zoonotic infection with delayed, nonspecific prodromes, mobile international contacts, constrained shipboard medical capacity, multijurisdictional oversight, and heightened post-coronavirus disease 2019 (COVID-19) public sensitivity to outbreak reporting. Cruise and expedition vessels represent complex epidemic environments. They carry multinational passengers and crew, traverse shifting legal and public health jurisdictions, and often operate far from tertiary medical facilities. Shipboard medical teams must therefore make decisions under conditions of limited diagnostics, constrained isolation capacity, restricted laboratory support, and uncertain evacuation logistics. The social architecture of a vessel, shared cabins, communal dining, excursions, caregiving, and common services facilitates frequent interpersonal contact. These dynamics are well recognized in outbreaks of respiratory, gastrointestinal, foodborne, and vaccine‑preventable diseases; however, rare rodent‑borne zoonoses are seldom incorporated into maritime preparedness exercises [,]. The MV Hondius cluster thus expands the scope of cruise health beyond routine onboard outbreaks to encompass planning for rare, high‑impact infections. The post‑COVID‑19 context amplifies the importance of this incident. The pandemic exposed both strengths and vulnerabilities in surveillance, border