WHO suspects human-to-human transmission on virus-hit cruise ship

A possible case of human-to-human transmission may be unfolding among close contacts aboard the cruise ship at the center of a hantavirus outbreak, the World Health Organization has said, as officials work to move the most serious cases off the vessel and bring the situation under control.

The agency said the immediate priority was evacuating ⁠two sick people before allowing the ship, ⁠currently ‌stationed in the Atlantic near Cape Verde, to continue ⁠toward the Canary Islands.

⁠It said the risk to the wider public remained low.

“We do believe that there may be some human-to-human transmission that is happening among the really close contacts,” the WHO’s epidemic and pandemic preparedness and prevention director Maria Van Kerkhove told reporters.

While person-to-person spread is considered uncommon, hantavirus can incubate for several weeks, raising the possibility that some infected people may still be symptom-free.

Hantavirus, which can trigger a potentially fatal respiratory illness, is typically spread when particles from rodent droppings or urine become airborne.

The WHO said “we have been told” there are no rats “on board the ship”.

Earlier, it ⁠said that two cases of hantavirus were confirmed with five more suspected after the ⁠outbreak on the vessel, carrying mostly British, American ‌and Spanish passengers.

Two Irish passengers are also on board the vessel.

The Department of Foreign Affairs said it is aware of two Irish citizens on board and is providing consular assistance.

“As of 4 May, ‌seven cases (two laboratory confirmed cases of hantavirus ⁠and ‌five suspected cases) have been identified, including three ⁠deaths, one critically ill ⁠patient and three individuals reporting mild symptoms,” WHO said.

Read more:Two Irish passengers on board virus-hit cruise ship Timeline of events on board MV HondiusWhat is hantavirus and how deadly is it?

The WHO also said it was attempting to trace people who were on a flight between the island of Saint Helena and Johannesburg taken by a cruise ship passenger who later died of hantavirus.

The Dutch woman, whose husband died of the virus on the ship, disembarked in Saint Helena with “gastrointestinal symptoms” on 24 April. Her condition “deteriorated during a flight to Johannesburg” and she died on 26 April, WHO said.

“Contact tracing for passengers on the flight has been initiated,” it said.

About 150 people remained stranded on the MV Hondius after three people – a Dutch couple and a German national – died, while others became ill, including a Briton who left the vessel and was being treated in South Africa, authorities added.

There are no specific drugs to treat the disease, so treatment focuses on supportive care, including putting patients on ventilators in severe cases.

WHO said the risk to the wider public was low and there was no need ‌for panic or travel restrictions.

However, authorities in the island nation ⁠of Cape Verde said they had refused permission for Dutch-flagged MV Hondius to dock as a precaution.

‘A lot of uncertainty’

“We’re not just headlines: we’re people with families, with lives, with people waiting for us at home,” Jake Rosmarin, a US travel blogger, said in a tearful Instagram video post from the ship yesterday.

“There is a lot of uncertainty and that is the hardest part,” he added.

A spokesperson for the ship’s Netherlands-based operator, Oceanwide Expeditions, said all passengers had been told to stay inside their cabins as a precaution against any possible spread ‌of the virus.

Oceanwide Expeditions was trying to arrange the repatriation of two crew members showing symptoms of the disease – one British and one Dutch – along with the body of the German national and ⁠a “guest closely associated with the deceased” who does not have symptoms.

The company said it was examining whether passengers could be screened and allowed to disembark in the Canary Islands ports of Las Palmas and Tenerife.

Spanish authorities said ‌they had not yet received a request for the ship to dock and disembark passengers there.

Cape Verde refused to let Dutch-flagged MV Hondius dock as a precaution

The Hondius left Ushuaia in southern Argentina in March, according to company documentation, on a voyage marketed as an Antarctic nature expedition, with berth prices ranging from €14,000 to €22,000.

It travelled past mainland Antarctica, the Falklands, South Georgia, Nightingale Island, Tristan, St Helena, and Ascension before reaching Cape Verdean waters on 3 May.

South Africa’s Health Department confirmed two of the deceased were Dutch nationals: a 70-year-old man, who died on St Helena on 11 April, and ⁠his wife, 69, who died in South Africa after collapsing at OR Tambo International Airport.

The British man being treated in a private clinic in Johannesburg became ill on 27 April, while the German passenger died ⁠on 2 May, Oceanwide Expeditions said.

Source not yet clear

Hantavirus usually begins with flu-like symptoms, including fatigue and fever, appearing one to eight weeks after exposure. A spokesperson for the RIVM said the source of the outbreak remained unclear.

“You could imagine, for example, that rats on board the ship transmitted the virus,” he said.

“But another possibility is that during a stop somewhere in South America, people were infected, for instance via mice, and became ill that way,” he added.

Daniel Bausch, a visiting professor at the Geneva Graduate Institute in Switzerland, said there was some evidence of human-to-human transmission in the Andes Virus, a species of hantavirus found in Argentina and Chile.

“So it’s significant that this cruise ship started its journey in Argentina,” he said.

“The good news is this is not going to be a big outbreak,” he added.