WHO traces more than 80 passengers on flight taken by hantavirus victim

Health officials are tracing dozens of travelers after a cruise passenger infected with hantavirus died following a flight from Saint Helena to Johannesburg, deepening concern over an outbreak aboard the MV Hondius.

There were 82 passengers and six crew on the 25 April flight, according to South African carrier Airlink.

Among them was a Dutch woman whose husband had died from the virus on the ship and whose condition “deteriorated during a flight to Johannesburg”, the WHO said in a statement.

She had disembarked in Saint Helena on 24 April with “gastrointestinal symptoms” and died after reaching the emergency department of a Johannesburg hospital, where she tested positive for hantavirus, the agency said.

Airlink runs a weekly service from the island, a journey of about four hours.

South African authorities instructed the airline to alert passengers that they must contact the health department, airline representative Karin Murray said.

The WHO said it believed hantavirus may have spread between people on the cruise ship, which on Tuesday was stranded off Cape Verde.

In addition to the Dutch couple, a German passenger has also died. There are seven confirmed and suspected cases.

Human-to-human spread is uncommon, and the UN health agency again said the risk to the broader public remained low from a disease usually transmitted through contact with infected rodents.

A Dutch couple and a German national have died, while a British national was evacuated from the vessel and is in intensive care in South Africa, officials said.

Two crew members need urgent medical treatment, the Dutch-flagged MV Hondius’s operator, Oceanwide Expeditions, said. Another person on board with a suspected infection has reported only a mild fever.

The operator also said that “no new symptomatic cases” of hantavirus had been identified on the ship.

The MV Hondius departed Ushuaia in southern Argentina in March

“At this stage, no new symptomatic individuals on board have been identified beyond those previously reported,” the company said in a statement.

The Dutch foreign ministry said it was arranging the medical evacuation of three people to the Netherlands. It remained unclear when, or where, the nearly 150 other people still aboard would be allowed to disembark.

The outbreak-stricken cruise ship is anchored off Cape Verde. The Atlantic island nation off West Africa had been due to serve as the voyage’s final stop, but authorities have refused to let passengers come ashore because of the outbreak.

People are most often infected with hantavirus through contact with infected rodents, or with their urine, droppings ‌or saliva.

But limited transmission among close contacts has been documented ⁠in some earlier outbreaks involving the Andes strain, which circulates in South America, including Argentina, and which the WHO believes may be involved in this case.

Testing is ongoing. The Hondius sailed from Ushuaia in southern Argentina in March.

The WHO said it had been informed that there were no rats on board.

“We do believe that there may be some human to human transmission that’s happening among the really close contacts, the husband and wife, people who have shared cabins,” Maria Van Kerkhove, the director of epidemic and pandemic preparedness and prevention at the WHO, told reporters in Geneva.

Dr Van Kerkhove said the immediate priority was to evacuate the two sick passengers still on board ‌and then allow the ship to continue to the Canary Islands.

Cape Verde said it refused permission for the Dutch-flagged MV Hondius to dock as a precaution

“We have heard from quite a few people on the boat,” Dr Van Kerkhove said earlier.

“We just want you to know we are working with the ship’s operators. We are working with the countries where you are from. We hear you, we know ⁠that you are scared,” she said, adding that officials were working hard to get people home safely.

Later, however, Spain’s health ministry said it saw no reason for the ship to stop ‌in the Canary Islands if all sick passengers were evacuated in Cape Verde, unless additional cases appeared.

The UN health body said its working assumption ⁠was that the first ‌cases, involving the Dutch couple who boarded the ship in Argentina after travelling in the country, were infected before joining the cruise.

It said other passengers may also have contracted the virus during bird-watching excursions to islands inhabited by birds and rodents during the voyage.

Genetic sequencing of the virus is being carried out

A WHO spokesperson said it “may take some time to get all the answers” about how the outbreak began.

Tarik Jašarević told RTÉ’s News at One that, in South Africa, genetic sequencing of the virus is under way to determine which type of hantavirus is involved.

“We are doing everything we can. We understand that people are scared, they are tired of being in their cabin, and they don’t know what’s next, but efforts are being done to understand the situation and make sure that everyone can get home safely.

“There are a number of people who have been identified to follow up with (from a flight to Saint Helena and Johannesburg) in terms of contact tracing.

“We believe the risk to the wider general public is low, because we know that the hantavirus is normally transmitted through contact with animals.

“If there is a human-to-human transmission, it has to be close contact.

“However, we take this event very seriously, and we are doing everything we can to understand it better to make sure that people on the boat can arrive back safely, Mr Jašarević said.

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The Hondius is carrying mainly British, American and Spanish passengers on a luxury voyage that left the southern tip of Argentina in late March.

The itinerary included the Antarctic peninsula, South Georgia and ⁠Tristan da Cunha – some of the most remote islands on Earth.

The trip was sold as an Antarctic nature expedition, with berth prices ranging from €14,000 to €22,000.

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?

‘A lot of uncertainty’ – passenger

“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 posted from the ship yesterday.

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

The first passenger to fall ill, a Dutch man, died on 11 April. ⁠His body remained on board until 24 April, when it “was disembarked on St Helena, with his wife accompanying the repatriation”, Oceanwide Expeditions said.

His wife, who had gastrointestinal symptoms when she left the vessel, later worsened during the flight to Johannesburg.

She died after arriving at the emergency department on 26 April, the WHO said, adding that contact tracing was under way for passengers on that flight.

South African authorities have confirmed that the British patient being treated in a Johannesburg hospital tested positive for hantavirus. The Netherlands has confirmed the virus in the Dutch woman who died.

South Africa’s National Institute for Communicable Diseases is sequencing the virus, and results could be available by Wednesday, Dr Van Kerkhove said.

Argentina continues to record the highest number of cases in the Americas region, the WHO said in December, with a lethality rate of about 32%, higher than average ‌and than for other strains of the virus.