Spat over hantavirus cruise ship’s destination as officials race to trace victims’ contacts
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By Issy Ronald, Lex Harvey, CNN
(CNN) — Three people were evacuated from the hantavirus-hit cruise ship on Wednesday, currently anchored off the coast of west Africa, as authorities rush to trace anyone who may have come into contact with the virus.
Another passenger previously on board the MV Hondius tested positive for hantavirus and is being treated at a Swiss hospital, Switzerland’s health ministry said Wednesday. That takes the total tally to eight cases of hantavirus – three confirmed and five suspected. Three people have died in the suspected outbreak and several others have fallen ill.
Meanwhile, local politicians are wrangling over the plan for the ship to dock in the Canary Islands, a Spanish archipelago.
While the rare disease is typically caused by contact with infected rodents’ urine, faeces or saliva, the World Health Organization (WHO) said some human-to-human transmission may have occurred among people on board the vessel.
And after sequencing the virus from some of those infected, health authorities confirmed this outbreak was caused by the Andes strain, which is known to have previously had some limited spread between people.
The WHO has emphasized that the outbreak does not pose a wider public health risk. But they are rushing to complete contact tracing, including contacting the 88 people on a flight one of the victims took before she died, to contain the outbreak.
And while Spain’s health minister insists that the ship docking in Tenerife, one of the Canary Islands, doesn’t pose a threat to the public, Fernando Clavijo, the archipelago’s president, said Wednesday he’s opposed to the ship docking there and requested an urgent meeting with Spain’s Prime Minister Pedro Sánchez. Clavijo belongs to the conservative People’s Party, which is Sánchez’s main opposition.
The government of the Canary Islands is not refusing to receive the vessel but “demands clear information” about it, the president’s office told CNN.
“The president is seeking clarification why the vessel is heading for the Canaries, when people could be repatriated from Cape Verde and not be left a further number of days on the ship,” his office told CNN.
Spain’s health minister Mónica García hit back at criticism, saying the government has been in constant contact with Clavijo at both a technical and political level.
Currently the vessel, which is operated by tour company Oceanwide Expeditions, is anchored off the coast of Praia, the capital of Cape Verde, an archipelago nation off Africa’s west coast. Almost 150 people, including 17 Americans, remain onboard.
A Dutch couple and German national have died while one British national remains in intensive care in South Africa, though the WHO said his condition is improving.
What happens next?
Three individuals were evacuated from Cape Verde, WHO chief Dr. Tedros Adhanom Ghebreyesus confirmed Wednesday, saying they will travel to the Netherlands.
One of those individuals is the ship’s British doctor, who was originally bound for the Canary Islands but is headed for the Netherlands now his condition has improved, the Spanish health ministry said Wednesday. Another is a German national who will be transported to a hospital in Düsseldorf, local public broadcaster WDR reported.
Two specialist doctors from the Netherlands will board and remain with the vessel after it leaves Cape Verde, the tour operator said Wednesday. Another doctor is already on board.
The plan is then for the ship to dock in Tenerife within three days, where the WHO believes safe disembarkation can happen, for both those on board and the general public, García, Spain’s health minister, said.
Oceanwide is liaising with relevant local authorities to plan the vessel’s exact arrival, quarantine and screening procedures for all guests, it said Wednesday. The 14 Spanish passengers on board will be transported to a military hospital after being examined, while other passengers will be repatriated, García said.
Strict health and safety procedures are currently in place on the ship, including isolation measures, hygiene protocols and medical monitoring. The company said the atmosphere “remains calm” and that passengers were “generally composed.”
Social distancing is being followed and passengers have the option for meals to be delivered directly to their cabin, one passenger, travel vlogger Jake Rosmarin, said in a statement to CNN Tuesday. Access to the outer decks is permitted for fresh air, though gathering in indoor areas such as the lounge is not allowed, he added.
Beyond the ship itself, authorities have initiated contact tracing for the 82 passengers and six crew members on the April 25 flight to Johannesburg with the Dutchwoman who later died. Airlink, which operated the flight, has provided South Africa’s health ministry with a passenger list and is helping to contact them, it said in a statement to CNN.
“At the time when the flight was operated Airlink was unaware that any of the passengers were unwell,” it added.
A passenger with hantavirus who later died was “briefly on board” a KLM aircraft in Johannesburg on April 25, the Dutch flight operator said in a statement Wednesday, but the crew did not allow them to travel “due to the passenger’s medical condition at the time.” The flight then departed for the Netherlands, and all passengers who were on board are now being informed by the Dutch health authorities, KLM said.
