WHO says cruise ship hantavirus outbreak is not the start of a pandemic

A deadly hantavirus outbreak aboard a luxury expedition cruise in the Atlantic has triggered a global health response, but the World Health Organization says the episode does not signal the start of a new Covid-style emergency.

“This is not the start of an epidemic. This is not the start of a pandemic,” WHO epidemic and pandemic preparedness and prevention director Maria Van Kerkhove told reporters, insisting: “This is not Covid.”

The WHO said it expects the outbreak to remain “limited” provided countries enforce public health measures and act in coordination.

“We believe this will be a limited outbreak if the public health measures are implemented and solidarity shown across all countries,” the WHO’s emergency alert and response director Abdi Rahman Mahamud told reporters.

The broader risk to public health remains low, ⁠Director-General ‌Tedros Adhanom Ghebreyesus said, while noting that the ⁠WHO ‌had seen reports of additional patients and that more ⁠cases could yet emerge because of the virus’s long incubation period.

‘We don’t anticipate a large epidemic’, WHO’s emergency alert and response director says

Authorities around the world have been racing to contain any further spread after the outbreak on the MV Hondius, ⁠tracking passengers who had already disembarked before the virus was identified, along with anyone who had close contact with them afterward.

Minister for Health Jennifer Carroll McNeill said the two Irish nationals on board the luxury cruise ship will need medical assessments when they reach Tenerife in the coming days.

Three people – a Dutch couple and a German national – died in the outbreak on the MV Hondius.

Eight people, including a Swiss citizen, are suspected to have contracted the virus, which is usually spread by rodents, the WHO said.

All passengers who left the ship in St Helena in the South Atlantic Ocean, where the vessel stopped on 24 April, have been contacted, the ship’s operator said. That group included people from at least 12 countries, among them seven British citizens and six from the US.

The first confirmed case of hantavirus came in early May.

The route of the MV Hondius

Contact tracing

Oceanwide Expeditions, which operates the ship, said it is now trying to establish the details of all passengers and crew who embarked and disembarked at various stops since 20 March. The Dutch couple, believed to be the first hantavirus cases, only boarded on 1 April.

Dutch airline KLM said yesterday that it removed the Dutch woman from a plane in Johannesburg on 25 April because ‌of her worsening condition. She died before she could ⁠reach the Netherlands.

According to broadcaster RTL, a KLM cabin crew member who had contact with her has now been admitted to a hospital in Amsterdam after developing possible hantavirus symptoms.

The Dutch health ministry did not confirm that the woman being tested is a KLM cabin crew member, and the airline also declined to do so.

But Dutch authorities told public broadcaster NOS that crew and passengers who assisted the Dutch woman before she died are being called every day for health checks.

Contagion requires very close contact

Tests have confirmed that the strain involved is the Andean variant, which can, in rare cases, spread between humans through very close contact.

Experts have underlined just how uncommon such transmission is, ‌but the outbreak has still put health systems on alert. In the US, the Centers for Disease Control and Prevention (CDC) said it was closely watching developments and added that the risk to the American public was extremely low at the time.

One French citizen has been in contact with ⁠a person who had fallen ill but was not showing symptoms, Foreign Minister Jean-Noel Barrot said.

Argentina’s health ministry has said it will carry out rodent trapping and analysis in the southern city ‌of Ushuaia, where the cruise ship began its journey.

Ship heads for Spain

The MV Hondius, with dozens of people still on board, left its position off Cape ⁠Verde yesterday after being stranded there for days and is due to dock in Spain’s Tenerife, in the Canary Islands, on Sunday, the EU’s Centre for Disease Prevention and Control (ECDC) said.

The ECDC said no one on the ship is currently showing hantavirus symptoms.

Once the ship reaches Tenerife, all non-Spanish citizens are expected to be repatriated to their home countries if they remain well, while 14 Spanish passengers will be quarantined in a military hospital in Madrid.

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Evacuations and tests

Three patients were evacuated from ⁠the ship yesterday. Two were admitted to a hospital in the Netherlands, while another was transferred to Germany for treatment.

One of the three has tested positive for hantavirus, the Dutch hospital treating the patient said.

“The RIVM (Dutch National Institute for Public Health and the Environment) has confirmed that the admitted patient has the hantavirus. The patient has been informed of this,” said the Radboud hospital.

Martin Anstee, an expedition guide, was one of the two hospitalised ⁠in the Netherlands, according to Sky News. He said he was “doing okay” but added that “there are still lots of tests to be done”.

The Duesseldorf University Clinic, which is treating the German evacuee, said she was not a confirmed case but a contact and was undergoing tests.

The plane carrying the third patient landed in the Netherlands this morning, and that person was taken to a hospital in Nijmegen, in the east of the country.

In Switzerland, a person admitted to hospital on Monday was stable but had symptoms consistent with hantavirus infection, including low fever, body aches and a cough, the hospital said.

A Danish citizen who was aboard the MV Hondius has returned home and has been advised to self-isolate as a precaution, Danish health authorities said. The person is considered low ‌risk, having had no close contact with those who later fell ill.

Plans being developed for care of Irish passengers

Ireland’s Department of Health said plans are being prepared to manage the care of two Irish passengers from the cruise ship when they return to Ireland.

It said decisions on where they will quarantine will be taken case by case, and that if they develop symptoms they will be assessed and treated as appropriate.

A consultant in Infectious Diseases at the National Isolation Unit at the Mater University Hospital said the two Irish people are awaiting clinical assessments that will determine the next steps.

“What we do also know at the moment is that everybody on board the ship seems to be asymptomatic,” Professor Christine Kelly said.

MV Hondius is expected to arrive in Tenerife by Saturday

Speaking on RTÉ’s Morning Ireland, she said the National Isolation Unit was prepared in the event of an outbreak.

“We work really closely with the Department of Health on an ongoing basis to prepare for all eventualities of what we call high-consequence infectious diseases.

“There are really robust plans in place for these scenarios. We simulate them, we train for them. That’s what we’re doing in the background all the time when we don’t have outbreaks.”

Prof Kelly said they were awaiting further guidance from the European Centre for Disease Control (ECDC) on isolation rules for people who have come into contact with the virus.

“There seems to be guidance from the ECDC which is recommending isolation for people on the ship,” she said.

“(For how long) hasn’t been confirmed yet and we’re still waiting for further guidance.”

The ECDC’s Head of Emergency Preparedness and Response said an “expert” from the agency boarded the MV Hondius yesterday and is helping the crew to “set up safe procedures” for the onward voyage to the Canary Islands.

Speaking on RTÉ’s Today with David McCullagh, Thomas Hoffman said passengers are isolating in their cabins and, if they need to go outside, must observe physical distancing measures that have been introduced on board.