Seventeen Americans Flown Home From Hantavirus-Hit Cruise Ship

Seventeen American citizens who were aboard the Dutch cruise ship MV Hondius are on evacuation flights to the United States after an outbreak of Andes hantavirus that has killed three people, the Department of Health and Human Services said, according to NBC News. Two of the passengers are traveling in biocontainment units as a precaution; HHS said one has mild symptoms and the other tested mildly positive for the virus. The flights are headed to a specialized pathogen treatment center in Nebraska.

The World Health Organization’s latest outbreak notice, published May 8 and revised May 9, counts eight cases linked to the ship, six confirmed and two probable, with three deaths, a case fatality ratio of 38 percent. All six confirmed cases were Andes virus. WHO was notified on May 2. The agency’s working hypothesis is that the first patient, a man who boarded on April 1 and died aboard on April 11, was infected before boarding, most likely through exposure in Argentina. Evidence points to later person-to-person spread on the ship, it said.

Andes virus is unusual. Most hantaviruses pass to people who breathe in particles from rodent urine or droppings. Andes virus can also spread between people, though generally only through close, sustained contact. Daniel Pastula, a neurology and infectious diseases professor at the University of Colorado Anschutz Medical Campus, wrote in The Conversation, republished by PBS NewsHour, that person-to-person spread is a concern in close quarters like a small cruise ship and that the incubation period, one to eight weeks, means people can feel well when they board.

Pastula said there is no specific treatment; care is supportive. New World hantaviruses, which affect the lungs, are fatal in about 40 percent of cases, he wrote. Still, he and health officials stress that the public risk is low. WHO rates the risk to passengers and crew as moderate and to the global population as low, and it advises against travel or trade restrictions. Concerns it cited include the high fatality ratio, passengers’ average age of about 65 and the ship’s close quarters.

The ship left Argentina on April 1 with close to 150 passengers on a 33-day voyage, PBS reported. WHO said 147 people were aboard when it was notified and 34 had already left the vessel. Researchers are tracking 29 people who disembarked on April 24, before the outbreak was identified, and residents of three U.S. states are being monitored, Pastula wrote. WHO’s notice mentions stops at Saint Helena, Ascension Island, Tristan da Cunha and Cabo Verde, with the Canary Islands a planned disembarkation point.

Residents of Tenerife protested the arrival, NBC reported, and the WHO director-general addressed their concerns. NBC also reported that investigators suspect bird-watching in Tierra del Fuego, Argentina, may be linked to the outbreak; WHO’s notice refers to possible rodent exposure during bird-watching activities in the region.

For perspective, the United States recorded 890 hantavirus cases from 1993 through the end of 2023, Pastula noted.