Hantavirus Cases Linked to MV Hondius Update

The World Health Organization (WHO) and Spanish health officials updated their report on hantavirus cases related to the cruise ship MV Hondius on Monday. So far, there have been seven confirmed cases, with an additional two under investigation.

This count excludes American passengers who returned to the U.S. with “mildly positive” test results.

Seventeen Americans were aboard the MV Hondius when the outbreak was identified. The vessel had set sail from Argentina on April 1st, carrying 147 passengers. The first illness was documented on April 6th, followed by the first of three fatalities on April 11th. Approximately 20 passengers disembarked at St Helena Island, and one later flew to South Africa, unwell, and died of respiratory failure shortly after arriving in Johannesburg. Several seriously ill passengers have been medically evacuated.

These circumstances complicate the “contact tracing” efforts aimed at identifying and testing those who may have been closely exposed. The strain of hantavirus involved in this outbreak is the Andes variant, the only one known to infect humans. Hantaviruses are known to be fatal in about one-third of cases, typically causing respiratory failure, and are usually spread through rodent droppings.

After being isolated offshore for several weeks, the MV Hondius docked in Tenerife, part of the Canary Islands, on Sunday morning. The evacuation of passengers, which was required due to previous refusals to dock, was expected to wrap up by Monday evening.

Upon reaching Tenerife, the 17 Americans departed for the U.S., landing at Omaha Eppley Airfield early Monday. Two passengers were transported in biocontainment units as a precautionary measure, according to the State Department. One British citizen with dual U.S. citizenship was also on the same flight.

There appears to be a disagreement between U.S. and Spanish health officials regarding the handling of passengers tested by an epidemiologist while they were still in the Canary Islands. Although these passengers showed no symptoms, they were screened due to the long incubation period of hantavirus. Tests were conducted as a precaution and sent to two laboratories.

One lab reported a negative result, while the other was inconclusive.

Spain’s Health Ministry expressed dissatisfaction with the U.S. classification of a case as “positive,” asserting that it was weakly positive on their end but not conclusive.

Another American passenger, treated for potential infection, reported a mild cough on May 6, but since it resolved quickly, the infection was deemed “possible” but not definitively confirmed.

After landing in Omaha, passengers were transported to the University of Nebraska Medical Center, which has a unit specifically for infectious diseases, including cases related to Ebola and the Wuhan coronavirus.

“One passenger will be moved to the Nebraska Biocontainment Unit, and the others will go to the National Quarantine Unit for evaluation and monitoring. The passenger in the biocontainment unit has tested positive but shows no symptoms,” said a representative from Nebraska Medicine.

The Centers for Disease Control (CDC) indicated that several U.S. passengers disembarked and returned before the outbreak was declared. The CDC has informed state health departments where these passengers reside, providing timely updates and guidance on safety measures for the passengers and their communities.

Jay Bhattacharyya, the Acting Director of the CDC, noted that returning passengers would be classified as “low risk” unless they had close contact with symptomatic individuals. In such cases, they could be considered “moderate or high risk.”

He mentioned that alternatives would be provided for returnees, allowing them the option to stay in Nebraska or safely return home if conditions permitted.

CDC protocols require monitoring for 42 days following the last possible exposure to hantavirus and instruct individuals to self-isolate immediately if they develop symptoms.

A French passenger on the MV Hondius began showing symptoms during her flight back to Paris, tested positive for the virus, and was hospitalized. She was among five French passengers returning to Paris.

France’s Minister of Health, Stéphanie List, mentioned that the woman is in isolation in Paris, and her condition is deteriorating. Health authorities have identified 22 individuals who were in contact with her.

The WHO continues to assess the public health risk level from the outbreak as “low,” stating that “a large-scale outbreak is not anticipated.” Measures can be taken to interrupt the chain of infection, leading to a limited outbreak.

Dr. Tedros Adhanom Ghebreyesus, the WHO’s Director-General, emphasized that this virus is not analogous to the coronavirus, asserting that the risk to the population in Tenerife remains low.

In an unusual move, Dr. Tedros expressed his intent to visit Tenerife to witness the operational response directly and show support for the health workers and officials involved.