Cape Town, South Africa — Health authorities are investigating a suspected hantavirus outbreak aboard the Dutch-flagged cruise ship MV Hondius that has killed three people and sickened at least three others, the World Health Organization (WHO) and South Africa’s Department of Health said.
WHO said investigators are working with national authorities and the ship operator, and that at least one case of hantavirus has been confirmed. One patient is in intensive care in a Johannesburg hospital, and the U.N. agency said it is coordinating efforts to evacuate two other symptomatic individuals from the vessel.
The Dutch foreign ministry told reporters it is exploring medical evacuation options and would coordinate moves if possible. Oceanwide Expeditions, which operates the MV Hondius, said the ship was off the coast of Cape Verde and that local authorities had visited the vessel but had not permitted disembarkation. The operator said the two people needing urgent care are crew members.
WHO Regional Director for Europe Dr. Hans Henri P. Kluge said the risk to the general public remains low and that neither panic nor travel restrictions are warranted at this stage. WHO teams are conducting laboratory testing, genetic sequencing and epidemiological investigations, and providing clinical support to passengers and crew.
Hantaviruses are typically transmitted through contact with urine, droppings or saliva of infected rodents and can cause severe illness. Two major clinical syndromes are associated with hantaviruses: hantavirus pulmonary syndrome, which affects the lungs, and hemorrhagic fever with renal syndrome, which affects the kidneys. While human-to-human transmission is uncommon, it has been reported in some outbreaks. There is no specific antiviral treatment, but early medical care improves the chance of survival.
South Africa’s Department of Health said the MV Hondius departed Argentina about three weeks ago on a voyage that included stops in Antarctica and the Falkland Islands and was bound for Spain’s Canary Islands. The first person to die was a 70-year-old man who became ill on board and whose body was removed at the British territory of Saint Helena. His wife later collapsed at a South African airport while attempting to travel to the Netherlands and died in a nearby hospital; Dutch officials confirmed two Dutch passengers died. A third deceased person’s body remained on board in Cape Verde, the operator said.
The patient in intensive care is a British national who fell ill near Ascension Island and was moved to South Africa for treatment. About 150 tourists and roughly 70 crew members were aboard at the time. South Africa’s National Institute for Communicable Diseases is carrying out contact tracing in the Johannesburg area to identify any possible exposures.
Authorities say they will continue public health assessments, testing and communications with affected countries and the ship operator as they manage care for those on board and follow up on contacts ashore.