Hantavirus: US plans evacuation flight for citizens on ship

The US says it is organizing an evacuation flight for American nationals on a cruise ship hit by an outbreak of hantavirus.

The Dutch-flagged MV Hondius is currently on its way to the Canary Islands, where it is expected to arrive on Sunday morning.

"The Department of ​State ‌is closely tracking the hantavirus outbreak on a Dutch cruise ship ‌in the Atlantic Ocean and maintaining ‌close ​contact with the cruise ship staff, Americans on board, and US and international ​health authorities," a US State Department spokesperson said.

The spokesperson said a repatriation flight is being arranged, and that the department is ready to provide consular assistance to Americans on board as soon as the ship reaches the island of Tenerife.

There are 17 US citizens among the more than 140 passengers aboard the ship, according to cruise operator Oceanwide Expeditions.

Spain's government says passengers aboard the cruise ship at the center of a hantavirus outbreak will be flown to their home countries soon after the vessel arrives in the Canary Islands on Sunday.

"That same day, we will have planes available and will be able to start getting these people onto the planes," Cabinet minister Angel Victor Torres told journalists.

Separately, the Spanish archipelago's regional government said adverse weather conditions meant the evacuation had to happen swiftly.

"The only window of opportunity we have to carry out this operation is around 12 o'clock on Sunday morning and until conditions change from Monday," regional government spokesman Alfonso Cabello told reporters.

He said failure to get passengers out in that window could mean the ship will have to leave again.

The MV Hondius is scheduled to reach the port of Granadilla on the island of Tenerife on Sunday morning.

Nearly 150 people from more than 20 countries are still on board the vessel.

Spanish authorities have said the ship will not be allowed to dock in Tenerife. Instead, it will anchor off shore, with passengers transferred to the port by a smaller boat before being taken to the airport by bus.

Spanish authorities say a 32-year-old woman from Alicante has symptoms consistent with a hantavirus infection and is being tested.

The woman was on board the same flight as a Dutch woman who was on the MV Hondius cruise ship and later died from the virus.

Authorities said the woman is displaying "mild respiratory symptoms" and has been placed in isolation in hospital. 

Secretary of State ​for Health ‌Javier Padilla said the test results were expected within 24 hours.

He said the woman had been sitting two rows behind the Dutch passenger — the wife of the first person to die in the outbreak — who was briefly on a Netherlands-bound plane from Johannesburg on April 25, but was removed before take-off.

She later died in a Johannesburg hospital.

Flight attendant tests negative

A flight attendant from KLM who came into contact with the same infected passenger and later showed mild symptoms has tested negative, the WHO said Friday.

KLM said Dutch health authorities were contacting people on the flight "as a precaution."

Three passengers aboard the Hondius cruise ship died after contracting what experts have identified as the Andes strain of the hantavirus — a version that can spread from human to human, but typically only after close contact.

Countries around the world are currently tracking passengers who were on the ship in a bid to prevent the virus from spreading further.

Third British infection suspected

Another suspected case of the virus was identified in a British national on the South Atlantic island of Tristan da Cunha on Friday.

The British health security agency did not disclose further details.

The Hondius made a stop at the remote island on April 15.

Two other British nationals who were on the ship have been confirmed to have the virus and are being treated in hospital in the Netherlands and South Africa.

No evidence of hantavirus in German case

A woman who was transferred to a hospital in the German city of Düsseldorf is showing no signs of a hantavirus infection.

The 65-year-old cruise ship passenger was picked up on Wednesday on the Atlantic Island of Cape Verde because she had been in close contact with another passenger who later died.

She was transferred to Düsseldorf for testing after being flown to the Netherlands.

The hospital said tests thus far had failed to detect the hantavirus, but that protective measures will remain in place because it can take "several weeks" for symptoms to appear.  

Singapore residents test negative

Meanwhile, two Singaporean residents who were on the MV Hondius have tested negative for the virus.

The two men, aged 65 and 67, disembarked from the ship in St Helena and were on the same flight as a confirmed hantavirus case to Johannesburg on April 25.

Singapore's Communicable Diseases Agency said they would be quarantined as a precaution for 30 days and will undergo further testing before being released.

