A cruise ship struck by a fatal hantavirus outbreak is en route to the Canary Islands, where remaining passengers are expected to be repatriated if they show no symptoms. The investigation into the outbreak continues as authorities work to determine the source of the infection.
Timeline of the Outbreak
The first passengers aboard the Dutch-flagged MV Hondius, sailing from Argentina to Cape Verde, fell ill in early April. Symptoms ranged from fever and gastrointestinal problems to pneumonia, acute respiratory distress syndrome, and shock. Three people have died since April 11, including a Dutch couple and a German woman, whose body remains on the ship. As of Thursday, there are eight suspected cases, with three confirmed as hantavirus by laboratory tests.
Three individuals with suspected hantavirus, including Martin Anstee, a 56-year-old retired British policeman working as an expedition guide, have been evacuated and are receiving medical care in the Netherlands. Another Briton is hospitalized in South Africa. One person was diagnosed after disembarking and returning to Switzerland, according to the European Centre for Disease Prevention and Control.
Two Britons who left the ship at Saint Helena in late April have returned to the UK and are self-isolating, though neither has reported symptoms. Close contacts of those on board are also self-isolating.
What Is Hantavirus?
Hantaviruses are a large group of viruses that circulate in rodents such as mice and rats. Distinct strains exist in different parts of the world. The viruses can spread to humans, typically through inhalation of droplets or dust contaminated with urine, faeces, or saliva from infected animals. In humans, hantavirus infection can cause life-threatening illness. Old world strains, found in Europe and Asia, tend to cause haemorrhagic fever with renal syndrome (HFRS), a kidney disease fatal in about 10% of cases. New world strains, found in the Americas, are more virulent, causing hantavirus pulmonary syndrome (HPS), which can kill more than a third of those infected.
Can It Spread Between People?
Most hantaviruses do not spread between people, but there have been cases of the Andes strain spreading from person to person. Laboratory tests have identified that strain as the cause of the outbreak on the MV Hondius. The virus is endemic to Argentina, where its host is the long-tailed pygmy rice rat. Infections are most likely through close and prolonged contact with someone in the early stages of the disease. In a previous outbreak in Argentina in 2018-19, three people who came into contact with infected rodents spread hantavirus to 34 others, 11 of whom died.
Where Did the Virus on MV Hondius Come From?
This remains the key question. As part of the investigation, public health officials are compiling travel histories for all passengers prior to boarding, about 140 of whom are still on the ship. One line of inquiry suggests that two passengers may have caught the virus on a birdwatching expedition in Argentina before joining the cruise.
What Happens Next?
The MV Hondius is bound for the Canary Islands and is expected to arrive in Tenerife this weekend. Once docked, the 19 British nationals believed to still be on board will be repatriated on a flight chartered by the UK Foreign Office, provided they are symptom-free. All are being closely monitored. Upon returning to the UK, they will be asked to self-isolate for 45 days, reflecting the long incubation period of hantavirus. Most symptoms develop within one to six weeks, but in extreme cases, it can take up to eight weeks.
