Hantavirus Outbreak on MV Hondius Cruise Ship: Source and Latest Developments

An American citizen who was aboard the MV Hondius cruise ship, the site of a hantavirus outbreak, has tested positive for the virus. At the same time, a French passenger has developed symptoms while being repatriated. The cruise ship is being evacuated, with passengers returning to their home countries one by one.

Passengers began returning home via military and government aircraft after the ship anchored near Tenerife, the largest island in Spain’s Canary Islands, on Sunday (May 10).

At least eight people who were on the ship have been confirmed or suspected to have contracted hantavirus. Three have died, and at least one is in critical condition in intensive care.

Earlier, officials from Spain’s Ministry of Health, the World Health Organization (WHO), and cruise company Oceanwide Expeditions asserted that no one among the more than 140 people on the MV Hondius had symptoms. However, the situation has changed.

As passengers are being repatriated for testing and monitoring, health officials are racing to determine the origin and mode of the outbreak.

No final conclusion has been reached, but clues are leading investigators to Argentina, where the MV Hondius departed on April 1.

Developments on the Ship

Passengers on the MV Hondius, anchored off Tenerife, were evacuated and taken ashore by small boats in full protective gear on Sunday (May 10). They were then boarded onto aircraft to various destinations over the weekend.

WHO Director-General Tedros Adhanom Ghebreyesus was present to oversee the process and stated that the risk of hantavirus infection for the people of Tenerife and the general public is very low.

Maria Van Kerkhove, WHO’s leading epidemiologist, recommended that all involved governments conduct testing and monitor passengers for at least 42 days from the suspected exposure.

Evacuation Points

Aircraft departing Tenerife carried passengers from more than 20 countries. Spanish citizens were evacuated first to a military hospital in Madrid, while Norway sent an air ambulance to pick up its citizens.

At least one of the 17 American passengers evacuated tested positive for the virus but remains asymptomatic, according to U.S. health officials. The plane carrying American passengers is expected to land on Monday (May 11) in Omaha, Nebraska, where they will be quarantined.

French Health Minister Stephanie Rist revealed that one of the five French passengers developed symptoms during the return flight on Sunday (May 10). The woman’s condition worsened rapidly in Paris. French Prime Minister Sebastien Lecornu stated that all five passengers are now in quarantine.

A Japanese citizen arrived in the UK on a flight arranged by the British government and will be monitored for up to 45 days. UK authorities said passengers would be quarantined in hospital for 72 hours, then self-isolate at home for six weeks.

In the Netherlands, an evacuation plane carrying 26 people from various countries landed in Eindhoven on Sunday evening (May 10). Dutch citizens will self-isolate at home for six weeks.

Other passengers from Germany, Greece, India, Portugal, Argentina, Belgium, Ukraine, Guatemala, the Philippines, and Montenegro are expected to be quarantined by local officials or repatriated.

German authorities said four Germans were transported from the Netherlands to Frankfurt University Hospital, from where they will be taken to their home cities and quarantined. None have tested positive.

Meanwhile, Australia dispatched an evacuation plane to pick up Australian, New Zealand, and some Asian citizens.

Passengers Who Left the Ship Earlier

At least 34 passengers and crew left the ship before May 2, the day the WHO first received reports of severe respiratory cases on the vessel while it was anchored off Cape Verde. Some disembarked at their stops, others were evacuated due to illness.

Six British military medics parachuted into the British territory of Tristan da Cunha in the South Atlantic on Saturday (May 9), where a passenger had disembarked on April 14. This passenger is now suspected of having the virus. The soldiers brought medical personnel with supplies and oxygen.

Four others are hospitalized: one in intensive care in Johannesburg, South Africa; two in the Netherlands; and one in Switzerland. Among them are a ship’s doctor and a crew member.

Three have died: one died on the ship, and a close contact later died in hospital. The timing of the third death remains unclear.

Origin of the Outbreak

Hantavirus is transmitted to humans through the respiratory tract when they inhale particles from the urine, feces, or saliva of infected rodents.

The current outbreak involves the Andes strain, which is endemic in rural areas of South America. This is the only known strain capable of human-to-human transmission.

The initial source of infection is unclear. Health officials are tracking an outbreak in Argentina, where the ship departed.

The first people to develop symptoms were an elderly Dutch couple on the cruise ship. Both died. However, it is unclear whether they were the first to contract the hantavirus.

Argentinian media reported that the couple visited a landfill in Ushuaia, a popular tourist destination in southern Argentina’s Patagonia region, to search for a rare bird. There is speculation that one of them may have come into contact with rat droppings there.

However, local health officials in Ushuaia consider this unlikely, telling reporters that the area has reported no hantavirus cases since 1996. Some experts suggest the area should still be checked, as ecosystems can change and hosts can move.

The negative attention on Ushuaia has impacted local businesses. The city is known as the “Gateway to Antarctica,” with most expeditions departing from there. There are concerns the outbreak could reduce tourist numbers.

Last week, Argentine health officials were deployed to the landfill area to collect rodent samples for hantavirus testing.

Other Hypotheses

Some believe the Dutch couple, who had traveled in the region for several months, may have been exposed to the virus in Chile or other parts of Argentina where the Andes strain is endemic.

Argentinian media reported that the couple arrived in Argentina on November 27. They then crossed into southern Chile and continued to Uruguay by car, staying there from March 13 to 27 before returning to Argentina.

Hantavirus is endemic in most of Chile, except the far north. The Andes strain is particularly endemic in Chile’s Aysen region. Chile shares a long border with Argentina.

Chilean health authorities confirmed the couple’s presence in the country but stated they traveled “during a period that does not correspond to the incubation period, so exposure would not have occurred within our country.”

Uruguay’s Ministry of Public Health stated there is no risk of transmission related to the couple in the country, as their symptoms began days after leaving Uruguay, meaning they were asymptomatic during their stay.