Britons stuck on a cruise ship linked to a suspected hantavirus outbreak will have to wait on board for a number of days, it has emerged.
A British passenger and a British crew member are among those taken ill in the suspected outbreak on the Dutch-flagged cruise ship MV Hondius.
Prime Minister Sir Keir Starmer has said plans are being made for the “safe onward travel” of Britons on the ship.
The vessel is currently off the coast of Cape Verde, where it is hoped the medical evacuation of a British crew member, along with a Dutch colleague and a passenger, will take place.
In an update on Tuesday, tour operator Oceanwide Expeditions said there is still not an “exact timeline” for when the medical evacuation to the Netherlands will happen.
But the ship will move on once the evacuation has taken place, with at least three days sailing to the Canary Islands, the company said.
One expert said that once the ship docks it is likely the remaining passengers and crew will be assessed and then “be taken into a period of quarantine”.
It comes as health authorities investigate the source of the virus, with some suggesting there could be a “mixture” of transmission, including close contact between passengers.
Experts said it is likely that initial infections were acquired off the ship with suspected human-to-human transmission among those with “really” close contact such as people who have shared a cabin.
Sir Keir said: “My thoughts are with those affected by the hantavirus outbreak onboard the MV Hondius.
“We are working closely with international partners to support British nationals on board and we’re putting plans in place for their safe onward travel.
“The risk to the wider public remains very low – protecting the British people is our number one priority.”
Some 19 British nationals were listed as passengers on the ship, which was sailing from Argentina to Cape Verde, with four British crew members.
Passengers are confined to their cabins while “disinfection and other public health measures are carried out”, the World Health Organisation (WHO) said.
The crew members are said to need “urgent medical care” after having acute respiratory symptoms, according to Oceanwide Expeditions.
Meanwhile the British passenger struck down by hantavirus is “understood to be improving” but remains in intensive care in Johannesburg after being medically evacuated on April 27.
A total of seven suspected cases have been identified – including three deaths.
Two of these cases have been confirmed as hantavirus.
Dr Maria Van Kerkhove, from the WHO, said: “As of today, seven individuals of the 147 passengers and crew have been reported ill, sadly, three have died.
“One patient is in intensive care in South Africa, although we understand that this patient is improving while two patients are still on board the ship and are being prepared for medical evacuation to the Netherlands for treatment.”
Medical teams from Cape Verde are providing support to the ship and have taken personal protective equipment (PPE) on board while health authorities investigate the source of the outbreak.
Dr Van Kerkhove: “The initial patient and his wife joined the boat in Argentina.
“And with the timing of the incubation period of hantavirus, which can be anywhere from one to six weeks, our assumption is that they were infected off the ship, perhaps doing some activities there.
“This was an expedition boat, and many of the people on board were doing bird watching, they were doing a lot of things with wildlife.
“So our assumption is they were infected off the boat and then joined the cruise.
“However, we do believe that there may be some human-to-human transmission that’s happening among the really close contacts – the husband and wife, people who have shared cabins, etc.
“So again, our assumption is that has happened, and that’s why we are operating and working with the ship to make sure that anyone who is symptomatic, anyone caring for patients, is wearing full personal protective equipment.
“The medical personnel who have boarded the boat have brought additional PPE as well.
“But hantaviruses don’t typically transmit that way – it’s really a rodent infection.”
A Dutch passenger died on board the ship on April 11.
On April 27, the wife of the passenger died, and authorities confirmed a variant of hantavirus.
On May 2, a German passenger on board died, though the cause has not yet been confirmed.
Hantavirus infections, which are usually spread by infected rodents’ urine or faeces, can lead to severe respiratory illness and can sometimes be fatal.
While it is rare, hantavirus infections can spread between people, according to the WHO.
There is no specific treatment or cure, but patients have a better chance of survival if they receive medical attention early.
Mark Fielder, professor in medical microbiology at Kingston University London, said: “With the current understanding of the ongoing infection and the likelihood that stringent infection control measures are being implemented on board the vessel, it is likely that further ongoing transmission will be limited.
“The isolation of infected patients, regular handwashing, monitoring of close contacts, and the application of infection control measures will all be critical to limiting and halting onward spread of the disease.
“Once the ship docks it is likely that arrangements will be made for the remaining passengers and crew to be medically assessed and then be taken into a period of quarantine and monitoring to ensure the control of any infection and provide early medical intervention where needed.”
