Hantavirus Outbreak on Cruise Ship

The World Health Organization (WHO) announced on Tuesday that it suspects there has been rare human-to-human transmission of hantavirus on a cruise ship tied to an outbreak. Tragically, three individuals have died after contracting the illness.

“We do think some human-to-human transmission may be occurring among close contacts on board,” said Maria Van Kerkhove, an epidemiologist with the WHO, during a press briefing. “This includes close quarters, like couples or those sharing cabins. So we believe this has taken place.”

The MV Hondius, a Dutch cruise ship with nearly 150 people, had been stranded off the coast of Cape Verde due to health concerns that prevented it from docking. On Tuesday, the Spanish government announced that the ship would be allowed to head to the Canary Islands for thorough investigation and disinfection.

The WHO further stated that, in collaboration with the European Union, it has officially requested Spain to accommodate the Hondius in the Canary Islands.

“The European Centre for Disease Prevention and Control (ECDC) will perform a detailed assessment of the ship to identify individuals needing urgent evacuation from Cape Verde. The others will proceed to the Canary Islands, where they should arrive in about three to four days,” the WHO elaborated.

Once they reach the Canary Islands, all passengers and crew will undergo medical evaluations before being sent back to their home countries. The WHO indicated that Cape Verde lacks the resources for this operation.

Apart from the three fatalities—two occurring on board and one shortly after leaving the vessel—there are four additional suspected or confirmed cases, including a British national who was evacuated and is in critical care in South Africa.

The remaining three cases on the ship will first be taken to Cape Verde and subsequently to the Netherlands for medical assistance, as conveyed by the ship’s operator, Oceanwide Expeditions.

Hantavirus is usually contracted through contact with rodents or their droppings, but the WHO suggested that the Andes strain might facilitate person-to-person transmission, albeit rarely. They believe the virus spread on the ship, which was on a lengthy polar cruise from Argentina to Antarctica and isolated South Atlantic islands. The mortality rate for humans infected with the virus can reach 50%.

Van Kerkhove mentioned that Spanish authorities are prepared to welcome the ship for a complete epidemiological investigation and disinfection, while also assessing the risk for passengers on board.

The Spanish Ministry of Health stated that its epidemiologists would evaluate the ship that afternoon.

“The aim of this intervention is to assess the health status of those on board, identify any symptomatic individuals, and categorize contacts as high-risk or low-risk,” the ministry explained. “This information will guide decisions on repatriation and the future route of the ship.”

Potential Quarantine for Passengers

Ann Lindstrand, the WHO’s representative in Cape Verde, emphasized that a pandemic-level threat from hantavirus is unlikely due to the limited potential for human transmission.

She affirmed that three individuals would be medically evacuated to the Netherlands on Tuesday, noting that their conditions were reassuring and they are stable after having received care from Cape Verdean medical teams on the ship.

Lindstrand added that Spanish and Dutch officials are actively discussing the immediate next steps for the onboard passengers, who have been advised to stay in their cabins as much as possible.

“If quarantine is deemed necessary, that decision will be made by health authorities in Spain or the Netherlands in close consultation with WHO’s guidance,” she remarked.

The potential quarantine period could last up to two months, given that the incubation for hantavirus ranges from one to eight weeks. “Eight weeks really is a long time in quarantine,” she said, while mentioning that she had spoken with a volunteer doctor on the ship, who indicated that passengers are handling the situation surprisingly well, although they are anxious about their next destination.

Ongoing Investigations

The WHO is collaborating with local authorities and Oceanwide Expeditions on a comprehensive public health risk assessment, although it’s unclear how the outbreak originated.

Ongoing investigations involve further lab tests and epidemiological inquiries, with medical care being provided to both passengers and crew.

A British man evacuated to South Africa on April 27 later tested positive for the virus and remains in critical condition. Reports indicate that an elderly Dutch man died on board on April 11, and his wife passed away two days later in South Africa after disembarking. Her blood later tested positive for the virus. A German passenger also died on May 2, but the cause of that death is yet to be officially determined, according to Oceanwide Expeditions.

The WHO is also tracing contacts from a flight shared with the 69-year-old passenger, who had gastrointestinal symptoms upon disembarkation and succumbed shortly after. “Contact tracing for passengers on that flight has begun,” they noted.

Of the 87 remaining passengers, 17 are American, 19 from the U.K., and 13 are Spanish nationals, along with a crew of sixty-one.

The ship departed from Ushuaia, Argentina, on April 1. Health officials stated that no passengers showed hantavirus symptoms when leaving. However, since symptoms can manifest up to eight weeks after exposure, there remains a possibility that passengers could have been incubating the virus if contracted prior to or during the cruise in Argentina or elsewhere.

It’s worth mentioning that Tierra del Fuego province hasn’t historically seen hantavirus cases, although other areas in Argentina witnessed outbreaks last year, resulting in 28 fatalities nationwide.

Oceanwide Expeditions offers month-long “Atlantic Odyssey” cruises on this vessel, which accommodates 170 passengers and is typically staffed with around 70 crew members, including a doctor.