Health personnel assisted patients onto a boat from the cruise ship MV Hondius, while stationary off the port of Praia, the capital of Cape Verde. AFP/Getty Images
Three people with suspected hantavirus were evacuated Wednesday morning from a cruise ship hit by an outbreak, as local objections mount over plans for the vessel to dock at the Canary Islands, a Spanish archipelago.
Fernando Clavijo, the leader of the Canary Islands, said Wednesday he is opposed to the ship docking there and requested an urgent meeting with Spain’s Prime Minister Pedro Sánchez. That contradicted the Spanish government, which said it would allow the ship to dock in Tenerife, one of the Canary Islands, in about three days, Spain’s public broadcaster TVE reported.
Meanwhile, another passenger previously on board the MV Hondius has tested positive for hantavirus and is being treated at a Swiss hospital, Switzerland’s health ministry said Wednesday.
Health authorities have emphasized that the outbreak does not pose a wider public health risk.
“We have no information whatsoever nor any official document from the government,” Clavijo, who belongs to the conservative People’s Party, which is Sánchez’s main opposition, told Spanish radio station Onda Cero.
“Without having information, I cannot allow them to enter the Canary Islands, because we don’t know what we are dealing with,” he added.
Currently, the vessel is docked off the coast of Praia, the capital of Cape Verde, an archipelago nation off Africa’s west coast, where medical personnel boarded the ship.
The World Health Organization (WHO) said some human-to-human transmission may have occurred among people on board the ship. Three people have died and several others fallen ill.
Almost 150 people, including 17 Americans, remain stranded on the MV Hondius, which is operated by tour company Oceanwide Expeditions.
Eight cases of hantavirus, a rare disease typically caused by contact with infected rodents’ urine, faeces or saliva, have been identified so far. Three of those are confirmed and five suspected, according to health authorities.
A Dutch couple and German national have died while one British national remains in intensive care in South Africa, though the WHO said his condition is improving. Of the three people evacuated, one is “associated with” the German national, according to the tour operator.
What happens next?
Three individuals were evacuated from Cape Verde, WHO chief Dr. Tedros Adhanom Ghebreyesus confirmed Wednesday, saying they will travel to the Netherlands.
One of those individuals is the ship’s doctor, who was originally bound for the Canary Islands but is headed for the Netherlands now his condition has improved, the Spanish health ministry said Wednesday.
Three people were evacuated from the ship Wednesday morning. AFP/Getty Images
Two specialist doctors from the Netherlands will also arrive and remain with the vessel after it leaves Cape Verde, the tour operator said Wednesday. Another doctor is already on board.
The plan is then for the ship to sail to the Canary Islands, which will take three days, according to the tour operator. Spanish authorities will then conduct a full epidemiological investigation and full disinfectation, Van Kerkhove said.
It is expected to head for Tenerife, according to TVE, following hours of uncertainty about which Canary Island the ship would be bound for.
Spain’s health ministry said European Center for Disease Prevention and Control authorities were working to determine who needs to be urgently evacuated in Cape Verde before the other passengers continue on to the Canary Islands.
Oceanwide is liaising with relevant local authorities to plan the vessel’s exact arrival, quarantine and screening procedures for all guests, it said Wednesday.
Strict health and safety procedures are currently in place on the ship, including isolation measures, hygiene protocols and medical monitoring. The company said the atmosphere “remains calm” and that passengers were “generally composed.”
One passenger, travel vlogger Jake Rosmarin, spoke of the fear and uncertainty percolating through the ship on Monday.
“What’s happening right now is very real for all of us here. We’re not just a story. We’re not just headlines,” he said in a video posted on Instagram, his voice cracking with emotion.
Social distancing is being followed and passengers have the option for meals to be delivered directly to their cabin, Rosmarin said in a statement to CNN Tuesday. Access to the outer decks is permitted for fresh air, though gathering in indoor areas such as the lounge is not allowed, he added.
An ambulance boat carriying crew members wearing hazmat suits, returns to the port of Praia on Tuesday after a visit to the cruise ship MV Hondius. AFP/Getty Images
“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.
Beyond the ship itself, authorities have initiated contact tracing for those on the flight to Johannesburg with the Dutchwoman who later died.
Authorities in Switzerland are also carrying out contact tracing for the patient currently in hospital. His wife, who was also on the trip, is currently asymptomatic and self-isolating as a precaution, the Swiss health ministry said.
“The risk to the general public is low,” Dr. Maria Van Kerkhove, WHO’s director for epidemic and pandemic preparedness and prevention, told reporters.
“This is not a virus that spreads like flu or like COVID. It’s quite different,” she said, outlining that any suspected human-to-human transmission would have occurred between very close contacts like married couples.
