A person in a hazmat suit is escorted to an ambulance from a medical aircraft thought to be carrying some of the passengers from the cruise ship MV Hondius, at Amsterdam’s Schipol airport on Wednesday. Photograph: Lina Selg/AFP/Getty ImagesA person in a hazmat suit is escorted to an ambulance from a medical aircraft thought to be carrying some of the passengers from the cruise ship MV Hondius, at Amsterdam’s Schipol airport on Wednesday. Photograph: Lina Selg/AFP/Getty ImagesExplainerWhere did the cruise ship hantavirus come from and what happens next?As the remaining passengers head for the Canary Islands we look at how the virus spreads and what is being done
The cruise ship hit with a deadly outbreak of hantavirus is on its way to the Canary Islands, where the remaining passengers are expected to be repatriated provided they have no symptoms. Here we look at the investigation into the outbreak and what comes next.
When did the outbreak start?
The first passengers onboard the Dutch-flagged MV Hondius, a cruise ship sailing from Argentina to Cape Verde, fell ill in early April, with symptoms ranging from fever, gastrointestinal problems, pneumonia, acute respiratory distress syndrome and shock. Three people have died since 11 April, including a Dutch couple and a German woman, whose body remains on the ship. As of Thursday there are eight suspected cases, three confirmed as hantavirus by lab tests.
Three people with suspected hantavirus, including 56-year-old Martin Anstee, a retired British policeman who worked on the ship as an expedition guide, have been evacuated and are receiving medical care in the Netherlands. Another Briton is in hospital in South Africa. Another person was diagnosed after disembarking and returning to Switzerland, the European Centre for Disease Prevention and Control said.
Two Britons who left the ship at Saint Helena in late April have returned to the UK and are self-isolating. Neither have reported any symptoms. Close contacts of those on 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. The viruses can spread to humans, typically through inhalation of droplets or dust contaminated with urine, faeces or saliva from infected animals. In people, hantavirus infection can cause life-threatening illness. The old world strains, found in Europe and Asia, tend to cause haemorrhagic fever with renal syndrome (HFRS), a kidney disease that is fatal in about 10% of cases. The new world strains, found in the Americas, are more virulent, causing hantavirus pulmonary syndrome (HPS), which can kill more than a third of those infected.
Can it spread between people?
Most hantaviruses do not spread between people, but there have been cases of the Andes strain spreading from person to person. Lab tests have identified that strain as the cause of the outbreak on the MV Hondius. The virus is endemic to Argentina, where its host is the long-tailed pygmy rice rat. Infections are most likely through close and 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 spread hantavirus to 34 others, 11 of whom died.
Where did the virus on MV Hondius come from?
This is the big question. As part of the investigation, public health officials are compiling travel histories for all of the passengers prior to boarding, about 140 of whom are still on the ship. One line of inquiry is that two passengers caught the virus on a birdwatching expedition in Argentina before joining the cruise.
What happens next?
The MV Hondius is bound for the Canary Islands and is expected to arrive in Tenerife this weekend. Once docked, the 19 British nationals thought still to be onboard will be repatriated on a flight chartered by the UK Foreign Office, if they are symptom-free. All are being closely monitored. On returning to the UK they will be asked to self-isolate for 45 days, reflecting the long incubation period of hantavirus. Most symptoms develop in one to six weeks, but in extreme cases it can take eight weeks.
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