A French woman infected with hantavirus aboard the MV Hondius cruise ship is in critical condition at a Paris hospital, on a life-support device that bypasses her heart and lungs, as the outbreak has sickened eleven people, killed three, and prompted a complex international quarantine response. The World Health Organization said Tuesday that nine of the cases have been confirmed, with two suspected, in what health authorities say is the first hantavirus outbreak on a cruise ship.
Dr. Xavier Lescure, an infectious disease specialist at Bichat Hospital, said the French patient has a severe form of the disease causing life-threatening lung and heart problems. She is on an extracorporeal membrane oxygenation (ECMO) machine — commonly called an artificial lung, which pumps blood out of the body, oxygenates it, and returns it — in what Lescure described as “the final stage of supportive care.”
Three people have died in the outbreak: a Dutch couple and another passenger. The couple, identified by the WHO as the first infected, had spent several months in Argentina and neighboring South American countries before boarding the ship and may have been exposed while visiting a garbage dump during a bird-watching tour, according to Argentine officials.
The evacuation of all 87 passengers and 35 crew from the ship in Tenerife was completed Monday, with personnel in full-body protective gear. Two aircraft arrived overnight in Eindhoven, Netherlands, carrying Dutch nationals as well as passengers from Australia and New Zealand and crew members from the Philippines, all of whom were placed into quarantine. Some crew stayed aboard, and the ship is now sailing to Rotterdam for cleaning and disinfection.
Tedros Adhanom Ghebreyesus, the WHO director-general, cautioned that more cases could emerge. “At the moment, there is no sign that we are seeing the start of a larger outbreak,” he told reporters. “But of course the situation could change, and given the long incubation period of the virus, it’s possible we might see more cases in the coming weeks.” He advised that returning passengers should remain in quarantine for 42 days, though he noted the WHO cannot enforce the guidance and that different countries may handle symptom monitoring differently.
Argentina’s health ministry said it will dispatch a team of scientific experts in the coming days to investigate the outbreak’s origin, focusing on the landfill where the infected Dutch couple may have encountered rodents. Local officials in the Argentine province where the cruise originated have challenged the theory that the virus began there.
In the Netherlands, twelve employees at Radboud University Medical Center in Nijmegen were ordered into six-week quarantine after improperly handling blood and urine from a hantavirus-positive passenger evacuated from the ship. The hospital said the “risk of infection is low” but the quarantine was a “precaution.” Spanish health officials confirmed a passenger tested positive and was quarantined at a military hospital in Madrid.
Hantavirus typically spreads through rodent droppings and is not easily transmitted between people. However, the Andes virus strain detected in this outbreak can, in rare cases, spread between humans. Symptoms — including fever, chills, and muscle aches — usually appear between one and eight weeks after exposure. There is no cure or vaccine, but the WHO says early detection and treatment improve survival rates.