Hantavirus cruise ship heads for Spain’s Canary Islands as officials race to trace victims’ contacts
By Issy Ronald, Lex Harvey, CNN
(CNN) — The hantavirus-hit cruise ship MV Hondius departed Cape Verde for Tenerife on Wednesday, as authorities rush to trace anyone who may have come into contact with the virus.
The journey from the archipelago nation off Africa’s west coast to Spain’s Canary Islands is expected to take three and a half days, the Spanish Ministry of Health told CNN.
The ship’s departure came soon after three people were evacuated from the vessel.
Two of them have landed in Amsterdam where they have been received by specialist medical teams, according to the cruise ship operator Oceanwide Expeditions. The plane carrying the third patient had to make an unscheduled landing at Gran Canaria Airport, in the Canary Islands, to refuel after being refused permission to do so in Morocco. A malfunction with the patient’s medical equipment caused further delays, a source at the ministry said.
“The patient does not pose a risk to public health and will remain on the runway until the situation is resolved,” the source said.
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.
The vessel, which is operated by tour company Oceanwide Expeditions, had previously been 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?
The plan is for the ship to dock in Tenerife, 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.
A spokesperson for the US State Department told CNN it was closely tracking the cruise ship, and remains in close contact with the crew as well as international and US health authorities. The State Department “stands ready to provide consular assistance” to any affected Americans, the spokesperson added, with 17 Americans remaining onboard.
Two Georgia residents who returned home after earlier disembarking the cruise ship are being monitored, the Georgia Department of Public Health said in a statement Wednesday. The individuals are not currently showing any signs of infection and are following recommendations from the US Centers for Disease Control and Prevention (CDC), the health department added.
One Arizona resident who was a passenger on the vessel is being monitored by public health and is not symptomatic, the state’s Department of Public Health told CNN.
“CDC has stood up an incident management system to manage the communications and engagement with various state, local and federal partners. This is the same approach CDC would do for many similar issues in the past,” said a former CDC official who has led some of these responses, which have included outbreaks of MPox, H5N1 avian influenza in dairy cattle, Oropouche virus, and Dengue.
“Department of State has the lead, but CDC has the technical responsibility,” the official said.
The UK Health Security Agency said none of the British citizens who remain onboard the ship are currently reporting symptoms. Two Brits who returned to the UK independently after being onboard the MV Hondius have been advised to self isolate, and neither of the individuals are currently reporting symptoms, the agency added.
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.”
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.
The Dutchwoman 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 a 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.
On Wednesday, in addition to the three people evacuated, an eighth case emerged 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.
On Wednesday, Argentine officials investigating the outbreak’s origins anonymously told The Associated Press the leading theory is that the couple contracted the virus during a bird-watching tour in the city of Ushuaia before boarding. They said the couple visited a landfill during the bird-watching tour where they may have been exposed to rodents carrying the infection.
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.
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 Pau Mosquera, Brenda Goodman, Jennifer Hansler, 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.
