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A deadly outbreak of the rare hantavirus unfolded over the course of weeks on a cruise ship that sailed from Argentina toward Antarctica and then across the Atlantic Ocean.
It stopped at or near remote islands on the way, as passengers and crew members fell sick, according to information from the cruise operator, the World Health Organization and ship tracking data.
Nearly a month passed between when an elderly Dutch man fell sick and died in the South Atlantic and when laboratory tests in South Africa — more than 3,500 kilometres away — first confirmed hantavirus infections.
Three passengers have died, one is in intensive care in a South African hospital and three others were evacuated from the ship on Wednesday. Another man who left the ship earlier in the voyage tested positive in Switzerland.
At a news briefing on Thursday, the WHO said that five of the eight suspected cases of hantavirus have now been confirmed.
Hantavirus usually spreads by inhaling contaminated rodent droppings and can spread person to person, though it is rare, according to the WHO.
The wider public health threat from the outbreak remained low, WHO Director-General Tedros Adhanom Ghebreyesus said, adding that the WHO was aware of reports of other patients and that there may be more cases due to the virus’s long incubation period.
Here’s a timeline on what we know has unfolded since the ship set sail last month.
April 1: Ship sets sail
The MV Hondius set off from southern Argentina on April 1.
On April 6, the 70-year-old Dutch man fell ill with fever, headache and diarrhea, WHO said.
April 11: Man dies after falling ill
The man died on board on April 11, after developing respiratory distress. The ship was between the British island territories of South Georgia and St. Helena in the middle of the South Atlantic, according to data from the ship tracking website MarineTraffic. The cause of death could not be determined, according to Oceanwide Expeditions.
The ship sailed on for nearly two weeks, stopping near the island of Tristan da Cunha before reaching St. Helena, where the Dutch man’s body was removed on April 24. His 69-year-old wife disembarked.
April 26: Wife dies in hospital after disembarking
The woman, who already had symptoms, became sicker during an April 25 flight to South Africa and collapsed at an airport there. She died at a hospital on April 26, WHO said.
The patient in Switzerland also disembarked in St. Helena, according to Swiss authorities, though his movements after that are not clear.
Another passenger, a British man, became sick on the ship after it left St. Helena and sailed to tiny Ascension Island, some 1,300 kilometres north. He had a high fever, shortness of breath and signs of pneumonia, according to WHO, and was evacuated from Ascension Island to South Africa on April 27. He is in intensive care in South Africa.
May 2: A 3rd death, first positive hantavirus result
The third fatality, a German woman, died on the ship on May 2, again after it had set sail for a new destination — this time the West African island nation of Cape Verde. She died four days after falling ill and also had signs of pneumonia, WHO said, which can be caused by hantavirus. Her body is still on the ship.
Health officials in South Africa tested the British man in intensive care for hantavirus after tests for other ailments were negative. They received a positive result for hantavirus on May 2, 21 days after the first passenger died.
May 3: WHO investigates suspected outbreak on ship
On Sunday, WHO announced it was investigating a suspected hantavirus outbreak on the ship, which had by that time reached Cape Verde waters.
The British man’s positive test prompted South African health authorities to test the Dutch woman’s body. That test came back positive on May 4.
Swiss authorities announced the positive test on the man there on May 6.
Contact tracing was underway.
World Health Organization director-general Tedros Adhanom Ghebreyesus said Thursday his organization will work alongside a cruise ship operator and governments after cases of hantavirus were reported among passengers. Medical teams, he said, will take care of patients and work to ‘prevent onward spread of the virus.’
After waiting off Cape Verde for three days, the ship headed to the Canary Islands, where Spain said it would accept it. People on board are from Britain, the United States, Spain, Netherlands, Germany and more than a dozen other countries.
More than 140 passengers and crew members were still on the Hondius as it departed Cape Verde for Spain’s Canary Islands.
Passengers and crew have been isolated in cabins with “physical distancing,” WHO said, in a lockdown reminiscent of the COVID-19 pandemic.
May 7: 5 of 8 suspected cases confirmed
As of May 7, five of the eight suspected cases of hantavirus have been confirmed, WHO said.
