Five of the eight suspected hantavirus cases connected to a cruise ship outbreak have now been confirmed, according to the World Health Organization.
WHO Director-General Tedros Adhanom Ghebreyesus said the overall public health threat from the outbreak remained low, although the organisation was aware of reports involving other patients and warned there could still be additional cases due to the virus’s lengthy incubation period, reports RTE.
The update comes as countries around the world move to prevent further spread of the virus following the outbreak aboard the MV Hondius by tracing passengers who had already left the vessel before the virus was identified, along with anyone who had close contact with them afterwards.
Minister for Health Jennifer Carroll McNeill said two Irish nationals who were on board the luxury cruise ship will require medical assessments upon their arrival in Tenerife in the coming days, reports RTE.
Three people — a Dutch couple and a German citizen — have died in connection with the outbreak on the MV Hondius.
The WHO said eight people, including a Swiss national, are suspected of contracting the virus, which is typically spread through rodents, reports RTE.
Oceanwide Expeditions said all passengers who disembarked in St Helena in the South Atlantic, where the ship stopped on 24 April, have been contacted. The operator said this group included people from at least 12 countries, including seven British nationals and six Americans.
The first confirmed hantavirus case emerged in early May, reports RTE.
Oceanwide Expeditions said it is now attempting to compile details of all passengers and crew who boarded or left the vessel at various ports since 20 March. The Dutch couple believed to be the first cases only boarded on 1 April.
Dutch airline KLM said yesterday that the Dutch woman was removed from a flight in Johannesburg on 25 April because her condition had worsened. She died before she could return to the Netherlands, reports RTE.
Broadcaster RTL reported that a KLM cabin crew member who had contact with the woman has since been admitted to a hospital in Amsterdam after developing possible hantavirus symptoms.
However, neither the Dutch health ministry nor KLM confirmed that the individual being tested was a crew member, reports RTE.
Dutch authorities told public broadcaster NOS that crew and passengers who assisted the Dutch woman are now receiving daily health monitoring.
Contagion requires very close contact
The virus detected in the victims has been identified as the Andean strain, which in rare cases can spread between humans through very close contact, reports RTE.
Experts have emphasised that such transmission is highly unusual, although the outbreak has placed health authorities on alert. In the United States, the Centers for Disease Control and Prevention (CDC) said it was closely monitoring developments and assessed the public risk as extremely low.
French Foreign Minister Jean-Noel Barrot said one French citizen had come into contact with a person who later became ill but was not displaying symptoms, reports RTE.
Argentina’s health ministry said it will carry out rodent trapping and testing in the southern city of Ushuaia, where the cruise originated.
Ship heads for Spain
The MV Hondius, which still has dozens of people on board, departed from waters off Cape Verde yesterday after being stranded there for several days and is expected to arrive in Tenerife in Spain’s Canary Islands on Sunday, according to the European Centre for Disease Prevention and Control (ECDC), reports RTE.
The ECDC said there are currently no people on board showing hantavirus symptoms.
Once the ship reaches Tenerife, all non-Spanish passengers who remain healthy are expected to be repatriated, while 14 Spanish passengers will undergo quarantine in a military hospital in Madrid, reports RTE.
Evacuations and tests
Three patients were evacuated from the vessel yesterday. Two were admitted to hospital in the Netherlands, while another was transferred to Germany for treatment.
A Dutch hospital confirmed that one of the three evacuees tested positive for hantavirus, reports RTE.
“The RIVM (Dutch National Institute for Public Health and the Environment) has confirmed that the admitted patient has the hantavirus. The patient has been informed of this,” said the Radboud hospital, reports RTE.
According to Sky News, expedition guide Martin Anstee was one of the two people hospitalised in the Netherlands and said he was “doing okay” but that “there are still lots of tests to be done”.
The Duesseldorf University Clinic, which is treating the German evacuee, said she is not a confirmed case but a close contact who is currently undergoing testing, reports RTE.
The aircraft transporting the third patient landed in the Netherlands this morning and the individual was taken to a hospital in Nijmegen in the east of the country.
In Switzerland, a patient admitted to hospital on Monday was stable but displaying symptoms associated with hantavirus infection, including mild fever, aches and coughing, the hospital said, reports RTE.
Danish health authorities said a Danish citizen who had been on board the MV Hondius has returned home and was advised to self-isolate as a precautionary measure. Officials assessed the person as being low risk because there had been no close contact with those who later became ill.
Plans being developed for care of Irish passengers
Ireland’s Department of Health said preparations are under way regarding the care of the two Irish passengers once they return home, reports RTE.
It said quarantine arrangements would be decided individually and that any passengers who become symptomatic would be assessed and treated accordingly.
Professor Christine Kelly, a consultant in infectious diseases at the National Isolation Unit at the Mater University Hospital, said the two Irish passengers are currently awaiting clinical assessments that will determine the next steps, reports RTE.
“What we do also know at the moment is that everybody on board the ship seems to be asymptomatic,” Professor Kelly said, reports RTE.
Speaking on RTÉ’s Morning Ireland, she said the National Isolation Unit was prepared in the event of any outbreak.
“We work really closely with the Department of Health on an ongoing basis to prepare for all eventualities of what we call high-consequence infectious diseases.
“There are really robust plans in place for these scenarios. We simulate them, we train for them. That’s what we’re doing in the background all the time when we don’t have outbreaks”, reports RTE.
Professor Kelly said authorities are awaiting additional guidance from the ECDC regarding isolation rules for those who may have come into contact with the virus.
“There seems to be guidance from the ECDC which is recommending isolation for people on the ship,” she said, reports RTE.
“(For how long) hasn’t been confirmed yet and we’re still waiting for further guidance.”
Thomas Hoffman, Head of Emergency Preparedness and Response at the ECDC, said an “expert” from the agency boarded the MV Hondius yesterday to assist the crew in implementing “safe procedures” during the onward journey to the Canary Islands, reports RTE.
Speaking on RTÉ’s Today with David McCullagh, Mr Hoffman said passengers are isolating inside their cabins and anyone leaving their room must maintain physical distancing measures that are now in place aboard the ship, reports RTE.
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