Almost 150 people, including 17 Americans, are stranded on a cruise ship off the coast of west Africa, after a suspected hantavirus outbreak on the vessel killed at least three people and left several others ill.
The MV Hondius, operated by tour company Oceanwide Expeditions, left Ushuaia, Argentina last month on a journey through remote parts of the Atlantic Ocean. Along the way, several passengers became sick with a rapidly progressing respiratory illness, the company said.
Seven cases of the rare rodent-borne hantavirus have been identified so far, including two confirmed cases and five suspected cases, the World Health Organization (WHO) said Monday.
The vessel with 149 people on board is currently anchored off Praia, the capital of Cape Verde, an archipelago nation off the west coast of Africa, after being refused entry to the port.
There is no plan yet for disembarking the remaining crew and passengers, with Oceanwide Expeditions saying they are considering sailing on to Spain’s Canary Islands.
Hantavirus can cause a severe and often deadly respiratory illness called hantavirus pulmonary syndrome, which killed Betsy Arakawa, the wife of the late actor Gene Hackman, last year.
Humans most commonly become infected through contact with rodents such as rats and mice, especially with their urine, droppings and saliva, according to the Centers for Disease Control and Prevention (CDC).
Just one type of hantavirus, the Andes virus, is known to be able to transmit from person to person, but it is rare. It is primarily found in Chile and Argentina, where the ship originated.
Still, health authorities emphasized that the outbreak does not represent a public health threat. “There is no need for panic or travel restrictions,” said Hans Kluge, WHO’s regional director for Europe.
Here’s what we know about the outbreak on the ship.
Where had the ship been?
The MV Hondius first left Ushuaia in Argentina over a month ago. According to the MarineTraffic ship-tracking site, the Dutch-flagged passenger cruise ship made stops in Antarctica before returning to Ushuaia for a night and leaving again on April 1. It then stopped at the British overseas territory of Saint Helena before anchoring Sunday off Praia, MarineTraffic said.
Along the way, passengers visited some of the world’s most remote islands, where they would have seen much wildlife, including whales, dolphins, penguins and seabirds, according to the trip’s itinerary.
When it reached Praia, the vessel was not authorized to dock at the port, with Cape Verde’s Health Ministry citing a need to protect the country’s public health. Authorities there sent staff to visit the ship and assess the situation.
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 after going into respiratory distress, WHO said.
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 on April 26. She tested positive for a variant of hantavirus, Oceanwide Expeditions confirmed Monday.
“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.
“We are still unable to comprehend that we have lost them. We wish to bring them home and commemorate them in peace and privacy,” they said.
After the ship left Saint Helena, a British national onboard fell sick on April 27. He is now in a critical condition at private medical facility in Johannesburg, the company said. He is the second confirmed hantavirus case.
CNN has reached out to the British Foreign, Commonwealth and Development Office.
On May 2, a German national 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.
What happens next?
Dutch authorities are actively preparing to evacuate the two symptomatic crew members and an individual associated with the passenger that passed away on May 2, the tour operator said.
The evacuation will involve two specialized aircraft equipped with medical equipment and staffed by trained medical crews. It’s not yet clear when this will take place.
“Sailing on to Las Palmas or Tenerife is being considered, where further medical screening and handling could take place, organized and supervised by the WHO and Dutch health services,” the company said, confirming that passengers will not disembark in Cape Verde.
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.”
One passenger, travel vlogger Jake Rosmarin, spoke of the fear and uncertainty percolating through the ship on Monday.
“What’s happening right now is very real for all of us here. We’re not just a story. We’re not just headlines,” he said in a video posted on Instagram, his voice cracking with emotion.
“We’re people, people with families, with lives, with people waiting for us at home. There’s a lot of uncertainty, and that’s the hardest part.”
Beyond the ship itself, authorities have initiated contact tracing for those on the flight to Johannesburg with the Dutchwoman who later died.
How did the outbreak occur?
According to WHO, all of the cruise ship victims became ill between April 6 and 28, reporting symptoms including “fever, gastrointestinal symptoms, rapid progression to pneumonia, acute respiratory distress syndrome and shock.”
It is not clear how the infections occurred. The Ministry of Health of Argentina’s southern Tierra del Fuego province, where Ushuaia is located, said there has never been a reported case of hantavirus in the province. However, hantavirus is endemic in other parts of Argentina and Chile, according to WHO. The Dutch couple who died had traveled in South America, including Argentina, before they boarded the ship, WHO said.
In late 2018 and early 2019, the Patagonian town of Epuyén — 1,400 kilometers (about 870 miles) from Ushuaia — experienced dozens of hantavirus infections, resulting in at least 11 deaths.
Scott Miscovich, a family physician and the president and CEO of Premier Medical Group, said it is highly unusual for a hantavirus outbreak to occur on a ship that has not traveled anywhere where the virus is endemic.
“When I first read this, I thought that they were making a misprint,” he told CNN following the news of the suspected outbreak.
There are two plausible ways that the suspected outbreak could have occurred, Miscovich said.
One, the ship could have become contaminated with rat or mice feces or urine; or two, one of the passengers could have picked up the Andes variant of hantavirus, for which there is some limited evidence of human-to-human transmission, Miscovich said.
If the evidence points to human transmission, Miscovich said, it will “change the future of travel medicine and infectious disease and tropical medicine.”
How deadly is hantavirus?
The disease is rare but highly deadly — about 38% of people who develop respiratory symptoms may die, according to the CDC. If the patients are elderly or immunocompromised, the mortality rate could be higher, Miscovich said.
There is no cure for hantavirus infection, beyond treatment of symptoms. Patients with severe breathing difficulties may need to be intubated, the CDC said.
As of the end of 2023, just 890 confirmed cases of hantavirus disease have been reported in the US since surveillance began in 1993.
CNN’s Teele Rebane, Begoña Blanco Muñoz, Rosanne Roobeek, Duarte Mendonca and Rocio Muñoz-Ledo contributed reporting.
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