Spanish authorities are preparing to receive more than 140 passengers and crew members from the cruise ship affected by the hantavirus outbreak.

The Dutch-flagged MV Hondius is due to arrive in Tenerife in the Canary Islands this weekend after sailing in from the Atlantic.

Emergency services say the ship will dock in a fully isolated, cordoned-off area, with evacuations carried out under carefully controlled conditions.

At least three passengers have died, though officials stress the risk to the wider public remains low.

The US and the UK have confirmed plans to fly their citizens home from the Spanish island located off the coast of northern Africa.

No one currently on board is showing symptoms.

Health authorities are racing to contain an outbreak of the hantavirus after the World Health Organization said that five confirmed infections had been identified among people connected to the MV Hondius.

Three people, a Dutch couple and a German national, have died since the cruise ship departed Argentina last month.

What's the latest?

Singapore's Communicable Diseases Agency said it isolated two residents linked to the ship.

President Donald Trump told reporters that he was briefed on the virus and was hopeful that it was under control. "It's very much, we hope, under control," he said.

Asked whether Americans should be concerned about any ‌spread of the ​virus, Trump replied: "I hope not." He also said, without elaborating, that a report on the virus was expected on Friday.

The vessel is now headed to Spain's Canary Islands.

Chile's Health Ministry has said that two of the deceased hantavirus patients could not have contracted the disease while in the country. 

The government in Santiago said that the two people visited the country too long ago for Chile to be a plausible point of infection. 

The Dutch married couple traveled first to Argentina, then through Chile and Uruguay, before returning to Argentina on March 27 to board the ship on April 1, according to Argentine officials. They had entered Chile on January 7. 

Chile's Health Ministry said in a statement that the pair traveled in the country "during a period that does not correspond to the incubation time, so exposure to the virus would not have occurred in our country." 

The incubation time — the period between contracting an infection and displaying symptoms — can vary quite considerably with hantaviruses, but the German Institute for Public Health says the first symptoms usually appear two to four weeks after being infected, or in exceptional cases after as many as 60 days. 

The World Health Organization (WHO) on Thursday said the incubation period could be up to six weeks.

Chile and Argentina are two of the countries that are home to the particular long-tailed pygmy rice rat that is thought to be the source of the Andes virus strain. 

Chile said its last documented case of human-to-human transmission of the Andes virus was in 2019.

The Netherlands' National Institute for Public Health and the Environment (RIVM) has said that it is testing three people showing possible symptoms who had come into contact with a person infected with the Andes strain of the hantavirus on a plane. 

"Two of these test results have come back negative. The remaining test is still being analyzed. These three individuals developed symptoms after coming into contact with a person infected with the Andes virus while on board an aircraft." the RIVM said. 

It said the country's public health service, the GGD, was advising other passengers from the flight on what steps if any they should take, saying it depended on factors like where their seat was and how much contact with the affected individual they had. 

"Passengers who had direct contact are being contacted daily by phone by the GGD to closely monitor their health status. Passengers who had close contact are asked to monitor their own symptoms," it said.

The individuals were on a flight from Johannesburg to Schiphol Airport outside Amsterdam that was carrying a passenger who subsequently died.

One person previously known to have come into contact with the deceased was a flight attendant on that plane who had been admitted to Amsterdam's UMC university hospital. While it appeared likely, the RIVM did not comment on whether she was one of the three tested individuals. 

South Africa is currently monitoring four people who came into contact with one of the hantavirus patients, the country's Department of Health has said.

The four individuals were passengers on an Airlink flight from St. Helena to Johannesburg, the department said.

Department of Health spokesman Foster Mohale said one of the patients was exhibiting symptoms.

"The individual has undergone clinical assessment and appropriate laboratory testing, with results pending confirmation," Mohale added.

"We appeal to all those who have been identified as close contacts of those who tested positive for Hantavirus to cooperate with the health officials conducting contact tracing to help us prevent the spread of this deadly virus," he said in response to questions from DW. 

He also urged the public "to stop spreading misinformation and fake news about the virus because this has the potential to stigmatize and deter people from coming forward, especially those identified for contact tracing and those experiencing symptoms."

The Leiden University Medical Center (LUMC) has said that a patient thought to have hantavirus, who was flown in on Wednesday, has tested positive. 

