Officials in the United States are monitoring Americans who traveled on the cruise ship at the center of the hantavirus outbreak that has caused three deaths.
The Centers for Disease Control and Prevention said in a May 6 news release that the State Department is "leading a coordinated, whole-of-government response" and is in contact with passengers and health authorities around the world.
Eight people who traveled on the MV Hondius, a cruise ship traveling in the Atlantic Ocean run by Netherlands-based operator Oceanwide Expeditions, have been linked to the outbreak so far. Three people have died.
Start the day smarter. Get all the news you need in your inbox each morning.
The World Health Organization said the particular strain has been confirmed as the Andes virus, which is believed to spread person-to-person.
Here's the latest.
Is hantavirus in the US?
Residents in at least five U.S. states who traveled on the MV Hondius are being monitored for potential hantavirus infections, according to officials and reports.
Health officials in Virginia told USA TODAY on May 7 that they are monitoring one resident who has since returned home. Virginia Department of Health spokesperson Maria Reppas said the resident is in good health.
Texas health officials are also tracking two residents who were passengers, the state's health department said. The travelers left the ship and entered the U.S. before the outbreak was identified and have not experienced any symptoms.
The New York Times reported May 6 that public health agencies in Georgia, Arizona and California are monitoring residents who were aboard the MV Hondius cruise but have since returned to their homes. None of the people being monitored have shown signs of illness, according to the Times.
The Georgia Department of Public Health is monitoring two residents, the agency said in a statement to USA TODAY on May 6.
"The individuals are currently in good health and show no signs of infection. They are following current recommendations from CDC," the Georgia DPH said in the statement.
The Times and Reuters reported that the Arizona Department of Health Services was notified about one resident who had been on the MV Hondius.
The California Department of Public Health said it was alerted by the CDC that state residents were also on board the ship. The agency did not disclose how many people were being monitored in California, according to the Times.
"At this time, the risk to the American public is extremely low," the CDC said in a statement about the cruise outbreak on May 6.
Where is the cruise ship now?
The MV Hondius departed from its location off Cape Verde, an island nation near Africa's west coast, on May 6 and headed north.
The ship will sail toward the Canary Islands off the coast of Spain. MV Hondius is expected to arrive at the port of Granadilla on the island of Tenerife during the "early hours" of May 10, Oceanwide said in a May 7 update.
"This is subject to change," the company added. "Oceanwide Expeditions remains in close and continual discussion with relevant authorities regarding our exact point of arrival, quarantine and screening procedures for all guests, and a precise timeline."
Early on May 6, three passengers with suspected infections were evacuated from the ship and taken to the Netherlands, Oceanwide said. Two are in the hospital in stable condition, while the third is now in Germany, WHO Director-General Tedros Adhanom Ghebreyesus said in a May 7 news briefing.
Oceanwide previously said two of those people were in "serious condition," and the third was currently asymptomatic but closely associated with an individual who died on board. Three more medical professionals also "embarked m/v Hondius to provide optimal medical care during the crossing."
"No symptomatic individuals are present on board," the company said on May 7.
The ship departed from Argentina on April 1 and traveled across the Atlantic, making "multiple stops in remote and ecologically diverse regions," including mainland Antarctica, South Georgia, Nightingale Island, Tristan da Cunha, Saint Helena and Ascension Island, according to WHO.
What's happening onboard?
Ghebreyesus said on May 7 that all passengers have been asked to remain in their cabins. "The cabins have been disinfected, and anyone who shows symptoms will be isolated immediately," he added.
WHO official Maria Van Kerkhove also said the organization is working alongside partners to provide both "psychosocial" and medical support.
"This is quite frightening for those who are on board," she said. "They want to have the right information and regular information about what's happening. Our understanding right now is that the morale has improved because the ship is moving and plans are being made to get them safely to shore and for their onward journey home."
Jake Rosmarin, a guest aboard MV Hondius, said in a statement that passengers are generally in good spirits and that safety protocols such as social distancing and masking are in place.
Passengers can have meals delivered to their cabin and are allowed access to outer decks for fresh air, he added.
"Oceanwide Expeditions and the crew have been doing everything within their ability to keep passengers safe, informed, and as comfortable as possible during this time," he said. The company confirmed to USA TODAY that the measures Rosmarin referenced were in place.