Authorities in Switzerland are also carrying out contact tracing for the patient currently in hospital. His wife, who was also on the trip, is currently asymptomatic and self-isolating as a precaution, the Swiss health ministry said.
“The risk to the general public is low,” Dr. Maria Van Kerkhove, WHO’s director for epidemic and pandemic preparedness and prevention, told reporters.
“This is not a virus that spreads like flu or like COVID. It’s quite different,” she said, outlining that any suspected human-to-human transmission would have occurred between very close contacts like married couples.
What do we know about the victims?
The first suspected case was a 70-year-old Dutchman, who suddenly fell ill on the ship with a fever, headache, abdominal pain and diarrhea, South Africa’s Health Department told CNN. He died on board on April 11.
The man’s wife, who was 69 years old and also Dutch, was taken to South Africa but collapsed at an airport while trying to fly home to the Netherlands and died at a nearby hospital. She tested positive for the Andes strain of hantavirus, South Africa’s health ministry confirmed Wednesday.
“The beautiful journey they experienced together was abruptly and permanently cut short,” the couple’s family said in a statement sent to CNN by Dutch charity Namens de Familie, which supports people receiving media attention after personal tragedy.
After the ship left Saint Helena, a British national onboard fell sick on April 27. He is now in intensive care at a private medical facility in Johannesburg, though his condition is improving, WHO said. He is the second confirmed hantavirus case.
On May 2, a German national, who presented with pneumonia, died on board the MV Hondius. While her cause of death has not yet been established, it is being treated as a suspected case.
And two crew members — one British and one Dutch national — are currently experiencing acute respiratory symptoms, requiring urgent care, Oceanwide Expeditions said. Hantavirus has not been confirmed in either case.
A seventh person reported a mild fever but is now feeling well, WHO said. They have provided a sample for hantavirus testing too.
An eighth case emerged Wednesday when Swiss authorities confirmed a man was being treated for hantavirus at the University Hospital Zurich. He had consulted his doctor after experiencing symptoms, before going to the hospital for testing. Doctors established he is suffering from the Andes strain of the virus, which can spread by limited human-to-human transmission, and he has been isolated.
How did the outbreak occur?
It’s not yet clear how the outbreak occurred. But WHO are working on the assumption that the Dutch couple who both died were infected off the ship, perhaps while doing some activities in Argentina before they joined the cruise, Van Kerkhove said.
The MV Hondius first left Ushuaia in Argentina over a month ago. It made stops in Antarctica before returning to Ushuaia for a night and leaving again on April 1, according to vessel tracker Marine Traffic. It then stopped at the British overseas territory of Saint Helena before anchoring Sunday off Praia, MarineTraffic said.
Hantavirus typically incubates for one to six weeks before patients start presenting symptoms so they likely fell ill some time after they were infected, she added.
According to WHO, the passengers who fell ill developed symptoms between April 6 and 28, including “fever, gastrointestinal symptoms, rapid progression to pneumonia, acute respiratory distress syndrome and shock.”
On their voyage, passengers visited some of the world’s most remote islands, where they would have seen a lot of wildlife, including whales, dolphins, penguins and seabirds, according to the trip’s itinerary.
“This was an expedition boat and many people were doing birdwatching, things with wildlife,” Van Kerkhove said.
Rodents live in some of these places, so there “could be some source of infection on the islands as well for some of the other suspected cases,” she added.
“We do believe there may be some human-to-human transmission happening among the really close contacts, the husband and wife, people who’ve shared cabins,” Van Kerkhove said.
Meanwhile, Rosmarin, one of the passengers, emphasized that the ship “is not a traditional cruise ship, but an expedition vessel” and had followed strict cleanliness protocols throughout its voyage since it visited “remote and environmentally sensitive regions.”
How deadly is hantavirus?
While hantavirus is rare, it is highly deadly – about 38% of people who develop respiratory symptoms may die, according to the CDC.
Symptoms start similar to the flu, with patients suffering from fatigue, fevers, chills and aches. But over time, the virus can damage the heart, lungs or kidneys, causing patients to suffer severe shortness of breath, organ failure and even death.
There’s no specific treatment for hantavirus, according to the CDC, beyond managing symptoms. Patients with severe breathing difficulties may need to be intubated, the CDC said.
This is a developing story and will be updated.
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CNN’s Teele Rebane, Christian Edwards, Begoña Blanco Muñoz, Rory Fleming, Rosanne Roobeek, Duarte Mendonca, Rocio Muñoz-Ledo, Hira Humayun, Sophie Tanno, Sarah Dean and Vasco Cotovio contributed reporting.
