The World Health Organization (W.H.O.) said on Monday that the risk to the general public was “low” from the outbreak of deadly hantavirus aboard a cruise ship currently isolated off the coast of West Africa.
The Dutch-flagged cruise ship Hondius departed Argentina for the Canary Islands three weeks ago, with 88 passengers and 59 crew aboard. Early in its voyage, several of the passengers and crew became sick with hantavirus, a disease that normally spreads through rodent droppings rather than human-to-human contact.
Hantaviruses attack the lungs or kidneys and can cause death through respiratory failure. There are no known vaccinations or cures, so doctors try to give patients supportive care, sometimes including ventilators and other respiratory aids, to get them through the most dangerous symptoms.
At least three of the victims have died, including a Dutch couple and a German national, and several patients are undergoing intensive care aboard ship. One of the victims, a British national, was evacuated to South Africa for treatment and is currently in critical condition. Medics were working on Monday to arrange evacuations for two more critically ill patients.
W.H.O. said on Monday it has confirmed two cases of hantavirus aboard the Hondius and suspects five more infections. Each case was “characterized by fever, gastrointestinal symptoms, rapid progression to pneumonia, acute respiratory distress syndrome and shock.”
“W.H.O. currently assesses the risk to the global population from this event as low and will continue to monitor the epidemiological situation and update the risk assessment,” the statement said.
Investigators are not yet certain how the outbreak began or if the infections were spread before the passengers and crew boarded the ship, possibly by contact with wildlife. There is only one species of hantavirus with documented transmission between humans, and it is found in Argentina and Chile, so human transmission cannot be completely ruled out.
The passengers have been told to remain in their cabins until medical screening is complete and the ship has been disinfected.
“We are working with authorities to understand the source of exposure through epidemiological investigations and doing contact tracing to identify any further cases. Laboratory tests are also ongoing,” said W.H.O. Epidemic and Pandemic Preparedness and Prevention Director Maria Van Kerkhove.
Although W.H.O. did not recommend quarantines or travel restrictions, the island nation of Cape Verde refused to grant the Hondius permission to dock, stranding most of the passengers and crew aboard the ship. Cape Verde officials said an air ambulance would be provided for the most severely ill passengers as needed.
Cruise operator Oceanwide Expeditions said it was exploring options to sail the ship to other ports in the Canary Islands, such as Las Palmas or Tenerife. Spain, which controls those territories, said it had not received a request from the Dutch government for docking permission as of Monday afternoon.
Seventeen of the passengers aboard the Hondius are reportedly American citizens. One of them, travel blogger Jake Rosmarin, has been posting on Instagram about the tense situation aboard the ship.
“We’re not just headlines: we’re people with families, with lives, with people waiting for us at home. There is a lot of uncertainty, and that is the hardest part, ” he said in one emotional post.
The U.S. State Department said it is “monitoring” the Hondius situation and is “ready to provide consular assistance” to the Americans on board.