Hantavirus May Have Spread Between Passengers on Cruise Ship, WHO Says

Hantavirus may have spread between passengers – The World Health Organization has indicated that human-to-human transmission of hantavirus might have occurred on the MV Hondius, a Dutch cruise ship, during its recent Atlantic crossing. This conclusion follows the deaths of three passengers and the identification of seven cases of the virus, two of which were confirmed and five suspected. While hantavirus is typically transmitted from rodents, the WHO has suggested that close contact among passengers could have facilitated its spread, though such cases are considered rare. The organization emphasized that the risk to the general public remains low, despite the ongoing investigation.

Close Contact and Intimate Settings

Dr. Maria Van Kerkhove, a WHO official, explained that some individuals aboard the ship were in “really close contacts,” such as couples sharing accommodations, which could create conditions for human-to-human transmission. She highlighted that while the virus is primarily spread through rodent excretions, the confined environment of the cruise ship may have allowed for more direct spread. “Intimate contact” was cited as a key factor in the potential transmission, though Van Kerkhove clarified that this is not the usual mode of spread for the virus.

The WHO also noted that the first infected individual might have contracted the virus before boarding the ship. This hypothesis is supported by the fact that the virus is commonly found in regions where rodents are prevalent, such as South America. The MV Hondius embarked on its journey from Argentina, where the initial outbreak is believed to have originated. However, the absence of reported rodents on board has raised questions about the exact source of the virus. Van Kerkhove acknowledged this uncertainty but reassured that the situation is being closely monitored.

Cases Identified and Patient Status

As of now, 149 people from 23 countries are still aboard the ship under strict precautionary measures. The vessel is currently anchored off the coast of Cape Verde, where it has remained since Monday. Among the confirmed cases, two were a Dutch married couple, with the wife diagnosed with hantavirus. A third confirmed case involves a 69-year-old UK national who was evacuated to South Africa for treatment. The husband of the Dutch woman and another deceased passenger, a German national who passed away on 2 May, have not yet been confirmed to have the virus, according to the WHO.

Van Kerkhove noted that the ship’s operator, Oceanwide Expeditions, is conducting tests on passengers and crew displaying symptoms. She also mentioned that disinfection efforts are underway and that those handling patients are using full personal protective equipment to minimize risks. While the transmission between humans is uncommon, the WHO remains cautious about the possibility of further spread among the 149 individuals still on board.

Spain’s Role and Next Steps

Spain has approved the MV Hondius to dock in the Canary Islands, where additional medical evaluations and risk assessments can occur. However, the country’s health ministry has expressed a willingness to take charge of the situation if needed. In a statement, they said, “Depending on epidemiological data gathered from the boat as it travels past Cape Verde, the most appropriate next stop for it will be decided. Until then, the health ministry will not take a decision, as we have explained to the WHO.” A spokesperson added that Spain has not yet received a formal request for the ship to stop at the Canaries but is prepared to assist should such a move be necessary.

Meanwhile, the cruise ship continues its journey, with officials prioritizing the treatment of two crew members from the Netherlands and the United Kingdom who are experiencing respiratory symptoms. These individuals are set to be medically evacuated by aircraft, along with a person linked to the German national who died. The WHO has not confirmed any further cases beyond the seven identified so far, though they remain vigilant about the possibility of additional infections.

Passenger Perspectives and Uncertainty

Despite the ongoing concerns, some passengers have reported a relatively positive mood on the ship. A passenger who chose to remain anonymous told the BBC on Monday, “We’re still on the vessel, and although there’s a lot of uncertainty, people are trying to stay calm. Hopefully, the other patients on board will be tested soon and then we’ll know what’s going on.” This sentiment was echoed by a travel vlogger named Jake Rosmarin, who posted on social media, “There’s a lot of uncertainty, and that’s the hardest part. We don’t know yet if we’re all in danger, but we’re keeping our fingers crossed for the best outcome.”

The German passenger, who succumbed to the virus on 2 May, was part of a group that included several other individuals who may have been exposed. The ship’s operator has stated that no one else has shown symptoms, but this does not rule out the possibility of more cases being identified in the coming days. Van Kerkhove explained that the investigation is focusing on the Andes strain of hantavirus, which is typically associated with South American regions and spreads through rodent contact. She mentioned that the cruise had visited multiple islands, some of which are known to host rodent populations, complicating the tracing of the virus’s origin.

Public Health Response and Precautions

Van Kerkhove emphasized that while the risk of hantavirus spreading beyond the ship is low, the WHO is taking all necessary steps to contain the outbreak. This includes regular disinfection of the vessel and ensuring that those in close proximity to infected individuals are protected. She also outlined the current working hypothesis: that the virus could have been transmitted through a combination of rodent exposure and human contact during the cruise’s voyage. “Our working hypothesis is that there’s probably a couple of different types of transmission that might be happening,” she said during a BBC Breakfast interview on Tuesday.

As the MV Hondius continues its journey, the WHO and Oceanwide Expeditions are coordinating to provide medical care and monitor the health of all passengers. The ship’s operator has not yet disclosed whether passengers will be allowed to disembark once it reaches its next port. However, Van Kerkhove highlighted the importance of continued vigilance, stating that the situation is being handled with the utmost care. She noted that the absence of rodents on board does not eliminate the possibility of human-to-human transmission, especially in a setting where people are in close quarters for an extended period.

Looking ahead, the WHO is working with Spanish authorities to determine the best course of action for the ship’s next stop. The Canary Islands offer a strategic location for further medical checks and potential isolation of infected individuals. The family of the Dutch couple, who had been on a romantic trip, expressed their grief in a statement. “The beautiful journey they experienced together was abruptly and permanently cut short,” they wrote. “We are still unable to comprehend that we have lost them. We wish to bring them home and commemorate them in peace and privacy.” This personal touch underscores the emotional impact of the outbreak on those affected.

As the investigation unfolds, the WHO is urging continued monitoring of the ship’s population. While the Andes strain is the primary focus, other strains of hantavirus are also being considered. The organization remains committed to providing accurate information and ensuring the safety of all individuals involved. With the ship now in the Atlantic, the next steps will depend on the results of ongoing tests and the assessment of the virus’s spread. The story of the MV Hondius serves as a reminder of how infectious diseases can take unexpected turns, even in seemingly controlled environments like cruise ships.