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MADRID (AP) — More than two dozen people from at least 12 different countries left a cruise ship hit by a deadly hantavirus outbreak without contact tracing
nearly two weeks after the first passenger died on board, the ship's operator and Dutch officials said Thursday. Health authorities on at least four continents are now tracking down and in some cases monitoring the cruise passengers who disembarked on April 24, and trying to trace others who may have come into contact with them since then.
World Health Organization officials say the risk to the wider public is low because hantavirus — usually spread by the inhalation of contaminated rodent droppings — isn't easily transmitted between people.“We believe this will be a limited outbreak if the public health measures are implemented and solidarity is shown across all countries,” said Dr. Abdirahman Mahamud, the WHO's alert and response director.
The Dutch health ministry reported Thursday that a flight attendant on a plane briefly boarded by an infected cruise passenger in South Africa was showing symptoms of hantavirus and would be tested in an isolation ward at a hospital in Amsterdam. The cruise passenger, a Dutch woman, was too ill to fly and was taken off the plane in Johannesburg, where she later died.
If the woman tests positive, she could be the first known person not on the MV Hondius to become infected in the outbreak.
Three cruise ship passengers have died in the outbreak, and several others are sick. Symptoms usually appear between one and eight weeks after exposure.
None of the remaining passengers or crew on the ship are currently symptomatic, according to WHO officials.
Three people, including the ship’s doctor, were evacuated Wednesday while the ship was near the West African island country of Cape Verde and taken to specialized hospitals in Europe for treatment.
The body of the Dutch man who was the first to die on board on April 11 was taken off the ship on the remote South Atlantic island of St. Helena on April 24, when his wife also disembarked. She then flew to South Africa a day later and died there.
Oceanwide Expeditions, the Netherlands-based cruise ship company, confirmed Thursday that 29 passengers left the vessel at St. Helena, while the Dutch Foreign Ministry estimated the number at about 40. The company had not previously disclosed that dozens more people left the ship on April 24.
Health authorities first confirmed hantavirus in a passenger on the ship on May 2, according to the WHO. That was in a British man evacuated from the ship to South Africa from Ascension Island three days after the St. Helena stop. He was tested in South Africa and is in intensive care.
It emerged Wednesday that a man tested positive for hantavirus in Switzerland after he disembarked at St. Helena, although his precise movements in between are unclear.
On Thursday, Singaporean health authorities announced they were monitoring two men who got off the ship at St. Helena and flew to South Africa and then home. The two men, who arrived in Singapore at different times, were being isolated and tested. One had a runny nose and the other showed no symptoms, according to Singapore's Communicable Diseases Agency.
British health officials stated that two passengers who flew home midway through the journey are self-isolating but do not have symptoms of illness. The U.K. Health Security Agency noted that “a small number” of contacts of the two are also self-isolating but are not showing any symptoms. Other contacts are being traced.
Authorities in St. Helena, where passengers disembarked, said they were monitoring a small number of people considered “higher risk contacts.” Those individuals are being advised to isolate for 45 days, according to the St. Helena government.
The vessel is currently sailing to Spain’s Canary Islands, a voyage expected to take three or four days, with more than 140 passengers and crew members still on board.
WHO Director-General Tedros Adhanom Ghebreyesus mentioned Thursday that he had been in regular contact with the ship's captain, stating that “morale has improved significantly since the ship started moving again.”
Authorities in South Africa are attempting to trace contacts of any passengers who previously disembarked from the ship, focusing mainly on an April 25 flight from St. Helena to Johannesburg, the day after passengers disembarked there.
The Dutch woman from the cruise ship who later died in South Africa briefly boarded that flight, officials have reported. The total number of cruise passengers among the 88 people on that flight remains unknown, but flights from St. Helena to South Africa are rare, occurring normally once a week.
The body of the third fatality, a German woman, is still on board the ship after she died on May 2.
Tests have confirmed that at least five people who were on the ship were infected with a hantavirus found in South America, known as the Andes virus. This strain is the only hantavirus believed to spread human-to-human and can lead to a severe and often fatal lung disease known as hantavirus pulmonary syndrome.
Argentina’s health ministry reported 28 deaths from hantavirus last year, an increase from an average mortality rate of 15 in the five years prior. Nearly a third of cases last year were fatal, according to the report.
The ship departed from Argentina, and investigations into the outbreak's source are focusing on that country.
Tedros indicated that a couple presenting the first two cases had traveled through Argentina, Chile, and Uruguay on a bird-watching trip before boarding the ship. They visited areas where the species of rat known to carry the Andes virus was present.
Tedros stated that the WHO is collaborating with health authorities in Argentina to understand their movements and has arranged for the shipping of 2,500 diagnostic kits from Argentina to laboratories in five countries.
