What we don’t know about the hantavirus outbreak as the cruise ship nears Spanish territory

THE HAGUE, Netherlands — Countries around the world are preparing to deal with the more than 140 passengers and crew aboard a hantavirus-stricken cruise ship en route to the Canary Islands.

The ship is expected to reach the Spanish island of Tenerife, off the coast of West Africa, early Sunday.

At least three passengers died and several other people were infected.

Hantavirus is usually spread by inhaling contaminated rodent droppings and is not easily transmitted between people. Some scientists believe the Andes virus involved in the cruise ship outbreak could, in rare cases, spread between people. But the World Health Organization says the risk the outbreak poses to the general public is low. Symptoms usually appear between one and eight weeks after exposure.

Authorities and the cruise operator have provided updates, but some key information is still missing.

Here’s what we don’t know:

Argentine investigators suspect a Dutch couple may have first contracted the virus on a bird-watching trip before boarding the cruise ship in Argentina on April 1. But no organization has confirmed where or how they contracted the disease.

Argentina’s Health Ministry has focused on the country’s southernmost city, Ushuaia. Officials plan to travel there in the coming days, according to a written statement to The Associated Press.

Spanish authorities are preparing to welcome the remaining passengers and crew members to Tenerife. Authorities said Friday that passengers would only be evacuated in small boats to buses once their repatriation flights were ready to take them.

The United States agreed to send a plane to the Canary Islands to collect its citizens, as did the British government. The U.S. passengers will be taken to a dedicated biocontainment and quarantine unit in Nebraska for evaluation, officials said Friday.

Other countries have not yet made their plans public and it is unclear how long boat passengers will have to wait for their flights.

Spain has requested medically equipped planes for passengers with symptoms, Virginia Barcones, head of the country’s emergency services, said Friday.

Cruise line Oceanwide Expeditions and Dutch officials said Thursday that more than two dozen people from at least 12 different countries left the ship on the remote South Atlantic island of St. Helena on April 24.

Among them, a Dutch woman who arrived with the body of her husband. He was the first passenger to die, but it was not until May 2 that health authorities first confirmed hantavirus in a passenger on the ship.

The delay left countries scrambling to track down passengers who had gotten off the ship about two weeks earlier.

Among the passengers was a resident of the remote island of Tristan da Cunha who was hospitalized with symptoms of hantavirus, according to the British Foreign Office.

Stephen Doughty, the British Overseas Territories Minister, said in a message to the British Overseas Territories that his thoughts were with “the islander currently in hospital and his spouse who is in isolation.”

Many passengers disembarking at St. Helena traveled to other countries, including the Dutch woman whose husband died on board. She flew to Johannesburg and then briefly boarded a plane preparing to fly to Amsterdam. She was deported because she was too ill to travel and later died.

South African and Dutch authorities are trying to locate anyone who came into contact with the woman during her trip. A flight attendant who had contact with her tested negative for hantavirus after reporting symptoms.

Some governments, such as the United Kingdom, have confirmed the whereabouts of their citizens who left the boat. However, British officials do not know or have not made public how many other people they have come into contact with since then.

In the United States, some state officials said they were monitoring a small number of residents who were on the ship and had already returned home. None show symptoms.