CDC says US faces 'extremely low risk' of hantavirus infection. Updates.

Guests, crew onboard hail from more than 20 countries

Nathan Diller

Guests and crew members currently aboard MV Hondius hail from two dozen countries around the world, from Europe to North America and beyond.

Below is a detailed breakdown from the ship's operator, Oceanwide Expeditions. The guest numbers include four medical staff on the vessel, the company said.

• Argentina: One guest
• Australia: Four guests
• Belgium: Two guests
• Canada: Four guests
• France: Five guests
• Germany: Five guests, not including a person who died on May 2, and one crew member
• Greece: One guest
• Guatemala:One crew member
• India: Two crew members
• Ireland: Two guests
• Italy: One guest
• Japan: One guest
• Spain: 13 guests and one crew member
• Montenegro: One crew member
• The Netherlands: Eight guests and five crew members
• New Zealand: One guest
• The Philippines: 38 crew members
• Poland: One crew member
• Portugal: One crew member
• Russia: One crew member
• Turkey: Three guests
• U.K.: 19 guests and three crew members
• Ukraine: Five crew members
• U.S.: 17 guests

Where has the cruise ship been?

Eve Chen

The MV Hondius began its Atlantic Odyssey voyage in Ushuaia, Argentina, on April 1. It was supposed to end in Praia, Cape Verde, on May 4, according to operator Oceanwide Expeditions.

The ship is now heading to the port of Granadilla, Tenerife, in the Canary Islands of Spain, where passengers and crew are expected to be screened before being repatriated.

Oceanwide shared the following updated timeline, as of May 8.

• April 1: Ship leaves Ushuaia with 175 people (114 guests, 61 crew).

• April 4-7: Ship stops at the island of South Georgia.

• April 13-16: Ship stops in Tristan da Cunha, including Inaccessible Island and Nightingale Island. Six guests embark and one crew member disembarks for a new total of 180 people (120 guests, 60 crew).

• April 17: Ship stops at Gough Island.

• April 21-24: Ship stops at the island of St. Helena. Upon initial booking, guests had the option of traveling the whole voyage from Ushuaia to Praia or disembarking in St. Helena. One crew member embarks and 32 guests disembark. This count includes a Dutch passenger who died on board and his Dutch wife, who passed away after leaving the ship. This brings the total to 149 people on board (88 guests, 61 crew).

• April 27: Two guests are medevaced via Ascension Island: a symptomatic British national and the patient's American partner. This brings the total to 147 people on board (86 guests and 61 crew).

Experts worry 'we are not prepared' for pandemic under Trump, RFK Jr.

Sara Moniuszko

World Health Organization officials have assured that the hantavirus outbreak is not the start of a pandemic. But as more headlines emerge about the potentially deadly infection, many are reminded of the COVID pandemic − and worried about the United State's preparedness.

Preparedness concerns have been fueled by the Trump administration's history of actions that medical experts say weaken public health, from spreading health misinformation to Health and Human Services Secretary Robert F. Kennedy Jr. ending long-standing childhood vaccine recommendations. Public trust in health institutions also eroded in the response to the COVID pandemic — spanning both Trump's and former President Joe Biden's administrations — which included communication missteps that former officials have publicly reflected on.

In a hantavirus-focused press briefing on May 7, the Infectious Diseases Society of America's CEO, Dr. Jeanne Marrazzo, shared concerns that “we are not prepared" for public health crises.

USA TODAY has reached out to the Department of Health and Human Services for comment.

Who are the 8 hantavirus related cases?

Melina Khan

Authorities with the World Health Organization and Oceanwide Expeditions have shared the following details on the eight people with either confirmed or suspected hantavirus.

