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- WHO suspects human-to-human hantavirus transmission on a cruise ship outbreak.
- The outbreak killed three people and left others ill; risk to the public is low.
- Evacuations, isolation and investigations are underway as ship heads to the Canary Islands.
GENEVA — Some human-to-human transmission may have occurred on board the cruise ship hit by a hantavirus outbreak that has left three people dead and several others ill, the World Health Organization said Tuesday.
"We do know that some of the cases had very close contact with each other and certainly human-to-human transmission can't be ruled out, so as a precaution, this is what we are assuming," Dr. Maria Van Kerhove, WHO's director for epidemic and pandemic preparedness and prevention, told reporters.
However, health authorities have emphasized that the outbreak does not pose a wider public health risk.
"The risk to the general public is low," Van Kerkhove said, outlining that any suspected human-to-human transmission would have occurred between very close contacts like married couples. "This is not a virus that spreads like flu or like COVID. It's quite different."
Almost 150 people, including 17 Americans, remain stranded on the MV Hondius, which is currently anchored off the coast of Praia, the capital of Cape Verde, an archipelago nation off Africa's west coast.
The ship, operated by tour company Oceanwide Expeditions, left Ushuaia, Argentina, last month on a voyage across the Atlantic Ocean, stopping off at some of the world's most remote islands. But along the way, several passengers fell sick with a rapidly progressing respiratory illness, the company said.
Seven cases of hantavirus, a rare disease typically caused by contact with infected rodents' urine, feces or saliva, have been identified so far. Two of those are confirmed and five are suspected, WHO said Monday.
Three people – a Dutch couple and a German national – have died while one British national remains in intensive care in South Africa, though Van Kerkhove said his condition is improving.
Two other people suffering from hantavirus symptoms remain on board the ship, though their medical evacuation is currently underway, Van Kerkhove said.
What happens next?
The top priority for health authorities is to evacuate the two symptomatic crew members so they can receive the medical care they require, Van Kerkhove said, adding that was underway Tuesday morning.
Such an evacuation involves two specialized, medically-equipped aircraft staffed by trained medical crews, the tour operator previously said on Monday.
Once they have been evacuated, the plan is for the ship to sail to the Canary Islands, where Spanish authorities will conduct a full epidemiological investigation and full disinfection, Van Kerkhove said.
The Spanish health ministry has not decided the most appropriate port for the ship, it said in a statement to CNN, which did not confirm if the ship is bound for the Canary Islands.
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.
Social distancing is being observed, and passengers have the option to have meals delivered directly to their cabin, Rosmarin said in a statement to CNN on Tuesday. Access to the outer decks is permitted for fresh air, though gathering in indoor areas such as the lounge is not allowed, 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.
Beyond the ship itself, authorities have initiated contact tracing for those on the flight to Johannesburg with the Dutchwoman who later died.
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 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 on board fell ill on April 27. He is now in intensive care at a private medical facility in Johannesburg, though his condition is improving, the 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.
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.
A seventh person reported a mild fever but is now feeling well, the WHO said. They have also provided a sample for hantavirus testing.
