Where did the cruise ship hantavirus come from and what happens next? | Hantavirus
The cruise ship hit by a deadly hantavirus outbreak is en route to the Canary Islands, where remaining passengers are expected to be repatriated provided they show no symptoms. Here we look at the investigation into the outbreak and what comes next.
When did the epidemic start?
The first passengers fell ill aboard the Dutch-flagged MV Hondius, a cruise ship from Argentina to Cape Verde, in April, with symptoms including fever, gastrointestinal problems, pneumonia, acute respiratory distress syndrome and shock. Three people have died since April 11, including a Dutch couple and a German woman. As of Thursday, there were eight suspected cases, including five confirmed as hantavirus through laboratory testing.
Where are those who have the virus?
The body of the Dutchman who died on board was removed from the ship to Saint Helena. He has not been tested for the virus. His wife then fell ill and deteriorated on a flight to Johannesburg. She died on arrival at the hospital. Tests confirmed she had the virus. Authorities are now tracking down the people she came into contact with along the way. The body of the deceased German woman is still on board.
A man who presented to the ship’s doctor with symptoms was evacuated from Ascension to South Africa, where he is in intensive care but his condition appears to be improving. He also tested positive for the virus.
Another man who landed in Saint Helena had returned to Switzerland, but consulted a doctor in Zurich after developing symptoms. He has now been admitted and tested positive for hantavirus.
Three other cases were evacuated to the Netherlands for treatment. One was a Dutch crew member, the other a German who flew to Düsseldorf. Martin Anstee, a 56-year-old retired British police officer who worked on the ship as an expedition guide, is hospitalized in Leiden.
On Thursday, a woman in Amsterdam, believed to be a flight attendant who came into contact with the woman who died in South Africa, showed possible symptoms.
Two Britons who jumped ship on St Helena at the end of April have returned to the UK and are self-isolating. Neither reported any symptoms. Close contacts of people on board the boat are also self-isolating.
What is hantavirus?
Hantaviruses are a large group of viruses that circulate in rodents such as mice and rats. Distinct strains are found in different parts of the world. Viruses can spread to humans, usually through inhalation of droplets or dust contaminated with urine, feces, or saliva from infected animals. In humans, hantavirus infection can cause life-threatening illness. Old strains, present in Europe and Asia, tend to cause hemorrhagic fever with renal syndrome (HFRS), a fatal kidney disease in about 10% of cases. The new global strains, found in the Americas, are more virulent, causing hantavirus pulmonary syndrome (HPS), which can kill more than a third of those infected.
Can this spread between people?
Most hantaviruses do not spread between people, but there have been cases where the Andes strain has spread from person to person. Laboratory tests identified this strain as the cause of the outbreak on the MV Hondius. The virus is endemic in Argentina, where its host is the long-tailed pygmy rice rat. Infections are more likely to occur during close, prolonged contact with someone in the early stages of the disease. In a previous outbreak in Argentina, in 2018-19, three people who came into contact with infected rodents transmitted hantavirus to 34 other people, 11 of whom died.
Do we know more about the strain?
Three laboratories in South Africa, Switzerland and Senegal are working to read the entire genome of the virus. This will be compared to the genetic makeup of previous hantaviruses that have caused outbreaks, including the 2018-2019 cases in Argentina. Anaïs Legand, the World Health Organization’s technical lead on viral hemorrhagic fevers, said: “This will let us know if we are seeing any changes. »
Maria van Kerkhove, infectious disease epidemiologist at WHO, said: “Based on the information we have so far, and they are still doing the sequencing, we haven’t seen anything unusual, but that’s why we’re bringing together the best minds, to be able to do this. »
Where does the MV Hondius virus come from?
That’s the big question. As part of the investigation, public health officials are compiling the travel history of all passengers before boarding, about 140 of whom are still on the ship. On Thursday, Dr. Tedros Adhanom Ghebreyesus, head of the World Health Organization, said the Dutch couple, who were the first two cases, had traveled through Argentina, Chile and Uruguay on a bird-watching trip “that included visits to sites where the rat species known to carry the virus was present.”
What happens next?
The MV Hondius is bound for the Canary Islands and is expected to arrive in Tenerife this weekend. Once at the dock, the 19 British nationals who are still on board will be repatriated on a flight chartered by the British Foreign Office, if they do not show any symptoms. All are closely monitored. When they return to the UK, they will be asked to self-isolate for 45 days, reflecting the long incubation period of hantavirus. Most symptoms appear within one to six weeks.
What is the risk to the public?
Given the long incubation period, more cases could occur among crew, passengers and contacts of infected people who left the ship. But the UK Health Security Agency and WHO have stressed the risk to the general public is low. “It’s not Covid, it’s not the flu; it spreads very, very differently,” Kerkhove said.