1. An adult male developed symptoms of fever, headache, and mild diarrhea on April 6 while on board the ship. He developed respiratory symptoms and died on board on April 11. His body was removed to St. Helena, a British Overseas Territory in the South Atlantic, on April 24.
2. An adult female, identified as the wife of the male who died on board on April 11, went ashore to Saint Helena on April 24 with gastrointestinal symptoms. Her symptoms worsened during a flight to Johannesburg, South Africa, on April 25. She died on April 26. The case was confirmed as a hantavirus infection on May 4.
   • Officials said the husband and wife were Dutch nationals and had traveled in South America, including Argentina, before they boarded the cruise ship.
   • KLM confirmed on May 6 that the woman traveled on board one of its flights.
3. An adult male reported a fever, shortness of breath and signs of pneumonia to the ship's doctor on April 24. After his condition worsened, he was medically evacuated to South Africa on April 27, where he is currently hospitalized in an intensive care unit. Testing confirmed a hantavirus infection on May 2. WHO official Maria Van Kerkhove said during a Thursday news briefing that the patient was “doing better.”
4. An adult female whose symptoms began on April 28 and included fever and signs of pneumonia. She died on May 2.
5. An individual who was evacuated from the ship on May 6 and was taken to the Netherlands for medical treatment.
6. An individual who was evacuated from the ship on May 6 and was taken to the Netherlands for medical treatment.
7. An individual who was evacuated from the ship on May 6 and was taken to the Netherlands for medical treatment.
8. A Swiss man who had traveled on the ship before returning home in late April. He has been admitted to a hospital in Zurich after exhibiting symptoms, according to WHO and Swiss public health officials.

CDC to send staffers to meet cruise ship in Canary Islands

Natalie Neysa Alund and Melina Khan

The United States Centers for Disease Control (CDC) is planning to send staffers to the Canary Islands to meet the MV Hondius when it arrives, according to reports from CNN, CBS and ABC.

The staffers will then escort Americans to the National Quarantine Unit in Nebraska, ABC News and CNNreported.

The unit at the University of Nebraska Medical Center in Omaha is the nation's only federally funded facility and was designed to handle people exposed to “highly hazardous communicable diseases,” according to information from UNMC.

USA TODAY has reached out to the CDC for comment.

Two new hantavirus exposures announced in New Jersey

Melina Khan

Two New Jersey residents were potentially exposed to a person with hantavirus who traveled on the MV Hondius, the state's department of health announced on Friday.

The two people did not travel on the ship, but traveled on the same flight as the infected individual, the agency said.

Neither person currently has symptoms of infection, and officials are monitoring them as a precaution.

Some passengers had already disembarked

Eve Chen

Prior to concerns about a possible hantavirus outbreak on the ship, travelers from a dozen countries disembarked the MV Hondius in the British territory of St. Helena on April 24.

Ship operator Oceanwide Expeditions said 30 people disembarked, including a passenger who died on board and is believed to be among the first hantavirus cases. His wife also got off the ship and flew to South Africa. She later died and was confirmed to have hantavirus.

On May 7, World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus said the agency has informed authorities in the following countries:

• Canada
• Denmark
• Germany
• Netherlands
• New Zealand
• Saint Kitts and Nevis
• Singapore
• Sweden
• Switzerland
• Turkey
• United Kingdom
• United States

The WHO is also working with authorities in South Africa – where an adult male is in intensive care after being medically evacuated from the ship and later confirmed to have hantavirus – and Spain, as the ship heads to the Canary Islands.

Dr. Maria Van Kerkhove, director of the WHO’s Department of Epidemic and Pandemic Management, said they've received reports of potential suspect cases in various countries. "Some of them have had reported links to the ship or passengers on the ship," she said. "All of those will be followed up with the relevant authorities in each country."

What will happen when the MV Hondius ship arrives at port?

Eve Chen

World Health Organization Technical Officer Anaïs Legand said passengers and crew on board the MV Hondius are being assessed for hantavirus symptoms and possible exposure to suspected or confirmed cases. All of that information will be shared with the team handling the ship's arrival in the Canary Islands.

"For us, it's very important that all passengers and crew members – we should not forget about crew members – are assessed when the ship has arrived by a trained medical team," Legand said in a hantavirus update streamed across the agency's social media on Friday.

Depending on individual risk levels, Legand said the WHO may recommend people from ship and arrival team members wear personal protective equipment like masks or gloves, but WHO Health Emergencies Communication lead Nyka Alexander said it's up to Spanish authorities to decide what to do with WHO's guidance.

Legand said individuals determined to be at risk for hantavirus will be asked to monitor for symptoms and told who to contact if any develop. "They will be asked to take their temperature, as possible, with a thermometer every single day for 42 days ... They will be asked to be checked every single day for all the symptoms that could be suggestive of early disease."

However it will be up to health authorities in their respective countries to decide how to monitor them after they're repatriated.

Silence from U.S. government on hantavirus 'is unacceptable'

Natalie Neysa Alund

Dr. Céline Gounder, an American physician who specializes in infectious diseases and global health, on Friday called on public health officials and the Trump Administration to be more transparent about the ongoing hantavirus outbreak.