"It has now been confirmed that the hospitalized patient has contracted the hantavirus," the hospital said in a statement on its website. "The patient has been informed of this and has given permission for this information to be shared."

"We are providing all the support and care the patient currently requires and are taking every precaution to do so safely," the LUMC said, noting that as always, it would not be disclosing a patient's personal details. 

Slightly earlier on Thursday, the Radboudumc university hospital in Nijmegen said that a patient it had admitted had also tested positive. He had also been flown off the cruise ship a day earlier. 

The RIVM said "appropriate isolation measures have been implemented in the ward" and that severe infectious disease specialists were handling the case.

Asked what was unusual about the current outbreak, Anais Legand, the technical lead on viral haemorrhagic fevers for the WHO responded. 

"What is most unusual, obviously, is that we have a transmission in a boat, which I think is the first documented to date with this particular virus," Legand said. "A boat makes it a very specific environment. We want to make sure that we have a good understanding of how the transmission has happened." 

"But there is no indication to date that there is something further [that is] unusual," she said. 

Legand said that a recent study out of Latin America had noted slight increases in caseloads and lethality in parts of the continent. 

"Just to recall that this update covers all hantaviruses that are documented in the Americas, where most countries at risk have good surveillance systems. And the increase can be related to several factors ... probably related to incidence in the rodent population, and different ecological and behavioral factors," Legand said.

However, she said that given that most hantaviruses cannot transmit human to human and only via rodents, these changes were more likely linked to the rodent population and probably "doesn't relate to this particular virus." 

WHO Director-General Tedros Adhanom Ghebreyesus described the outbreak as a "serious incident" but nevertheless said his organization deemed the overall risk to the public to be low. 

"Given the incubation period of the Andes virus, which can be up to six weeks, it's possible that more cases may be reported," Tedros said at the press conference. "While this is a serious incident, WHO assesses the public health risk as low."

He said the organization was working with "multiple governments and partners" on the response. He voiced thanks to Spanish Prime Minister Pedro Sanchez for accepting a request from him to receive the stranded ship. 

"The ship is now sailing for the Canary Islands, and we are confident in the capacity of Spain to manage this risk, and we are supporting them to do so," Tedros said. "Once again, we assess the risk to the people of the Canary Islands as low." 

The regional authorities on the Canary Islands have voiced dissatisfaction with Spain's decision to let the ship dock in Tenerife, which is currently planned to take place on Saturday. 

The WHO panel were asked during the session what similarities they saw to the outbreak of the COVID pandemic six years ago, with US infectious disease epidemiologist Maria van Kerkhove saying she wanted to be "unequivocal." 

"This is not coronavirus. This is a very different virus. We know this virus," she said. "Hantaviruses have been around for a while, there's a lot of details that we know ... I want to be unequivocal here: This is not SARS-COV2, this is not the start of a COVID pandemic, this is an outbreak that we see on a ship."

She said it was beneficial that the area in question was confined, with just five confirmed cases to date. She said that many steps were being taken to try to limit onward spread and contact. 

"We completely understand why these questions are coming and we are trying to provide all the information we can. That's why we're having a press conference here: to give accurate information," van Kerkhove, a member of the WHO's Health Emergencies Program, said.

"This is not the same situation we were in six years ago. It doesn't spread the same way. It's very different: it's that close, intimate contact that we've seen."

WHO chief Tedros also gave some extra details on the couple who first died from the virus.

"Prior to boarding the ship, the first two cases had traveled to Argentina, Chile and Uruguay on a bird-watching trip which included visits to sites where the species of rat that's known to carry hantavirus was present."

He added that the WHO is trying to track the movement of the couple.

He expressed gratitude for the cooperation of the company, as well as "the passengers and crew who are going through a very difficult and frightening situation."

Tedros also said he had been in touch with the ship's captain, who said morale has improved since the ship started moving again.

Despite the apparent rising number of cases, WHO chief Tedros said the "WHO assesses the public health risk as low."

He went on to lay out the agency's priorities: 

• Making sure patients receive care
• Keeping the passengers who are still on the ship safe and being treated with dignity
• Preventing the virus from spreading further

"Investigations into the cause of the outbreak are continuing," the WHO chief added.