CRUISE SHIP

CNN– The World Health Organization said Thursday that five confirmed infections have been identified among people connected to the cruise ship MV Hondius, as health authorities across several countries race to trace and contain the outbreak.

Three people – a Dutch couple and a German national – have died since the vessel departed Argentina last month. 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.

Meanwhile, a total of 146 people from 23 different countries are still aboard the vessel under “strict precautionary measures,” operator Oceanwide Expeditions said Thursday.

While at least 30 passengers disembarked at the remote South Atlantic island of Saint Helena in late April and several critical cases were air-evacuated to Europe this week, those remaining passengers are scheduled to arrive in Spain’s Canary Islands this weekend before they are flown back to their respective home countries.

Spanish authorities said in their latest update that the ship will arrive in Tenerife around noon local time (7:00 am ET) on Sunday.

Here’s what we know about some of the countries where cruise ship passengers are either being treated for hantavirus or monitored for potential infection.

• The Netherlands: Three passengers have arrived in the Netherlands for treatment, the vessel’s operator Oceanwide Expeditions said Thursday. They are a British national, a 65-year-old German and a 41-year-old Dutch crew member. Two of the passengers are in serious condition, while the third evacuee, who the company said is not currently showing symptoms, is also receiving medical care. Separately, a Dutch government spokesperson told CNN Thursday that a woman had gone to a Amsterdam hospital for testing after possible exposure linked to the ship. Dutch media reported she is a KLM airline crew member who had contact with a 69-year-old Dutch woman who died in South Africa last month. If she tests positive, she would be the first non-passenger connected to the incident to contract the virus. Dr. Bram Goorhuis, an infectious disease physician at the Amsterdam University Hospital who is treating the KLM crew member, told CNN that doctors are expecting to receive her test results later on Thursday.
• South Africa: A British national who fell sick onboard the vessel on April 27 was transferred to a private medical facility in Johannesburg, South Africa, where he remains in intensive care. He is the second confirmed hantavirus case. The WHO said his condition is improving.
• Switzerland: On Wednesday, WHO Director-General Tedros Adhanom Ghebreyesus said a passenger who returned to Switzerland after leaving the ship tested positive and is being treated in Zurich.
• UK: In the UK, the Health Security Agency said two British nationals who left the ship at St. Helena on April 24 are isolating at home as a precaution following possible exposure. The agency said is aware of five other British nationals who disembarked the vessel that day, including four that are still there. Contact tracing efforts are continuing for a seventh person who has not yet returned to the UK, it said.
• US: Health authorities in the United States said they are monitoring three people who previously disembarked and returned home. Officials in Georgia said two residents are under observation and have shown no symptoms, while Arizona health authorities said one individual is also asymptomatic. MedPageToday reported that other American passengers had returned to Texas and Virginia.
• Singapore: Two Singaporean residents – both men in their 60s – are self-isolating and being tested for hantavirus, the country’s Communicable Diseases Agency said Thursday. One of the men “has a runny nose but is otherwise well,” it said, while the other is asymptomatic.

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The situation has captured international attention as passengers have disembarked and dispersed across multiple countries before the outbreak was fully understood, prompting some to draw comparisons to the early days of the Covid-19 pandemic.

Oceanwide said Thursday that they were working to “establish details of all passengers and crew who embarked and disembarked on various stops of m/v Hondius since March 20,” amid concern for the global spread of the virus.

Medics escort a patient, second right, evacuated from the MV Hondius cruise ship with suspected hantavirus infection, to an ambulance after being flown Wednesday to Schiphol airport, Amsterdam, Netherlands. Peter Dejong/AP

The World Health Organization on Thursday said while it expects more cases to emerge, it does not anticipate a large epidemic anywhere similar to Covid, and underlined that there is no evidence of a widespread transmission risk.

The outbreak has been linked to the Andes strain of hantavirus, a rare but potentially severe virus that in some cases can spread between humans through close contact.

It’s not yet clear how the outbreak occurred. But WHO are working on the assumption that the Dutch couple who died were infected off the ship, possibly while sightseeing in Argentina before joining the cruise.

The first two cases “travelled through Argentina, Chile and Uruguay on a bird-watching trip which included visits to sites where the species of rat known to carry the virus was present,” Ghebreyesus told reporters Thursday.

Ships at dock at Granadilla port, where the MV Hondius, carrying nearly 150 people, is expected to arrive within three days, Spain’s Health Minister Monica Garcia said. Borja Suarez/Reuters

As the Hantavirus typically incubates for one to six weeks before patients start presenting symptoms, it is likely they fell ill some time after they were infected, according to health officials.

The WHO said in a post to social media that it is “working with relevant countries to support international contact tracing, to ensure that those potentially exposed are monitored and that any further disease spread is limited.”

This story has been updated with additional developments.

CNN’s Pau Mosquera, Brenda Goodman, Vasco Cotovio and Marlon Sorto contributed reporting.

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