Three passengers aboard a Dutch cruise ship have died and at least three others are seriously ill in a suspected outbreak of hantavirus, a rare rodent-borne disease, according to the World Health Organization and the vessel’s operator. The MV Hondius, carrying 87 passengers and 61 crew, has been stranded off the coast of Cape Verde since Monday after local health authorities refused to let it dock, citing public health concerns. Two crew members are in urgent need of medical care, and a possible new case has been identified among those remaining on board.
The outbreak, which began weeks into the ship’s polar voyage from Argentina to Antarctica and remote South Atlantic islands, has prompted a coordinated international response involving the WHO, Cape Verdean health officials, and South African authorities, who are conducting contact tracing after an infected passenger died at Johannesburg’s main airport.
The Hondius departed Ushuaia, Argentina, on April 1, according to Argentine provincial authorities. Health officials there said no passengers showed hantavirus symptoms at the time of departure. But because the virus can incubate for up to eight weeks, “the passengers could have been incubating the disease if they acquired it within the country or elsewhere in the world,” Juan Facundo Petrina, director of epidemiology for Tierra del Fuego province, told the Associated Press.
The first death was a 70-year-old Dutch man who fell ill with fever, headache, abdominal pain and diarrhea and died on board April 11. His body was taken off the vessel nearly two weeks later on the British territory of Saint Helena, where it is awaiting repatriation. His 69-year-old wife left the ship and later collapsed at Johannesburg’s airport; she died at a hospital, and her blood tested positive for the virus posthumously, South African Health Minister Aaron Motsoaledi said. A third passenger, a German national, died on the ship and his body remains on board, according to a statement from Oceanwide Expeditions.
A British man was evacuated from the ship on April 27 at Ascension Island and taken to South Africa, where he tested positive for hantavirus and remains in critical condition in intensive care. Two sick crew members — one British, one Dutch — have respiratory symptoms and need urgent medical care, the operator said.
Cape Verde’s Health Ministry said Monday that the ship would not be allowed to dock and would stay in open waters near the shore because of public health concerns. A medical team of two doctors, a nurse and a laboratory specialist has visited the ship three times, said Dr. Ann Lindstrand, a WHO official in Cape Verde. She told the AP that authorities were planning medical evacuations in which passengers would be taken from the ship by ambulance to an airport.
“It’s been very tricky for Cape Verdean authorities,” Lindstrand said. “What they have to deal with is a public health event. And of course, they have been thinking about the protection of the population here.”
Oceanwide Expeditions said it would consider moving the ship to one of the Spanish islands — Tenerife or Las Palmas — if it cannot evacuate passengers in Cape Verde. The WHO said it was working with local authorities and the operator on a “full public health risk assessment” and that “detailed investigations are ongoing, including further laboratory testing, and epidemiological investigations.”
Hantavirus is a rodent-borne illness spread by contact with rodents or their urine, saliva or droppings. WHO says it is rare but can spread between people. There is no specific treatment or cure, but early medical attention can increase chances of survival. Paul Hunter, a professor of medicine at the University of East Anglia and an expert on infectious disease, said the virus comes from rodents.
A previous hantavirus outbreak in southern Argentina in 2019 killed at least nine people and prompted a judge to order dozens of residents of a remote town to stay in their homes for 30 days. Last year, Argentina recorded 28 deaths from the virus, according to the health ministry.
South Africa’s National Institute for Communicable Diseases is conducting contact tracing for people who may have been exposed to infected cruise passengers, particularly the 69-year-old woman who collapsed at Johannesburg’s O.R. Tambo International Airport, one of Africa’s busiest. The country’s health department urged the public not to panic, saying WHO was “coordinating a multicountry response with all affected islands and countries to contain further spread of the disease.”
Dr. Hans Henri P. Kluge, WHO regional director for Europe, said in a statement Monday that while the disease is severe in some cases, “it is not easily transmitted between people. The risk to the wider public remains low. There is no need for panic or travel restrictions.”