Gounder told reporters the only public officials she had seen comment about it from the fedearl government was the president, who said "he hoped" everyone was going to be OK.

"And you don't manage an infectious disease outbreak, even one that we do not think is going to become a pandemic, you don't manage that with hope alone," Gounder said. "We have not been told what the plans are… what kind of surveillance they are doing day to day... It’s abnormal to see this much silence from the U.S. government.”

“There are activities that are happening behind the scenes… but one of the things I think we learned from the COVID pandemic is that communication is one of the most important responses for this, so people know how to protect themselves and don’t have to worry."

“The silence is unacceptable in the moment," Gounder emphasized. "It breeds conspiracy theories and I think there should be day to day updates from the CDC (Centers for Disease Control).”

This hantavirus often spreads via sex, saliva

Natalie Neysa Alund

On Friday, Dr. Céline Gounder, an American physician who specializes in infectious diseases and global health, said the Andes virus, the type of hantavirus affecting people now, is often transmitted between people who have sex, including the exchange of saliva and other intimate contact. 

"So think of it as those big juicy droplets that you might sneeze out and you really need to be within a close perimeter of a person to be infected that way," Gounder told reporters during a late morning interview. "It has required much more significant, more intimate contact. That's not to say this is an STD, but rather that it has been transmitted through sexual partners, people who sleep in the same bed together, that level of close contact over a prolonged period of time."

US State Department arranging flight for Americans on board cruise ship

Francesca Chambers

The State Department said Friday that it has been in close contact with the staff of the Dutch cruise liner, Americans on board, and U.S. and international health authorities.

The department said it is working with the CDC, HHS and the Spanish government to arrange a repatriation flight for American passengers on the cruise ship. The State Department said consular assistance would also be available to Americans on board as soon as the ship arrives in Tenerife, Spain.

No new hantavirus cases for now, WHO says

Eve Chen

As of Friday, the World Health Organization said there are still eight hantavirus-related cases tied to the MV Hondius: five confirmed cases and three suspected.

Echoing her colleagues' previous statements, WHO Emergencies Communications Lead Nyka Alexander said in a live streamed update on hantavirus on Friday, "The risk to the public remains low."

That's the case for the general public, but she noted the risk for people on board the cruise ship is moderate.

Alexander confirmed no one currently on the ship is showing hantavirus symptoms.

She added that a WHO colleague onboard said people are happy the ship is finally moving and feel like they can see a light at the end of the tunnel.

The ship had previously been holding off the coast of Cape Verde formedical evacuations completed on Wednesday.

Can hantavirus spread person to person?

Melina Khan

While hantavirus is primarily a rodent-borne virus, the strain at the center of the MV Hondius outbreak is believed to be spreading person to person, according to the WHO.

The WHO said on May 6 that the strain has been confirmed through laboratory testing as Andes virus, which is found in South America and believed to spread human-to-human.

"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've shared cabins, etcetera," WHO official Maria Van Kerkhove said during a May 5 news conference.

Flight attendant tests negative for hantavirus

Natalie Neysa Alund

World Health Organization leaders on Friday said a KLM flight attendant who came in close contact with a woman who died from a hantavirus infection in Johannesburg had tested negative for the virus.

"We have received notification through our IHR focal point that the Dutch flight attendant tested negative," spokesperson Amna Smailbegović, a WHO spokesperson, told USA TODAY.

The commercial flight attendant had been ​admitted ​to ⁠a hospital in ​Amsterdam one day earlier ⁠with signs of ⁠a ​possible infection, where she was tested, Dutch Health Ministry spokesperson Mischa Stubenitsky said.

Local media reported the flight attendant woman works for KLM, an airline that confirmed a cruise passenger who died from hantavirus had traveled on board one of its flights.

Where is the cruise ship now?

Eve Chen

The MV Hondius is on its way to the Canary Islands off the coast of Spain.

As of Thursday, both the World Health Organization and the ship's operator, Oceanwide Expeditions, said no one on board was showing any hantavirus symptoms.

Oceanwide estimates the MV Hondius will arrive at the port of Grandilla in Tenerife early Sunday, but noted that's subject to change.

"Oceanwide Expeditions remains in close and continual discussion with relevant authorities regarding our exact point of arrival, quarantine and screening procedures for all guests, and a precise timeline," the expedition cruise company said in a news release.

The government of Tenerife, which previously expressed opposition to the ship's arrival, is planning to activate its Island Emergency Plan starting Saturday evening. The Cabildo de Tenerife said on X that it's continuously monitoring operations and coordinating with health and state authorities.

