The World Health Organization (WHO) reported this Tuesday that two cases of hantavirus were confirmed and five other suspected cases linked to the outbreak detected on a Dutch cruise ship that was crossing the Atlantic Ocean and that is now quarantined off the coast of Cape Verde.
“A third person on board is now showing symptoms, bringing to three the number of people who have reported high fever and/or gastrointestinal symptoms and remain on board,” the WHO added.
The outbreak was recorded aboard the MV Hondius cruise ship, which departed from the Argentine city of Ushuaia, in the province of Tierra del Fuego.
The ship was scheduled to dock in Cape Verde on Tuesday, but local authorities prohibited passengers from disembarking for safety reasons.
According to Oceanwide Expeditions, some 149 people and crew members remain stranded on board under “strict precautionary measures,” waiting for a place to disembark.
Although the atmosphere on board seems to be good, according to a passenger told the BBC, there is concern among travelers.
“There is a lot of uncertainty, and that is the most difficult part,” said the vlogger of travel Jake Rosmarin in a social media post from the boat.
Hantavirus is a strain of virus transmitted by rodents.
Humans are mainly infected by inhalation of suspended particles from dry excrement of these animals.
Infections typically occur when the virus is transmitted through the air through a rodent’s urine, droppings, or saliva, according to the U.S. Centers for Disease Control and Prevention (CDC).
Maria Van Kerkhove, director of epidemic and pandemic preparedness and prevention at the WHO, said Tuesday that the organization suspects that there may have been human-to-human hantavirus transmission on the Dutch cruise ship.
“Some people on board the ship were couples sharing a cabin, so it was quite intimate contact,” Van Kerkhove said.
He added that the WHO suspects that the first person who fell ill could have contracted the virus before boarding.
Possible landing in the Canary Islands
Van Kerkhove highlighted that the organization is in talks with the Spanish authorities about the possibility of the ship docking in the Canary Islands.
According to the WHO, Spain would have granted permission for the ship to dock in the islands, where a risk assessment and more exhaustive medical monitoring could be carried out.
However, the Spanish Ministry of Health lowered those expectations.
In a statement, he stated that “based on the epidemiological data collected on the ship as it passed through Cape Verde, it will be decided which is the most appropriate next stop for it.”
And he added: “Until then, the Ministry of Health will not make any decision, as we have explained to the WHO.”
A spokesperson for the Spanish Ministry of Health told the BBC that no request had yet been received for the ship to stop in the Canary Islands.
However, Spanish authorities are prepared to take charge of the situation should that change, the spokesperson added.
This would include the provision of medical assistance, testing and disinfection.
They did not want to say whether passengers would be allowed to disembark.
For its part, the company Oceanwide Expeditions indicated that it is studying the option of sailing to Las Palmas or Tenerife (in the Canary Islands) “as entry points for disembarkation.”
There medical examinations and “other necessary procedures” could be carried out.
Van Kerkhove stressed that the WHO’s “top priority” remains the care of the two crew members who remain on board with respiratory symptoms.
According to Oceanwide Expeditions, both would be airlifted to the Netherlands for medical care, along with a person “related” to the German citizen who died.
As of Tuesday morning, no other crew members had shown symptoms.
“The atmosphere on board is pretty good”
Although transmission of hantavirus from person to person is rare, Van Kerkhove explained on the program BBC Breakfast that some infections could have occurred with contact between people who shared cabins.
He added that the virus could have initially been contracted from rodents before the ship left Ushuaia, Argentina, or during one of its stops.
The specialist highlighted that the cruise visited numerous islands, some of which are home to rodent populations.
“Our working hypothesis is that there is probably more than one type of transmission underway,” he concluded.
One passenger, who asked to remain anonymous, told the BBC that, according to the crew, the Cape Verde authorities “don’t want anything to do with us.”
“Still, from what I can see, the atmosphere on board is quite good,” he added.
He also indicated that as of Tuesday, only one test had been carried out on one person who was transferred to South Africa and who tested positive for hantavirus.
“We still don’t know if the other cases are related to that virus or if it is something different,” he explained.
“If they all turn out to be hantaviruses, then the mode of transmission is somewhat mysterious. We have been told that there are no rodents on board and that human-to-human transmission is difficult or rare,” he said.
“We hope that tests will soon be carried out on the rest of the patients to better understand what is happening,” he added.
Another passenger, vlogger Travel official Jake Rosmarin posted a video from the ship on social media on Monday in which he stated that “what is happening right now is very staunch for all of us who are here.”
“We are not just a story. We are not just newspaper headlines, we are people. People with lives, with families, with people who are waiting for us at home,” he cried.
“The only thing we want right now is to feel safe, have clarity and be able to return home.”
Acting urgently
Oceanwide Expeditions provided an account of the events and reported that a Dutch passenger became ill on board and died on April 11 while the ship was at sea.
His wife later died upon arriving at a sanatorium in Johannesburg, South Africa, after having flown from the island of Saint Helena, where she disembarked from the ship.
In a statement, the family of the Dutch couple declared that “the beautiful journey they lived together was abruptly and definitively interrupted.”
“It is still difficult for us to accept that we have lost them. We want to bring them home and pay tribute to them in peace and privacy,” he added.
The researchers work based on the hypothesis that the “Andes” variant of the virus, which spreads in South America, where the cruise began, has been detected in the two confirmed cases.
As of Tuesday, hantavirus cases had only been confirmed in the Dutch woman who died and a British citizen who was hospitalized in Johannesburg after being evacuated.
The cause of death of the other passengers is under investigation.
The company added that a third passenger died on Saturday aboard the MV Hondius.
Oceanwide Expeditions indicated that the cause of this death has not yet been determined and confirmed that the passenger was of German nationality.
The WHO stated that it is “acting urgently” to provide support to the MV Hondius and thanked the South African authorities for caring for the British patient.
WHO regional director for Europe, Hans Henri P. Kluge, stated that “hantavirus infections are rare.”
Although in some cases it can be serious, it is not easily transmitted between people.
The risk to the population in recent years remains low. There is no reason to panic or restrict travel.
The MV Hondius is said to be a 107.6 meter long polar cruise ship, with capacity for 170 passengers in 80 cabins, in addition to 57 crew members, 13 guides and a doctor.
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- 3 dead in a possible hantavirus outbreak inside a cruise ship that set sail from Argentina
