From US to Singapore, cruise passengers are being monitored for hantavirus

CAPE TOWN, South Africa (CNN) — The World Health Organization said Thursday that five confirmed hantavirus infections have been identified among people connected to the cruise ship MV Hondius, as health authorities across several countries race to trace and contain the outbreak.

Three people — a Dutch couple and a German national — have died since the vessel departed Argentina last month. The first suspected case was a 70-year-old Dutchman, who suddenly fell ill on the ship with a fever, headache, abdominal pain and diarrhea, South Africa’s Health Department told CNN. He died on board on April 11.

Meanwhile, a total of 146 people from 23 different countries are still aboard the vessel under “strict precautionary measures,” operator Oceanwide Expeditions said Thursday.

RELATED | A cruise ship is waiting for help after a suspected outbreak of rare hantavirus onboard killed 3

While at least 30 passengers disembarked at the remote South Atlantic island of Saint Helena in late April and several critical cases were air-evacuated to Europe this week, those remaining passengers are scheduled to arrive in Spain’s Canary Islands this weekend before they are flown back to their respective home countries.

Spanish authorities said in their latest update that the ship will arrive in Tenerife around noon local time (5:00 a.m. MDT) on Sunday.

RELATED | Masks, movies and solo deck walks: life aboard a hantavirus-hit cruise ship

Here’s what we know about some of the countries where cruise ship passengers are either being treated for hantavirus or monitored for potential infection.

• The Netherlands: Three passengers have arrived in the Netherlands for treatment, the vessel’s operator Oceanwide Expeditions said Thursday. They are a British national, a 65-year-old German and a 41-year-old Dutch crew member. Two of the passengers are in serious condition, while the third evacuee, who the company said is not currently showing symptoms, is also receiving medical care. Separately, the Netherlands’ health institute said that three people showing symptoms after coming into contact with an infected person aboard an aircraft have been tested for the Andes variant of hantavirus, with two tests coming back negative and a third still pending. Dutch media reported that one person who went to an Amsterdam hospital for testing is a KLM airline crew member who had contact with a 69-year-old Dutch woman who died in South Africa last month. If she tests positive, she would be the first non-passenger connected to the incident to contract the virus. Dr. Bram Goorhuis, an infectious disease physician at the Amsterdam University Hospital who is treating the KLM crew member, told CNN that doctors are expecting to receive her test results later on Thursday.
• South Africa: A British national who fell sick onboard the vessel on April 27 was transferred to a private medical facility in Johannesburg, South Africa, where he remains in intensive care. He is the second confirmed hantavirus case. WHO said his condition is improving.
• Switzerland: On Wednesday, WHO Director-General Tedros Adhanom Ghebreyesus said a passenger who returned to Switzerland after leaving the ship tested positive and is being treated in Zurich.
• United Kingdom: In the U.K., the Health Security Agency said two British nationals who left the ship at St. Helena on April 24 are isolating at home as a precaution following possible exposure. The agency said it is aware of five other British nationals who disembarked the vessel that day, including four who are still there. Contact tracing efforts are continuing for a seventh person who has not yet returned to the U.K., it said.
• United States: Health authorities in the U.S. said they are monitoring three people who previously disembarked and returned home. Officials in Georgia said two residents are under observation and have shown no symptoms, while Arizona health authorities said one individual is also asymptomatic. MedPageToday reported that other American passengers had returned to Texas and Virginia.
• Singapore: Two Singaporean residents — both men in their 60s — are self-isolating and being tested for hantavirus, the country’s Communicable Diseases Agency said Thursday. One of the men “has a runny nose but is otherwise well,” it said, while the other is asymptomatic.
• Canada: Three people in Canada are self-isolating, including two people in Ontario and one in Quebec, government authorities said Thursday. One of those people was not on the cruise but was on the same flight home as two Canadians who were aboard the vessel.

The situation has captured international attention as passengers have disembarked and dispersed across multiple countries before the outbreak was fully understood, prompting some to draw comparisons to the early days of the COVID-19 pandemic.

Oceanwide said Thursday that they were working to “establish details of all passengers and crew who embarked and disembarked on various stops of m/v Hondius since March 20,” amid concern for the global spread of the virus.

WHO said on Thursday that while it expects more cases to emerge, it does not anticipate a large epidemic anywhere similar to COVID-19, and underlined that there is no evidence of a widespread transmission risk.

The outbreak has been linked to the Andes strain of hantavirus, a rare but potentially severe virus that in some cases can spread between humans through close contact.

It’s not yet clear how the outbreak occurred. But WHO is working on the assumption that the Dutch couple who died were infected off the ship, possibly while sightseeing in Argentina before joining the cruise.

The first two cases “traveled through Argentina, Chile and Uruguay on a bird-watching trip which included visits to sites where the species of rat known to carry the virus was present,” Ghebreyesus told reporters Thursday.

As the Hantavirus typically incubates for one to six weeks before patients start presenting symptoms, it is likely they fell ill some time after they were infected, according to health officials.

WHO said in a post to social media that it is “working with relevant countries to support international contact tracing, to ensure that those potentially exposed are monitored and that any further disease spread is limited.”