More hantavirus suspected from cruise ship. Latest on illnesses
An eighth hantavirus-linked case has been identified among passengers who traveled on a cruise ship in the Atlantic Ocean, officials announced on Wednesday, May 6.
The World Health Organization said the particular strain has been confirmed as the Andes virus.
Three people have died since the outbreak began on the MV Hondius, a cruise ship run by Netherlands-based operator Oceanwide Expeditions.
Three others were evacuated from the ship earlier today.
Here's the latest.
Where is the cruise ship now?
The MV Hondius departed from its location off Cape Verde, an island nation near Africa's west coast, on May 6 and headed north.
The ship will sail toward the Canary Islands off the coast of Spain. "This is expected to take 3-4 days," Oceanwide said in an update. "Three additional medical professionals have embarked m/v Hondius to provide optimal medical care during the crossing."
One medicalized aircraft carrying two of the three people evacuated from the vessel landed in the Netherlands, and the pair were met by medical personnel. A second aircraft carrying the third person "is currently experiencing a delay," but the passenger is in stable condition, according to the company.
Oceanwide previously said two of those people were in "serious condition," and the third was currently asymptomatic but closely associated with an individual who passed away on board.
"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 company added. "We are unable to confirm the details of onward travel for guests at this stage. This is dependent on medical advice and the outcome of stringent screening procedures."
The ship departed from Argentina on April 1 and traveled across the Atlantic, making "multiple stops in remote and ecologically diverse regions," including mainland Antarctica, South Georgia, Nightingale Island, Tristan da Cunha, Saint Helena and Ascension Island, according to WHO.
What's happening onboard?
"The situation is being closely monitored, and as a precaution, passengers have been asked to remain in their cabins while disinfection and other public health measures are carried out," WHO official Maria Van Kerkhove said during a May 5 news conference. "Medical teams from Cabo Verde are providing support on board the ship.”
The Centers for Disease Control and Prevention said in a May 6 press release it is closely monitoring the situation and that the State Department is "leading a coordinated, whole-of-government response including direct contact with passengers, diplomatic coordination, and engagement with domestic and international health authorities."
The ship also has "plenty" of food and water on board, she added. Jake Rosmarin, a guest aboard MV Hondius, said in a statement that passengers are generally in good spirits and that safety protocols such as social distancing and masking are in place.
Passengers can have meals delivered to their cabin and are allowed access to outer decks for fresh air, he added.
"Oceanwide Expeditions and the crew have been doing everything within their ability to keep passengers safe, informed, and as comfortable as possible during this time," he said. The company confirmed to USA TODAY that the measures Rosmarin referenced were in place.
Are there rats or mice on cruise ships?
Generally, no, according to Walt Nadolny, professor emeritus of marine transportation and global business at the State University of New York Maritime College, and a former environmental officer for Carnival Cruise Line and Norwegian Cruise Line. "In my time on cruise ships, inspecting everything from the bilge to the galleys to passenger cabins, I've never seen a rodent or evidence of rodent droppings," he told USA TODAY.
There are traps "all over the place" as a precaution, he said, but no rodents are typically caught. Cruise lines usually appoint a designated crew member onboard to be in charge of those procedures.
The Centers for Disease Control and Prevention’s Vessel Sanitation Program also routinely inspects ships that stop at U.S. ports across various areas, including pest and insect management. Inspectors interview "the person in charge of the plan to manage pests on the ship," according to the health agency’s website, and confirm that employees are knowledgeable about pest control.
There are equivalent authorities in other jurisdictions, as well.
Van Kerkhove said during the briefing that the cruise operator told the WHO there were no rats on board MV Hondius.
How is hantavirus transmitted?
Human hantavirus infection is primarily transmitted through contact with the urine, feces or saliva of infected rodents. Although uncommon, limited human-to-human transmission has been reported in previous outbreaks, per the WHO.
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, Van Kerkhove said during the 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, 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.
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.
The New York Times reported on May 6 that according to officials, U.S. residents in at least three states are being monitored for the virus after being on the ship and returning home, although they're not showing symptoms. The Georgia Department of Public Health confirmed to USA TODAY that it is monitoring two people. The California Department of Public Health and Arizona Department of Health Services also said they're monitoring at least one resident, respectively, according to The Times.
Hantavirus symptoms
Symptoms typically begin two to three weeks after infection, and can include fever, chills, muscle aches, vomiting and diarrhea. In serious cases, it can cause issues with lung and heart function, per the Mayo Clinic.
How many people on cruise are sick from hantavirus?
According to the WHO, eight cases, including three lab-confirmed cases of hantavirus, have been identified among those who traveled on the ship. Three people have died from their infections.
Here's a summary of the cases, per the WHO and Oceanwide Expeditions:
- 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.
- 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.
- 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.
- An adult female whose symptoms began on April 28 and included fever and signs of pneumonia. She died on May 2.
- An individual who was evacuated from the ship on May 6 and was taken to the Netherlands for medical treatment, Ghebreyesus said in a post on X.
- An individual who was evacuated from the ship on May 6 and was taken to Netherlands for medical treatment, per Ghebreyesus.
- An individual who was evacuated from the ship on May 6 and was taken to the Netherlands for medical treatment, per Ghebreyesus.
- 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.
Melina Khan is a national trending reporter for USA TODAY. Keep up with her on X @melinakh and Instagram @bymelinakhan.
(This story has been updated to add additional information.)