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A suspected outbreak of hantavirus on a cruise ship sailing in the Atlantic Ocean has killed three people and sickened at least three others, the World Health Organization and South Africa’s Department of Health said Sunday. The WHO said an investigation was underway and that at least one case had been confirmed, as the ship remained off the coast of Cape Verde and medical care and evacuation planning continued.

In a statement provided to The Associated Press, the WHO said it was aware of and supporting “a public health event involving a cruise vessel sailing in the Atlantic Ocean.” The WHO said detailed investigations were ongoing, including further laboratory testing and epidemiological investigations, and that sequencing of the virus was also underway.

South Africa’s Department of Health said the MV Hondius, a Dutch-flagged ship, had left Argentina about three weeks earlier for a cruise that included visits to Antarctica, the Falkland Islands and other stops. The voyage was described as eventually heading to Spain’s Canary Islands across the Atlantic, and the department said the ship had been sitting off the coast of Cape Verde during the outbreak response.

The South African health department said the first victim was a 70-year-old man who died on the ship, and whose body was removed in the British territory of Saint Helena in the South Atlantic. The department said the man’s wife collapsed at an airport in South Africa as she tried to take a flight to her home country of the Netherlands, and that she died at a nearby hospital.

The department identified the patient in intensive care in a Johannesburg hospital as a British national, saying the person became ill near Ascension Island after the ship left Saint Helena. Authorities later transferred the patient from Saint Helena to South Africa, and the department said the case was being managed at the Johannesburg hospital.

South Africa’s Department of Health said about 150 passengers were onboard at the time of the outbreak, while noting that the cruise’s operator typically travels with around 70 crew members. The Dutch company that operates the cruise said the ship had not allowed anyone to disembark and that local authorities were assisting.

Oceanwide Expeditions said one of the remaining victims’ bodies was still onboard the ship in Cape Verde and that its priority was ensuring two crew members requiring urgent medical care received treatment. The company said local health authorities visited the vessel to assess the two symptomatic individuals and had not yet decided on whether to transfer them into medical care in Cape Verde.

WHO said it was working with national authorities and the ship’s operators to conduct a “full public health risk assessment” and to provide support for people still onboard. South Africa’s National Institute for Communicable Diseases said it was conducting contact tracing in the Johannesburg region to identify whether other people were exposed to infected passengers in South Africa.

The WHO and South African department of health said hantavirus infections are spread mainly through contact with the urine or feces of infected rodents such as rats and mice. Hantaviruses are found worldwide, and the viruses gained broader attention after Betsy Arakawa, the wife of actor Gene Hackman, died from hantavirus infection in New Mexico last year, according to the report.

Hantaviruses can cause two serious syndromes, according to the U.S. Centers for Disease Control and Prevention: hantavirus pulmonary syndrome, which affects the lungs, and hemorrhagic fever with renal syndrome, which affects the kidneys. While infections are rare, the WHO said hantavirus can also be spread between people, and that there is no specific treatment or cure, but early medical attention can improve the chance of survival.