Are you or someone you know on the ship? Share your story
If you or someone you know is on the MV Hondius, and you are able to safely share your experience, please get in touch.
You may be contacted by a CNN reporter for a future story. We will not publish your response without speaking to you first.Share your story What is your name and location? How can we get in touch?
What do we know about the victims?
The first suspected case was a 70-year-old Dutchman, who suddenly fell ill on the ship with a fever, headache, abdominal pain and diarrhea, South Africa’s Health Department told CNN. He died on board on April 11.
The man’s wife, who was 69 years old and also Dutch, was taken to South Africa but collapsed at an airport while trying to fly home to the Netherlands and died at a nearby hospital. She tested positive for a variant of hantavirus, Oceanwide Expeditions confirmed Monday.
“The beautiful journey they experienced together was abruptly and permanently cut short,” the couple’s family said in a statement sent to CNN by Dutch charity Namens de Familie, which supports people receiving media attention after personal tragedy.
“We are still unable to comprehend that we have lost them. We wish to bring them home and commemorate them in peace and privacy,” they said.
Three people have died in the outbreak. CNN
After the ship left Saint Helena, a British national onboard fell sick on April 27. He is now in intensive care at a private medical facility in Johannesburg, though his condition is improving, WHO said. He is the second confirmed hantavirus case.
On May 2, a German national, who presented with pneumonia, died on board the MV Hondius. While her cause of death has not yet been established, it is being treated as a suspected case.
And two crew members — one British and one Dutch national — are currently experiencing acute respiratory symptoms, requiring urgent care, Oceanwide Expeditions said. Hantavirus has not been confirmed in either case.
A seventh person reported a mild fever but is now feeling well, WHO said. They have provided a sample for hantavirus testing too.
An eighth case emerged Wednesday when Swiss authorities confirmed a man was being treated for hantavirus at the University Hospital Zurich. He had consulted his doctor after experiencing symptoms, before going to the hospital for testing. Doctors established he is suffering from the Andes strain of the virus, which can spread by limited human-to-human transmission, and he has been isolated.
How did the outbreak occur?
It’s not yet clear how the outbreak occurred. But WHO are working on the assumption that the Dutch couple who both died were infected off the ship, perhaps while doing some activities in Argentina before they joined the cruise, Van Kerkhove said.
The MV Hondius first left Ushuaia in Argentina over a month ago. It made stops in Antarctica before returning to Ushuaia for a night and leaving again on April 1, according to vessel tracker Marine Traffic. It then stopped at the British overseas territory of Saint Helena before anchoring Sunday off Praia, MarineTraffic said.
Hantavirus typically incubates for one to six weeks before patients start presenting symptoms so they likely fell ill some time after they were infected, she added.
Health workers pictured disembarking the MV Hondius on Monday. Qasem Elhato/AP
According to WHO, the passengers who fell ill developed symptoms between April 6 and 28, including “fever, gastrointestinal symptoms, rapid progression to pneumonia, acute respiratory distress syndrome and shock.”
On their voyage, passengers visited some of the world’s most remote islands, where they would have seen a lot of wildlife, including whales, dolphins, penguins and seabirds, according to the trip’s itinerary.
“This was an expedition boat and many people were doing birdwatching, things with wildlife,” Van Kerkhove said.
Rodents live in some of these places, so there “could be some source of infection on the islands as well for some of the other suspected cases,” she added.
Only one type of hantavirus, the Andes virus, is known to have some limited human-to-human transmission. Though it is rare, it is primarily found in Chile and Argentina, where the ship originated, and it is this strain which infected passengers, WHO confirmed Wednesday after health authorities in South Africa and Switzerland sequenced the virus.
“We do believe there may be some human-to-human transmission happening among the really close contacts, the husband and wife, people who’ve shared cabins,” Van Kerkhove said.
Meanwhile, Rosmarin, one of the passengers, emphasized that the ship “is not a traditional cruise ship, but an expedition vessel” and had followed strict cleanliness protocols throughout its voyage since it visited “remote and environmentally sensitive regions.”
How deadly is hantavirus?
While hantavirus is rare, it is highly deadly – about 38% of people who develop respiratory symptoms may die, according to the CDC.
Symptoms start similar to the flu, with patients suffering from fatigue, fevers, chills and aches. But over time, the virus can damage the heart, lungs or kidneys, causing patients to suffer severe shortness of breath, organ failure and even death.
There’s no specific treatment for hantavirus, according to the CDC, beyond managing symptoms. Patients with severe breathing difficulties may need to be intubated, the CDC said.
This is a developing story and will be updated.