The World Health Organization (WHO) stated it was tracing individuals who were on a flight from Saint Helena island to Johannesburg that had carried a cruise passenger who later died from hantavirus.
There were 82 passengers and six crew members aboard the 25 April flight, according to South African airline Airlink, reports RTE.
Among them was a Dutch woman whose husband had died from the virus on the ship, and whose health “deteriorated during a flight to Johannesburg”, WHO said in a statement.
She had disembarked in Saint Helena on 24 April with “gastrointestinal symptoms” and passed away upon reaching the emergency department of a Johannesburg hospital, where she tested positive for hantavirus, reports RTE.
“Contact tracing for passengers on the flight has been initiated,” WHO said, reports RTE.
Airlink runs a weekly flight from the island, with a journey time of roughly four hours.
South African authorities instructed the airline to inform passengers that they must get in touch with the health department, spokesperson Karin Murray said, reports RTE.
WHO indicated it suspects the virus may have spread between individuals aboard the cruise ship, which as of Tuesday remained stranded off Cape Verde.
In addition to the Dutch couple, a German passenger has also died, with seven confirmed and suspected infections in total, reports RTE.
Transmission between humans is uncommon, and the UN health body emphasised that the broader public risk remains low, as the disease is usually spread through contact with infected rodents.
Officials confirmed that a Dutch couple and a German national have died, while a British citizen was evacuated from the vessel and is currently in intensive care in South Africa, reports RTE.
Two crew members require urgent medical attention, according to Oceanwide Expeditions, operator of the Dutch-flagged MV Hondius. Another suspected case onboard has only shown mild fever symptoms.
The operator further stated that “no new symptomatic cases” of hantavirus have been identified onboard, reports RTE.
“At this stage, no new symptomatic individuals on board have been identified beyond those previously reported,” it said in a statement, reports RTE.
The Dutch foreign ministry said preparations were underway to medically evacuate three individuals to the Netherlands, though it remains unclear when or where the nearly 150 remaining passengers will disembark.
The ship affected by the outbreak is currently anchored off Cape Verde, which had been its final stop, but the island nation has refused to allow passengers ashore due to the situation, reports RTE.
Hantavirus infections typically occur through contact with infected rodents or exposure to their urine, droppings, or saliva.
However, limited human-to-human transmission has been observed in past outbreaks involving the Andes strain, found in South America including Argentina, which WHO believes may be relevant in this case, reports RTE.
Testing is ongoing. The Hondius departed Ushuaia in southern Argentina in March.
WHO noted it had received information indicating there were no rats onboard, reports RTE.
“We do believe that there may be some human to human transmission that’s happening among the really close contacts, the husband and wife, people who have shared cabins,” Maria Van Kerkhove, WHO’s epidemic and pandemic preparedness director, told reporters in Geneva, reports RTE.
Dr Van Kerkhove said efforts are now focused on evacuating the two ill passengers still onboard before the ship proceeds to the Canary Islands.
“We have heard from quite a few people on the boat,” Dr Van Kerkhove said earlier, reports RTE.
“We just want you to know we are working with the ship’s operators. We are working with the countries where you are from. We hear you, we know that you are scared,” she said, adding efforts are ongoing to safely return passengers home, reports RTE.
Later, Spain’s health ministry stated there was no need for the ship to stop in the Canary Islands if all infected individuals are evacuated in Cape Verde, unless further cases arise.
The UN health agency said its current assumption is that the initial Dutch couple, who boarded the ship in Argentina after travelling there, were infected before joining the cruise, reports RTE.
It added that other passengers may have contracted the virus during bird-watching excursions to islands inhabited by birds and rodents.
Genetic sequencing of the virus is currently being conducted, reports RTE.
A WHO spokesperson said it “may take some time to get all the answers” regarding how the outbreak started.
Tarik Jašarević told RTÉ’s News at One that genetic sequencing in South Africa is underway to determine the specific hantavirus strain involved, reports RTE.
“We are doing everything we can. We understand that people are scared, they are tired of being in their cabin, and they don’t know what’s next, but efforts are being done to understand the situation and make sure that everyone can get home safely, reports RTE.
“There are a number of people who have been identified to follow up with (from a flight to Saint Helena and Johannesburg) in terms of contact tracing, reports RTE.
“We believe the risk to the wider general public is low, because we know that the hantavirus is normally transmitted through contact with animals, reports RTE.
“If there is a human-to-human transmission, it has to be close contact, reports RTE.
“However, we take this event very seriously, and we are doing everything we can to understand it better to make sure that people on the boat can arrive back safely, Mr Jašarević said, reports RTE.
The Hondius is carrying mainly British, American, and Spanish passengers on a luxury voyage that began from southern Argentina in late March.
The itinerary included visits to the Antarctic Peninsula, South Georgia, and Tristan da Cunha—among the most remote islands globally, reports RTE.
The trip was marketed as an Antarctic wildlife expedition, with cabin prices ranging between €14,000 and €22,000.
The first affected passenger, a Dutch man, died on 11 April. His body remained onboard until 24 April, when it “was disembarked on St Helena, with his wife accompanying the repatriation”, Oceanwide Expeditions said, reports RTE.
His wife, who had gastrointestinal symptoms at the time of disembarkation, later worsened during a flight to Johannesburg.
She died on arrival at the emergency department on 26 April, WHO said, adding that contact tracing for that flight is ongoing, reports RTE.
South African officials confirmed that the British patient receiving treatment in Johannesburg tested positive for hantavirus, while the Netherlands confirmed the infection in the deceased Dutch woman.
South Africa’s National Institute for Communicable Diseases is conducting virus sequencing, with results expected by Wednesday, Dr Van Kerkhove said, reports RTE.
Argentina continues to report the highest number of cases in the Americas, WHO said in December, with a fatality rate of around 32%, higher than average and compared to other strains of the virus, reports RTE.
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