In an alarming turn of events, more than 24 individuals from at least a dozen countries departed a cruise ship plagued by a hantavirus outbreak, without undergoing any contact tracing, nearly two weeks after the first on-board death. This information was confirmed by both the ship’s operator and Dutch officials on Thursday.
Health agencies across four continents are actively working to locate and sometimes monitor these cruise passengers who disembarked on April 24. They are also attempting to trace others who may have interacted with them since their departure.
According to the World Health Organization, the threat to the general public remains minimal. This is because hantavirus, which typically spreads through inhalation of infected rodent droppings, does not easily transmit from person to person.
Dr. Abdirahman Mahamud, WHO’s director of alert and response, stated, “If public health protocols are enforced and countries collaborate, we anticipate this outbreak will remain limited.”
The Dutch health ministry reported that a flight attendant, who briefly shared an aircraft with an infected cruise passenger in South Africa, is exhibiting symptoms of hantavirus. The attendant is undergoing testing in isolation at a hospital in Amsterdam. The infected passenger, a Dutch national, was too unwell to continue the flight and passed away after being deplaned in Johannesburg.
Should the flight attendant test positive, it would mark the first case of hantavirus infection linked to the outbreak involving someone not on board the MV Hondius.
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Three cruise ship passengers have died in the outbreak, and several others are sick. Symptoms usually show between one and eight weeks after exposure.
None of the remaining passengers or crew on the ship are currently symptomatic, the ship’s operator said.
1st hantavirus case on board was confirmed May 2
Three people, including the ship’s doctor, were evacuated Wednesday while the ship was near the West African island country of Cape Verde and taken to specialized hospitals in Europe for treatment.
The body of the Dutch man who was the first to die on board on April 11 was taken off the ship on the remote South Atlantic island of St. Helena on April 24, when his wife also disembarked. She then flew to South Africa a day later and died there.
Oceanwide Expeditions, the Netherlands-based cruise ship company, said Thursday that 30 passengers left the vessel at St. Helena, while the Dutch Foreign Ministry put the number at about 40. The company had not previously said publicly that dozens more people left the ship on April 24.
It wasn’t until May 2 that health authorities first confirmed hantavirus in a passenger on the ship, the WHO says. That was in a British man evacuated from the ship to South Africa from Ascension Island three days after the St. Helena stop. He was tested in South Africa and is in intensive care there.
Passengers who disembarked April 24 are being monitored
It emerged Wednesday that a man tested positive for hantavirus in Switzerland after he disembarked at St. Helena, though his precise movements in between aren’t clear.
On Thursday, Singaporean health authorities said they were monitoring two men who got off the ship at St. Helena and flew to South Africa and then home. The two men, who arrived in Singapore at different times, were being isolated and tested, officials said. One had a runny nose and the other had no symptoms, Singapore’s Communicable Diseases Agency said.
British health officials say two people who were passengers aboard the ship but flew home midway through the journey are self-isolating but do not have symptoms of illness. The U.K. Health Security Agency said “a small number” of contacts of the two are also self-isolating but are not showing any symptoms. Other contacts are being traced.
Authorities in St. Helena, the remote, volcanic British territory in the South Atlantic where passengers got off, said they were monitoring a small number of people who were considered “higher risk contacts.” Those higher risk contacts were being told to isolate for 45 days, the St. Helena government said.
South Africa is tracing contacts from an April 25 flight
The vessel is now sailing to Spain’s Canary Islands, a voyage that is expected to take three or four days, with more than 140 passengers and crew members still on board.
WHO Director-General Tedros Adhanom Ghebreyesus said Thursday that he had been in regular touch with the ship’s captain, and that “morale has improved significantly since the ship started moving again.”
Authorities in South Africa are also trying to trace contacts of any passengers who previously got off the ship. They have focused mainly on an April 25 flight from St. Helena to Johannesburg, the day after passengers disembarked there.
The Dutch woman from the cruise ship who later died in South Africa briefly boarded that flight, officials have said. It’s not known how many other cruise passengers also were among the 88 people on it, but flights from St. Helena go to South Africa and are rare, normally once a week.
The body of the third fatality, a German woman, is also still on board the ship after she died on May 2.
Andes virus is only hantavirus that spreads human-to-human
Tests have confirmed that at least five people who were on the ship were infected with a hantavirus found in South America, called the Andes virus. The only hantavirus thought to spread human-to-human, it can cause a severe and often fatal lung disease called hantavirus pulmonary syndrome.
Argentina’s health ministry said there were 28 deaths from hantavirus last year, up from an average mortality rate of 15 in the five years before that. Nearly a third of cases last year were fatal, it said.
The ship departed from Argentina and investigations into the source of the outbreak are focusing on that country.
Tedros said the couple that presented the first two cases had traveled through Argentina, Chile and Uruguay on a bird-watching trip before boarding the ship. The Dutch couple visited sites where the species of rat that is known to carry Andes virus was present, he said.
Tedros said the WHO is working with health authorities in Argentina to understand their movements, and that the WHO had arranged for shipping 2,500 diagnostic kits from Argentina to laboratories in five countries.
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