Three people have died and at least three others are sick after a possible hantavirus outbreak on board a cruise ship sailing in the Atlantic Ocean, the WHO (World Health Organization) reported on Sunday (3).
The three dead were passengers on a cruise, said Oceanwide Expeditions, the company that operates the ship, called MV Hondius, which is currently anchored in Praia, capital of Cape Verde, an island country off the west coast of Africa.
At 7pm on Sunday (Brasília time), Cape Verdean authorities had not authorized passengers to disembark to receive medical care, but local health authorities visited the ship and assessed two symptomatic crew members who “required urgent medical attention”, Oceanwide Expeditions said in a statement.
Hantavirus can cause a serious and often fatal respiratory illness called hantavirus pulmonary syndrome, which killed Betsy Arakawa, wife of the late actor Gene Hackman, last year.
According to the CDC (Centers for Disease Control and Prevention), infection in humans most commonly occurs through hair and mice, especially through the urine, feces and saliva of these animals.
Only one type of hantavirus, the Andes virus, is known to be able to transmit from person to person, but this is rare. It is found mainly in Chile and Argentina, the ship’s countries of origin.
Where was the ship?
The MV Hondius sailed from Ushuaia, Argentina, about seven weeks ago, according to data from MarineTraffic, which identified it as a Dutch-flagged passenger cruise ship. It made stops in Antarctica and the British overseas territory of Saint Helena before anchoring on Sunday in Praia, the capital of Cape Verde, according to MarineTraffic.
According to Oceanwide Expeditions, the vessel has capacity for 170 passengers and 71 crew, including a doctor. The company informed the CNN that it is “focused on the health and safety of passengers and crew” and that it will release more information as it becomes available.
It is unclear how the infections occurred. The Ministry of Health for the province of Tierra del Fuego, where Ushuaia is located, said there has never been a reported case of hantavirus in the province.
Of the six symptomatic individuals, only one case has been in the laboratory so far, while the other five are suspected cases, the WHO reported.
“To date, one case of hantavirus infection has been laboratory confirmed, and there are five additional suspected cases. Of the six affected individuals, three have passed away and one is currently in intensive care in South Africa.”
WHO is aware of and supporting a public health event involving a cruise vessel sailing in the Atlantic Ocean. To date, one case of hantavirus infection has been laboratory confirmed, and there are five additional suspected cases. Of the six affected individuals, three have died…
— World Health Organization (WHO) (@WHO)
“Detailed investigations are ongoing, including further,” the WHO said. “Medical care and support is being provided to passengers and crew. Sequencing of the virus is also underway.”
Scott Miscovich, a family physician and president and CEO of Premier Medical Group, said it is extremely unusual to have a hantavirus outbreak on a ship that has not traveled anywhere where the virus is endemic.
“When I first read this, I thought it was a misprint,” he told CNN following news of the possible outbreak.
What do we know about the victims?
The first victim was a 70-year-old man. He died on the ship and his body was taken to St Helena, the South African Department of Health said in a statement carried by the AP.
The man’s wife collapsed at an airport in South Africa while trying to board a flight back to the Netherlands, her home country, and died at the hospital, the department said, according to the AP.
Two of the deceased passengers were Dutch, a spokesman for the Dutch Ministry of Foreign Affairs confirmed to Reuters.
A British national who fell ill after the ship departed from St Helena is being treated in Johannesburg, South Africa’s health department said.
The tour operator reported that no decision has yet been made regarding the transfer of crew members to receive medical care.
Dutch authorities have agreed to repatriate symptomatic crew members, as well as the body of a deceased individual, to the Netherlands, Oceanwide Expeditions reported.
“Oceanwide Expeditions’ priority is to ensure that the two symptomatic individuals on board receive appropriate and prompt medical care,” the company said.
The WHO said it is “facilitating coordination between Member States and ship operators for the medical evacuation of two symptomatic passengers, as well as the full assessment of public health risks and support for the remaining passengers on board.”
Miscovich said it was puzzling that authorities did not prioritize evacuating the ship.
“If I were to be involved in this, the first thing that would need to happen is to get the ship to dry land, and basically everyone would need to disembark and be assessed,” he said.
A CNN contacted the South African Department of Health, the UK Ministry of Foreign, Commonwealth and Development, the Dutch Ministry of Foreign Affairs and the Ministry of Health of Cape Verde.
How deadly is hantavirus?
According to the CDC, strains of hantavirus found in the Western Hemisphere can cause hantavirus pulmonary syndrome, which is primarily transmitted by deer mice in the US.
Initial symptoms include fatigue, fever, muscle pain, as well as headaches, dizziness, chills and abdominal problems in some patients. Later symptoms of hantavirus pulmonary syndrome include coughing, shortness of breath, and chest tightness.
Hantaviruses, found mainly in Europe and Asia, can also cause serious kidney disease.
There is no cure for hantavirus infection other than treating the symptoms. Patients with severe breathing difficulties may need to be intubated, according to the CDC.
The disease is rare but highly lethal — about 38% of people who develop respiratory symptoms can die, according to the CDC. If patients are elderly or immunocompromised, the death rate can be even higher, Miscovich said.
By the end of 2023, only 890 confirmed cases of hantavirus disease have been reported in the US since surveillance began in 1993.
Most of the cases occur in New Mexico, the same state where Arakawa was found dead in the home she shared with Hackman. Dead rodents and rodent nests were later found in eight outbuildings on the property.
Miscovich said “all signs point” to the virus originating somewhere on the ship.
“This ship will be searched and they will find something,” he said.
