Hantavirus outbreak on cruise ship not ‘another COVID’, WHO says

Three people have died and several others have fallen ill aboard the Dutch-flagged MV Hondius, prompting a major international public health response involving countries across Europe, Africa and Latin America.

The first alert came from the United Kingdom, which notified WHO under International Health Regulations (IHR) of the outbreak after passengers aboard the vessel developed severe respiratory illness during the trip from Argentina to Cabo Verde.

Briefing journalists in Geneva, WHO Director-General Tedros Adhanom Ghebreyesus said eight cases had been reported so far, including five laboratory-confirmed infections and three suspected cases linked to the rare Andes strain of hantavirus

Low risk to humans

Hantaviruses are zoonotic viruses carried by rodents and are usually transmitted to humans through contact with infected animals or their urine, saliva or droppings (checkout WHO’s hantavirus factsheet here).

The Andes strain, found in parts of Latin America, is the only known hantavirus capable of limited human-to-human transmission.

According to WHO, transmission generally requires close and prolonged contact, particularly among household members, intimate partners or healthcare workers.

“At this stage, the overall public health risk remains low,” Dr. Tedros said.

WHO officials are clear that the outbreak is very different from the 2020 coronavirus pandemic which killed millions worldwide.

“This is not SARS-CoV-2. This is not the start of a COVID pandemic,” said Maria Van Kerkhove, WHO acting director for epidemic and pandemic management.

“Hantaviruses have been around for quite a while. We know this virus. It does not spread the same way that coronaviruses do.”

Investigation underway

The first known patient developed symptoms on 6 April and later died aboard the vessel. His wife also became ill and died after being evacuated to South Africa, where laboratory testing confirmed hantavirus infection.

Prior to boarding, the pair had travelled through Argentina, Chile and Uruguay on a birdwatching trip, including visits to sites where the rodent species known to carry the virus is present.

Another passenger died on 2 May and while one man remains in intensive care in South Africa, WHO said his condition is improving. Other patients have been transferred to hospitals in the Netherlands for treatment.

WHO said no passengers or crew currently remaining aboard the ship are showing symptoms.

International effort

The outbreak has triggered action under the International Health Regulations, the global framework designed to coordinate responses to cross-border health threats.

WHO said it is working closely with authorities in Cabo Verde, Spain, the Netherlands, South Africa, the United Kingdom and Argentina, alongside the European Centre for Disease Prevention and Control.

Spain has agreed to allow the vessel to dock in the Canary Islands – an autonomous Spanish community – after Cabo Verde declined the request because of public health concerns.

Dr. Tedros thanked Spanish Prime Minister Pedro Sánchez for what he described as an act of “solidarity” and “moral duty”.

“The risk to the people of the Canary Islands is actually low.”

WHO initiative in Cabo Verde

A WHO expert, Dutch doctors and a European disease specialist boarded the ship in Cabo Verde earlier this week and are overseeing medical assessments and infection prevention measures during the voyage to Tenerife.

Speaking to UN News, WHO Representative in Cabo Verde Ann Lindstrand said the agency had been supporting local authorities from the beginning of the outbreak response.

“During the trip to the Canary Islands we have been able to bring medical supplies, so if somebody gets sick on the boat, there will be medical doctors and supplies to be able to take care of them during the journey.”

She said in coordination with WHO, national health authorities are contacting passengers who disembarked earlier to advise them to seek medical attention quickly if symptoms develop.

Passengers still aboard have been asked to remain in their cabins while disinfection procedures are carried out. Anyone developing symptoms will be isolated immediately.

Social media disinformation

Addressing disinformation circulating on social media, Dr. Abdirahman Mahamud of WHO’s Health Emergencies Programme stressed that there are no signs this is the early stages of a pandemic.

Infection has occurred in a confined setting involving prolonged close contact among passengers aboard the ship, similar to a limited Andes hantavirus outbreak recorded in Argentina in 2018–2019. In that case, transmission was linked to a social gathering involving a symptomatic individual and resulted in only a small number of cases.

Dr. Mahamud said existing public health measures, including contact tracing, isolation and monitoring, are well understood and can effectively break chains of transmission, making a large-scale epidemic unlikely.

Monitoring continues

WHO warned that additional cases may still emerge because the incubation period for Andes hantavirus can be up to six weeks.

“Viruses don’t care about politics, and they don’t care about borders,” Dr. Tedros said. “The best immunity we have is solidarity.”