Global authorities rush to track hantavirus, but predict ‘limited’ outbreak

Health officials in a growing number of countries raced Thursday to track down people linked to a deadly hantavirus outbreak on a cruise ship. The World Health Organization (WHO) has also predicted “limited” spread of the virus if public health measures are implemented.

“This is not COVID; this is not influenza,” Maria Van Kerkhove, head of epidemic and pandemic preparedness at the WHO, said on Thursday at a press conference in Geneva. “It spreads in a very, very different way.”

Transmission of hantaviruses — a family of viruses carried by rodents — from human to human is rare. The Andes strain of hantavirus, confirmed in the cases linked to the cruise, is the only one known to be transmitted between people, but transmission occurs mainly through close personal contact, Van Kerkhove explained.

“This is not the beginning of an epidemic; this is not the beginning of a pandemic,” he said.

Since April 11, three passengers aboard the MV Hondius, a Dutch-flagged cruise ship, have died and at least five other people have fallen ill after showing symptoms of hantavirus, according to the WHO. Health officials have confirmed five cases of hantavirus on the ship so far, all involving the Andes strain, found mainly in South America.

People in several countries are now being tested or monitored after possible contact with the virus.

Three people in the Netherlands who developed symptoms after coming into contact with an infected person on a flight have been tested for the virus, Dutch public health authorities said. Two results were negative, and the third was still being analyzed.

Earlier, the Dutch Ministry of Health reported that a flight attendant was being tested for hantavirus in a hospital on Thursday, after having contact with an infected person.

Dutch media outlets reported that the flight attendant worked for KLM Royal Dutch Airlines. The company declined to comment, citing the privacy of its employees, and the Ministry of Health did not clarify whether the two negative results included the flight attendant’s case.

Authorities also did not say whether the flight attendant had symptoms or whether she had worked on a flight that one of the victims of the ship’s outbreak had briefly boarded the day before her death. That victim, a 69-year-old Dutch woman, died on April 26 in Johannesburg.

On Thursday night, Tedros Ghebreyesus, director general of the World Health Organization, said in a statement that the flight attendant, who had been reported as symptomatic, tested negative in two tests. The information was first published in the Inside Medicine newsletter. The result is considered reassuring because it suggests that the virus is not being transmitted in ways different from those already observed in previous outbreaks. Ghebreyesus, however, warned that the virus could have a long incubation period.

The day before her death, the Dutch woman boarded flight KLM 592, from Johannesburg to Amsterdam, and spent around an hour on the plane, according to the company. Barbara de Beukelaar, a passenger on that flight, said in a telephone interview that the woman was taken onto the plane in a wheelchair.

Airline employees attended to the passenger and decided to remove her from the flight, which lasted almost 12 hours, due to her health condition, KLM said.

“No one on board imagined they were dealing with a contagious virus,” de Beukelaar said.

KLM said it had handed over the passenger list to Dutch health authorities for contact tracing.

The Hondius — with almost 150 passengers and crew from around two dozen countries — was heading towards the Canary Islands this Thursday, after three people who could be infected were evacuated to the Netherlands.

The ship will not dock in the Canary Islands, but will remain anchored off the coast until passengers are transported by boat to Tenerife, from where evacuation flights will depart for their countries, Canary authorities said. The ship is expected to arrive at the location on Sunday.

On Thursday night, President Donald Trump said he had been briefed on the outbreak. “It is very much, we hope, under control,” he told reporters.

Oceanwide Expeditions, the Dutch company that operates the cruise, said in a statement on Thursday that two of the people evacuated to the Netherlands were symptomatic crew: a 56-year-old British man and a 41-year-old Dutch citizen.

A 65-year-old German woman, without symptoms, was also evacuated. She is being examined in Germany, according to Düsseldorf University Hospital.

Genetic sequencing of samples in South Africa suggests that the virus is almost identical to the version seen in Argentina and has not undergone mutations that make it a greater threat, according to Tulio de Oliveira, director of the Center for Epidemic Response and Innovation at Stellenbosch University in South Africa. De Oliveira was not directly involved in the study, but said the results were presented to a group of experts of which he is a member.

Tracking down everyone who may have had contact with those infected could prove challenging.

On April 24, 30 people from at least 12 countries left the ship in St. Helena, a remote island in the South Atlantic. This was more than a week before the first confirmed case of the virus, according to Oceanwide.

The company said it had contacted the people who disembarked in Saint Helena. At least one of them, a man in Switzerland, was admitted to a hospital in Zurich and tested positive for the virus, according to the WHO.

“We are working to establish details of all passengers and crew who have embarked and disembarked the ship since March 20,” Oceanwide said.

In Singapore, two people who were on the ship were in isolation and being tested for the virus, according to the National Center for Infectious Diseases. In Denmark, local health officials said a Danish passenger on the ship, who had not been tested for hantavirus, was in self-isolation and had no symptoms.

In France, a French citizen who had contact with one of the cruise passengers on an April 25 flight from Saint Helena to Johannesburg has shown mild symptoms and is in isolation, French authorities said on Thursday. That person is also undergoing diagnostic testing, authorities said. Another seven French people who were on the flight are being monitored.

In the United States, residents of five states were being monitored for possible hantavirus infection after being on the ship, officials said. None of them had symptoms.