A cruise ship is waiting for help after a suspected outbreak of rare hantavirus onboard killed 3

CAPE TOWN, South Africa — CAPE TOWN, South Africa (AP) — A Dutch cruise ship with nearly 150 people on board, including 17 Americans, was waiting for help off the coast of Cape Verde in the Atlantic Ocean on Monday after a suspected outbreak of the rare hantavirus killed three passengers and left at least three others seriously ill, the World Health Organization and the ship’s operator said.

The MV Hondius, which was on a week-long polar cruise from Argentina to Antarctica and then several remote islands in the South Atlantic, had requested help from local health authorities on Sunday after heading to the island of Cape Verde off the coast of West Africa, but no one has yet been allowed to disembark, the company operating the cruise said.

There are 88 passengers on board – including one deceased – and 61 crew members, two of whom are sick, the operator said on Monday. The passengers include 17 Americans, 19 British and 13 Spanish, among other nationalities.

The three deceased passengers came from the Netherlands and Germany. The German remains on board. A British man is in intensive care in South Africa.

A 70-year-old Dutch man who presented with fever, headache, abdominal pain and diarrhea was the first victim and died on board on April 11, the ship’s Netherlands-based operator, Oceanwide Expeditions, said in a statement giving new details. His body was removed from the ship almost two weeks later on the British territory of St Helena, some 1,200 miles (1,900 kilometers) from the African coast, and was awaiting repatriation.

His wife, aged 69, was transferred to South Africa at the same time, but collapsed at a Johannesburg airport and died in a nearby hospital, the South African health ministry said.

The ship then sailed to Ascension Island, another isolated Atlantic outpost about 800 miles (1,300 kilometers) to the north, where a sick Briton was removed from the ship and evacuated to South Africa on April 27. He later tested positive for hantavirus, a rare infection transmitted by rodents that can cause serious respiratory illness or hemorrhagic fever, South Africa’s health ministry said.

He is in critical condition and is currently in intensive care at a South African hospital, where he is being kept in isolation, authorities said.

A third passenger died on board on Saturday and was identified as a German national. The body is still on the ship, the cruise line said. He said the three deaths have not yet been confirmed to be due to hantavirus, as the only person confirmed to have the virus is the man in intensive care in South Africa.

The WHO said that while only one case of hantavirus was confirmed through testing, the other five cases were suspected to be hantavirus.

Two crew members still on board the Hondius – a Briton and a Dutchman – need urgent medical treatment, Oceanwide said, adding that it was still waiting on Monday for permission from local authorities in Cape Verde to evacuate passengers and crew. The company said it was considering settling on one of the Spanish islands of Las Palmas or Tenerife if it was unable to get passengers off the ship in Cape Verde.

Oceanwide said it was dealing with a “serious medical situation” on the ship and that “strict precautionary measures were underway on board, including isolation measures.” He said no other people on board had symptoms.

The World Health Organization said Sunday it was working with local authorities and the ship’s operators to conduct a “comprehensive public health risk assessment” and was trying to coordinate the evacuation of the two patients from the ship.

“Detailed investigations are underway, including additional laboratory tests and epidemiological investigations,” WHO said. “Medical care and support is being provided to passengers and crew. Sequencing of the virus is also underway.”

The Dutch Foreign Ministry said it was also exploring options to evacuate some people from the ship.

Hantaviruses, found throughout the world, are a family of viruses that are spread primarily through contact with the urine or feces of infected rodents such as rats and mice. They gained attention after the late actor Gene Hackman’s wife, Betsy Arakawa, died of a hantavirus infection in New Mexico last year.

Hackman died about a week later at their home of heart disease.

In rare cases, hantavirus infections can spread between people, the WHO said. There is no specific treatment or cure, but early medical attention can increase the chances of survival.

Hantaviruses cause two serious syndromes, according to the U.S. Centers for Disease Control and Prevention: hantavirus pulmonary syndrome, affecting the lungs, and hemorrhagic fever with renal syndrome, affecting the kidneys.

The CDC says lung disease is more commonly seen in hantavirus infections in the Americas.

“Although serious in some cases, it is not easily transmitted between people,” Dr. Hans Henri P. Kluge, WHO regional director for Europe, said Monday. “The risk to the general public remains low. There is no need to panic or restrict travel.”

South Africa’s health ministry said the ship left Ushuaia, in southern Argentina, on a cruise that included visits to Antarctica, the Falkland Islands, South Georgia and other remote South Atlantic islands.

Although Oceanwide Expeditions did not specify exactly which cruise the ship was on, it advertises on its website 33- or 43-night “Atlantic Odyssey” cruises on the 107-meter (351-foot-long) Hondius that follow this route, with passengers having the opportunity to visit Antarctica and some of the world’s most remote islands.

The Hondius has 80 cabins and a capacity of 170 passengers, the company said. He typically travels with about 70 crew members, including a doctor, he said.

Although there is no information from authorities on the possible source of the suspected outbreak, a previous hantavirus outbreak in southern Argentina in 2019 killed at least nine people. That prompted a judge to order dozens of residents in an isolated town to stay home for 30 days to stop the spread.

Meanwhile, the South African National Institute for Communicable Diseases was carrying out contact tracing in the Johannesburg area to identify whether other people in South Africa had been exposed to infected cruise ship passengers. The deceased woman, aged 69, was trying to board a flight back to the Netherlands at Johannesburg’s main international airport, considered the busiest in Africa, when she collapsed.

“There is no need for (the) public to panic,” South Africa’s health department said, adding that WHO was “coordinating a multi-country response with all affected islands and countries to contain the spread of the disease.”

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AP writer Mike Corder in The Hague, Netherlands, contributed.