The World Health Organization announced on Thursday that there are now five confirmed Hantavirus cases from the Atlantic cruise ship outbreak, with three more suspected, and warned that further cases are possible. Despite the three fatalities, the WHO insisted that the outbreak on the MV Hondius is not the start of an epidemic or a repeat of the spread of Covid-19.
So far, eight cases have been reported, including three deaths. Five of the eight cases have been confirmed as Hantavirus and the other three are suspected, WHO chief Tedros Adhanom Ghebreyesus said. The species of Hantavirus involved in this case is the Andes virus, which is found in Latin America, he told a press conference in Geneva.
He stressed that none of the remaining passengers or crew on the ship are currently symptomatic. However, given that the incubation period of the Andes virus, the only species of Hantavirus that spreads between people, can be up to six weeks, he warned that it is possible that more cases may be reported.
A 65-year-old German woman potentially exposed to the Hantavirus on the Dutch cruise ship Hondius has been transported to the University Hospital in Düsseldorf for examination. According to the hospital's announcement on Thursday, the woman is asymptomatic and is undergoing infectious disease testing. She is believed to have had contact with a German passenger who died aboard the ship on May 2nd.
Düsseldorf Fire Department organized the transfer from Amsterdam Airport on Wednesday evening using a convoy of six vehicles. Emergency personnel wore specialized protective suits to prevent potential infection. The fire department stated the woman's condition is stable and she currently shows no symptoms of infection.
Two evacuation flights brought people from the ship to Amsterdam on Wednesday. The German woman was on one flight, while two sick crew members from Britain and the Netherlands were on another aircraft.
The National Reference Laboratory for Hantaviruses at the Robert Koch Institute in Berlin has received samples from the German contact person for testing. Authorities are specifically checking for the Andes virus, a South American variant of Hantavirus that can be transmitted from person to person, unlike most Hantavirus strains which are only transmitted through rodent contact.
After the evacuation operation, the cruise operator Oceanwide Expeditions reported there are no symptomatic individuals remaining on board the vessel.
Two crew members showing symptoms were evacuated to the Netherlands on Wednesday. One has been admitted to Leiden University Hospital. The two patients in hospital in the Netherlands following evacuation from Cape Verde are in stable condition, according to WHO officials.
Health authorities are also testing a KLM flight attendant who had brief contact with a potentially infected Dutch passenger and is experiencing mild symptoms, according to the Dutch Health Ministry.
In the United Kingdom, two British nationals who were aboard the Hondius have been instructed by authorities to quarantine after returning home. The UK Health Security Agency (UKHSA) confirmed neither individual is currently showing symptoms. The two returned to the United Kingdom independently of each other, the health authority stated.
Denmark has reported one passenger from the ship has entered self-isolation, according to the Danish Patient Safety Authority. Meanwhile, Singapore has quarantined two former Hondius passengers for testing, with health authorities reporting one has a runny nose while the other remains symptom-free.
The patient in intensive care in South Africa is doing better, according to WHO's epidemic and pandemic preparedness director Maria Van Kerkhove. Two infected individuals remain hospitalized in Switzerland and South Africa, with contact persons being isolated and tested in Denmark, Great Britain, and Singapore.
The Dutch-flagged Hondius departed Ushuaia on the southern tip of Argentina on April 1st with 114 passengers and dozens of crew members for a cruise across the Atlantic Ocean to Cape Verde off the coast of West Africa. The first fatality occurred on April 11th when a Dutch passenger died on board.
His wife disembarked on the island of St. Helena in the South Atlantic on April 24th, flew to Johannesburg, and died in a hospital there on April 26th. The third death occurred on May 2nd when a German female passenger died aboard the ship.
According to Oceanwide Expeditions, 28 additional passengers disembarked at St. Helena on April 24th along with the Dutch victim's wife. All of these individuals have since been contacted by authorities.
The cruise ship had been anchored off Cape Verde since Sunday with approximately 150 people on board. On Wednesday, it set sail north from Cape Verde towards Tenerife. The Hondius will dock within three days at the port of Granadilla, Spanish Health Minister Mónica García Gómez announced. All foreign passengers will be flown back to their home countries from there, provided their health condition permits.
Tedros said he had been in regular contact with the ship's captain, including earlier Thursday. He told me morale has improved significantly since the ship started moving again, he said.
This is not the start of an epidemic. This is not the start of a pandemic, said Maria Van Kerkhove, the WHO's epidemic and pandemic preparedness director who was the agency's technical lead on Covid-19 throughout the coronavirus crisis. This is not Covid; this is not influenza. It spreads very, very differently.
The WHO emergency alert and response director Abdi Rahman Mahamud added that we believe this will be a limited outbreak if the public health measures are implemented. The disease is usually spread from infected rodents, typically through urine, droppings and saliva. The Andes strain of Hantavirus is the only one with documented human-to-human transmission.
The World Health Organization suspects the Dutch passenger contracted the Hantavirus before boarding the ship. Tedros said that prior to boarding the ship on April 1st, the first two cases, a Dutch couple who have both died, had travelled through Argentina, Chile and Uruguay on a bird-watching trip, which included visits to sites where the species of rat known to carry Andes virus was present.
WHO expert Anaïs Legand pointed to the incubation period as evidence. The 70-year-old man began showing symptoms including fever and headaches on April 6th, just five days after the ship departed from Ushuaia on April 1st.
In most cases, the incubation period between infection and symptom onset is two to three weeks, Legand said. The man was clearly exposed to virus contact before going on board. The infection is certainly connected to a rodent. Legand said the RNA of the virus could be detected in a case from the first day of onset of symptoms, which typically occur two to three weeks after exposure to the virus.
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The WHO is awaiting the results of full genome sequencing of the virus from South Africa, Switzerland and Dakar, which will help determine the clustering pattern compared to previous outbreaks with a high level of detail. It will give us a sense of whether or not we are seeing some changes, said Legand, a WHO technical expert on viral haemorrhagic fevers. Van Kerkhove added that nothing unusual had been detected so far in the virus.
Tedros announced that 2,500 diagnostic kits would be sent from Argentina to laboratories in five countries. The WHO was working with Argentina, which followed the United States in quitting the agency, to trace the couple's movements.
Argentine authorities have announced an increase in Hantavirus cases in the South American country. The Health Ministry registered 101 cases in the current epidemiological year, nearly double the 57 cases recorded in the previous period. However, biologist Raúl González Ittig told AFP this is not extraordinary and represents isolated cases.
The ministry has dispatched experts to Tierra del Fuego province in southern Argentina, where Ushuaia is located, to collect samples from rodents.
The UN health agency said it expected the outbreak to be limited, so long as public health measures are properly implemented. The European Commission continues to assess the risk of infections in Europe as low. The specific virus strain identified in patients in Johannesburg and Zurich is the South American Andes virus type that allows for human-to-human transmission, unlike the typical rodent-only transmission route of most Hantavirus variants.
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