How did the hantavirus outbreak start?
On May 6, WHO said the strain of hantavirus has been confirmed through laboratory testing as Andes virus, a strain found in South America that is believed to spread person-to-person.
Officials believe a husband and wife, Dutch nationals, were infected while they were off the cruise ship. The couple traveled through Argentina, Chile and Uruguay on a bird-watching trip that "included visits to sites where the species of rat that's known to carry Andes virus was present," Ghebreyesus said on May 7.
Others with suspected infections may have come in contact with the virus on islands during the voyage as well, according to Van Kerkhove.
She noted that instances of human-to-human transmission in previous Andes virus outbreaks have primarily been among close contacts, including those who have had close physical contact. "And we believe that's happening, and has happened in the case here on the ship, as well, between the couple, the first and second cases, and also a medical doctor providing care," she said.
WHO has also said the current risk to the rest of the world is low, but it is continuing to monitor the situation and provide updates. Van Kerkhove emphasized that "this is not the start of an epidemic. This is not the start of a pandemic, but it is a good opportunity to say that investment in pathogens like this are critical, because therapeutics, diagnostics, vaccines, save lives."
What is hantavirus?
Hantaviruses are a group of viruses that naturally infect rodents and are occasionally transmitted to humans, according to the World Health Organization.
Human hantavirus infection is primarily transmitted through contact with the urine, feces or saliva of infected rodents. Although uncommon, limited human-to-human transmission has been reported in previous outbreaks, per the WHO.
Symptoms in humans typically begin two to three weeks after infection, and can include fever, chills, muscle aches, vomiting and diarrhea. In serious cases, it can cause issues with lung and heart function, per the Mayo Clinic.
How many people on cruise are sick from hantavirus?
According to the WHO, eight cases, including five lab-confirmed cases of hantavirus, have been identified among those who traveled on the ship. Three people have died from their infections.
On May 7, a woman in the Netherlands was being tested for a possible hantavirus infection, Mischa Stubenitsky, a spokesperson for the Dutch Health Ministry, confirmed to USA TODAY.
Local media in the Netherlands reported that the woman is a flight attendant for KLM, the airline that confirmed one of the cruise passengers who died from hantavirus traveled on board one of its flights. When contacted by USA TODAY, the airline said it does not comment on individual cases for privacy reasons.
Here's a summary of the eight confirmed and suspected cases per WHO:
- An adult male developed symptoms of fever, headache, and mild diarrhea on April 6 while on board the ship. He developed respiratory symptoms and died on board on April 11. His body was removed to St. Helena, a British Overseas Territory in the South Atlantic, on April 24.
- An adult female, identified as the wife of the male who died on board on April 11, went ashore to Saint Helena on April 24 with gastrointestinal symptoms. Her symptoms worsened during a flight to Johannesburg, South Africa, on April 25. She died on April 26. The case was confirmed as a hantavirus infection on May 4.
- Officials said the husband and wife were Dutch nationals and had traveled in South America, including Argentina, before they boarded the cruise ship.
- KLM confirmed on May 6 that the woman traveled on board one of its flights.
- An adult male reported a fever, shortness of breath and signs of pneumonia to the ship's doctor on April 24. After his condition worsened, he was medically evacuated to South Africa on April 27, where he is currently hospitalized in an intensive care unit. Testing confirmed a hantavirus infection on May 2.
- An adult female whose symptoms began on April 28 and included fever and signs of pneumonia. She died on May 2.
- An individual who was evacuated from the ship on May 6 and was taken to the Netherlands for medical treatment.
- An individual who was evacuated from the ship on May 6 and was taken to the Netherlands for medical treatment.
- An individual who was evacuated from the ship on May 6 and was taken to the Netherlands for medical treatment.
- A Swiss man who had traveled on the ship before returning home in late April. He has been admitted to a hospital in Zurich after exhibiting symptoms, according to WHO and Swiss public health officials.
Contributing: Mary Walrath-Holdridge
This story was updated to add new information.
This article originally appeared on USA TODAY: Hantavirus being monitored in US. Latest on cruise ship outbreak
