Dozens given permission to leave cruise ship amid Hantavirus outbreak, contact tracing in effect

On April 1, the MV Hondius, a Dutch cruise ship operated by Oceanwide Expeditions, departed a port in Ushuaia, Argentina. The ship planned on stopping in Antarctica, South Georgia, Tristan da Cunha, Saint Helena, Ascension Island, Cabo Verde, and the Canary Islands. The ship departed port with 88 passengers and 59 crew members. The expedition was planned to last until at least May 12. Instead, the ship became the biggest story in the world, with a deadly Hantavirus detected on board. On April 6, a man began displaying symptoms, including a headache, nausea, and mild diarrhea. The World Health Organization would later confirm that this was the first positive case of Hantavirus on the ship. The WHO announced that the passenger was likely infected before boarding the ship.

On April 2, the ship stopped in Antarctica for three days, with passengers undergoing an Antarctic expedition segment with zodiac landings and wildlife excursions. While crossing the South Atlantic, Case 1 begins displaying symptoms. While the infected individual was ill, the ship stopped in South Georgia for three days, leaving port on April 10. On April 11, Case 1 turned for the worse. Case 1 died on April 11 between South Georgia and Tristan da Cunha. On April 13, the ship stopped in Tristan da Cunha, with passengers visiting the city. On approximately April 20, the wife of Case 1 began showing symptoms of Hantavirus, beginning with nausea and quickly experiencing respiratory decline.

The next stop came on April 24, with the ship stopping in Saint Helena. In Saint Helena, the body of Case 1 was removed from the ship, and Case 2 was transported to a medical centre. More than 25 passengers permanently disembarked out of fear of illness. The WHO has cited this mass disembarkment as a potential global exposure event. Shortly after the ship left port in Saint Helens, Case 3 was discovered as a British man began experiencing Hantavirus symptoms. Outside of the ship, Case 2 deteriorates on a flight from Saint Helena to Johannesburg. Case 2 later dies in South Africa. Testing in South Africa confirms Hantavirus as the source of the illness and subsequent death. This is the first lab-confirmed case.

On April 27, the first medical evacuation happens, with Case 3 airlifted from the ship to Johannesburg. Medical staff quickly confirm that Case 3 is suffering from Hantavirus, most likely the Andes strain. In the following days, the ship announces that multiple serious illnesses were on board, with two crew members and multiple passengers showing symptoms. On May 2, Case 4, a German woman dies aboard the MV Hondius. This is when international investigations began. On May 5, the cruise ship stops in Cape Verde, with multiple evacuations occurring. It is announced that the ship's doctor is showing symptoms, raising concerns about the risk to doctors treating patients. The ship departed Cape Verde, given permission to dock in Tenerife, Canary Islands, for a full evacuation. The ship is expected to arrive on May 9.

What countries did the passengers come from?

Authorities have begun monitoring passengers from around the world. On the ship, there were passengers from Canada, Singapore, Switzerland, the United States, the Netherlands, the UK, Germany, and Denmark. The WHO has been in contact with each of those countries' governments. One Swiss passenger tested positive for Hantavirus, and Singapore confirmed that its two former passengers were both isolating, with one displaying mild symptoms. There has been no report on whether either passenger has tested positive, but both were tested upon their return to Singapore.

Canadians Isolating

There were four Canadians on board the MV Hondius, with three of them being evacuated on May 5. All three of the evacuated Canadians are currently isolating in Canada, with two in Ontario and one in Quebec. According to Ontario Health Minister Sylvia Jones, they are not considered a transmission risk, but the situation is ‘fluid,' and the province is preparing to see if any other Canadians will need to isolate. Jones claimed the monitoring process would last 30 days. No further information about the Canadians on board has been released, but at least one Canadian remains on board the MV Hondius.

What is Hantavirus?  

Hantaviruses are zoonotic viruses that naturally infect rodents and are occasionally transmitted to humans. Infection in people can result in severe illness and often death, although the diseases vary by type of virus and geographical location. To date, human-to-human transmission has been documented only for the Andes virus in the Americas and remains uncommon. Symptoms begin between one and eight weeks after exposure, depending on the type of virus, and typically include fever, headache, muscle aches and gastrointestinal symptoms (pain, nausea, vomiting).

There is no licensed specific antiviral treatment or vaccine for hantavirus infection.