The cruise ship MV Hondius, which has attracted worldwide attention due to a suspected outbreak of person-to-person hantavirus infections, is now en route to dock. Following a request from Tedros Adhanom Ghebreyesus, the World Health Organization’s director-general, Spain has allowed the ship to dock near Tenerife in the Canary Islands, with its arrival expected on Sunday.
This marks the first occasion where hantavirus transmission is suspected on a cruise ship, and the situation is developing. Given the lengthy incubation period of hantaviruses, it may take weeks to resolve, with potential months before scientists determine the virus’s origin on the ship and whether subsequent cases resulted from human contact or involvement of rodents known to carry hantaviruses.
The WHO held a press conference on Thursday to address the situation. Here are five main points:
Plans to Disembark Remaining Passengers and Crew
Currently, there are no ill individuals onboard the ship, according to Maria Van Kerkhove, a senior WHO official. Three people, including the ship’s doctor, who fell ill, have been evacuated to the Netherlands.
Efforts are being made to evaluate the health status of the remaining approximately 145 passengers and crew from 23 countries to determine their likelihood of exposure to known cases. The WHO and the passengers’ home countries are collaborating on safe disembarkation and repatriation plans.
“We are coordinating with all nations whose citizens are on the ship to ensure a safe return,” Van Kerkhove stated, who is the acting director of epidemic and pandemic management. Tedros noted the stress faced by those on the ship, mentioning his conversation with the ship’s captain, who reported an improvement in morale since the ship resumed its journey.
Evidence Suggests Outbreak Started Pre-Voyage
The initial hypothesis is that the first two cases—a couple who boarded in Argentina—were infected before the cruise began. Since hantavirus symptoms can take up to six weeks to appear, it is plausible the couple contracted the virus earlier.
Tedros revealed the couple had been on a bird-watching trip through Chile, Uruguay, and Argentina, visiting areas known to have rats carrying the Andes virus, which is responsible for this outbreak. The WHO is collaborating with Argentina to better understand the couple’s movements before boarding.
U.S. and Argentina’s Involvement Despite WHO Withdrawal
Though the U.S. and Argentina have communicated their withdrawal from the WHO, both nations are actively participating in efforts to trace the outbreak’s source and repatriate those aboard the ship. “The collaboration with U.S. institutions is progressing well with transparent information sharing,” noted Abdi Mahamud, director of WHO’s health emergency alert and response operations.
Information exchanges are being facilitated through the International Health Regulations treaty, which aims to manage cross-border disease outbreaks. Anaïs Legand, WHO’s lead on viral hemorrhagic fevers, praised the collaboration with the CDC. Tedros expressed hope that the U.S. and Argentina might reconsider their withdrawal, emphasizing that “viruses don’t respect borders or politics; our best defense is solidarity.”
No New Disease Dynamics Detected
The Andes virus has rarely been known to spread from person to person, with the largest outbreak occurring in Epuyén, Argentina, in 2018-2019. Although the current outbreak is still being investigated, experts believe the novel aspect is its occurrence on a cruise ship.
“There’s no evidence of anything unusual beyond the ship setting with its diverse nationalities,” said Legand. Mahamud noted that the ship’s confined space resembles conditions from previous outbreaks, such as the one in Epuyén initiated at a crowded event. Legand added that labs in South Africa, Switzerland, and Senegal are sequencing the virus to uncover any changes or insights into transmission.
Ongoing Emergence of Suspected Cases
Reports of potential cases continue to surface globally, such as a flight attendant exposed to a confirmed case and a Swiss man from the ship who disembarked before the outbreak’s discovery. With the ship’s varied international stops and passengers, many could have been exposed. Potential contacts are advised to monitor for symptoms, which can mimic other respiratory illnesses, for several weeks. Some cases may be confirmed, while many may not, but public health’s role is to investigate all possibilities, explained Van Kerkhove.