Also on X, Spain's Health Ministry said it was working with multiple countries to plan the evacuation and repatriation of everyone on board "with all public health guarantees."

Spain reports suspected hantavirus case

Natalie Neysa Alund

Spanish authorities on Friday confirmed a woman in the European country's southeastern province of Alicante has symptoms consistent with a hantavirus infection.

The suspected case involves a woman who was a passenger on the same flight as a patient who died in Johannesburg after travelling on the MV Hondius cruise ship and contracting the virus, Spain's Secretary of State for Health, Javier Padilla, said during a news conference.

Which US states are monitoring hantavirus?

Melina Khan

No cases tied to the outbreak have been reported in the United States, and the CDC said the overall risk to Americans is low.

Officials in six states have confirmed they are monitoring residents who recently traveled on board the MV Hondius for hantavirus symptoms:

• Arizona: One state resident was recently a passenger on the ship, but is not symptomatic and is being monitored, Magda Rodriguez, a spokesperson for the Arizona Department of Health Services, said in an email to The Arizona Republic, part of the USA TODAY Network.
• California: Residents were recently on the ship with other passengers infected with hantavirus, though there is no indication that they are sick, Grant Boyken, a spokesperson for the California Department of Public Health, confirmed in an email to The Desert Sun, part of the USA TODAY Network.
• Georgia: Two residents who traveled on MV Hondius are "currently in good health and show no signs of infection," the Georgia Department of Public Health said in a statement to USA TODAY on May 6.
• New Jersey: Two people living in the state were potentially exposed to a person infected with hantavirus who departed from the MV Hondius. The residents were not passengers on the cruise ship; the potential exposure occurred during air travel. Neither person has any symptoms, the state's health department announced on Friday.
• Texas: Two residents were passengers on the ship and returned to the U.S. before the outbreak was identified. They have not experienced any symptoms, the state's health department said in a statement.
• Virginia: One resident who returned home from the ship is in good health and is being monitored, Virginia Department of Health spokesperson Maria Reppas told USA TODAY on May 7.

Is there a vaccine for hantavirus?

Sara M Moniuszko and Eve Chen

There is no specific treatment that cures hantavirus diseases, according to the World Health Organization, but early supportive medical care is "key to improve survival."

This care includes clinical monitoring and managing any respiratory, cardiac or other complications, the organization says.

"We've seen some online discussion as well indicating that perhaps ivermectin is useful in this case, but we have not seen any research that shows that ivermectin is an effective treatment for hantavirus," Nyka Alexander, WHO Emergencies Communications Lead said in a hantavirus update streamed live across the agency's social media channels on Friday.

How did the hantavirus outbreak start?

USA TODAY Staff

Officials believe a husband and wife, Dutch nationals, were infected while they were off the cruise ship, engaging in wildlife expeditions. Others with suspected infections may have come in contact with the virus on islands as well, WHO official Maria Van Kerkhove said during a briefing.

"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've shared cabins, etcetera," Van Kerkhove said.

On May 6, the WHO said the strain of hantavirus has been confirmed through laboratory testing as Andes virus, a strain found in South America that is believed to spread person-to-person.

The WHO has also said the current risk to the rest of the world is low, but it is continuing to monitor the situation and provide updates.

What causes hantavirus?

Sara M Moniuszko

Hantaviruses are a group of viruses that naturally infect rodents, sometimes long‑term without apparent illness, and are occasionally transmitted to humans, according to the World Health Organization.

"Although many hantavirus species have been identified worldwide, only a limited number are known to cause human disease," the WHO adds.

Hantavirus is primarily spread by rodents through exposure to their urine, droppings or saliva and less commonly through a scratch or bite, according to the Centers for Disease Control and Prevention.

"While rare, hantavirus may spread between people and can lead to severe respiratory illness and requires careful patient monitoring, support and response," the WHO notes.

Hantavirus monitored by White House, CDC

Swapna Venugopal Ramaswamy

As U.S. residents are being monitored for hantavirus after traveling on the MV Hondius, a cruise ship now tied to several cases of the virus, the White House is working with the CDC and State Department to monitor the situation.

"While possible risks to the American public remain low, the CDC has convened leading experts on Andes virus to assist in this effort to ensure Americans are protected. The entire Administration remains vigilant," White House Spokesman Kush Desai told USA TODAY.