That’s how the hantavirus spread on a cruise ship, according to health experts

A suspected hantavirus outbreak on a cruise ship in the Atlantic Ocean has raised questions about how the rare, often fatal disease could spread among passengers and crew, and whether it could continue to infect the 150 or so people now stranded on the ship after three have died.

Although it is usually transmitted to humans through contact with contaminated rodent waste, health officials say it is possible for human-to-human transmission, although it is very limited. That could partly explain what happened in this incident, said Maria Van Kerkhove, the World Health Organization’s director of epidemiology and pandemic preparedness and prevention.

“We believe that there is a possibility of person-to-person transmission that occurs between people who are very close, husband and wife, people who have shared bedrooms,” Van Kerkhove told reporters at a press conference on Tuesday, referring to the couple who died of suspected hantavirus cases after spending time on the MV Hondius, a Dutch cruise ship that was there. a focal point with an apparent breakout while charting a week long trip.

Investigations, isolation protocols and contact tracing efforts were underway in hopes of pinpointing the source of the suspected outbreak and stopping the spread, but how it might have happened was still unclear, the WHO said in a statement. At a news conference, Van Kerkhove suggested that the husband and wife may have contracted the virus while exploring wildlife in Argentina, before joining the cruise. He said the UN health organization often operates under the assumption that the virus came from outside the ship.

“Their trip stopped at many islands off the coast of Africa, and I saw a lot of wild animals on those islands. There are birds. Some islands have a lot of rats. Some don’t,” said Van Kerkhove. “Therefore, there may be a source of infection in the islands and other suspected cases.”

One known strain of hantavirus spreads among humans

Hantaviruses are a family of viruses that can cause severe respiratory symptoms, and even death, in people around the world, according to the US Centers for Disease Control and Prevention. People usually get the virus after coming into contact with airborne particles from feces, urine or saliva. But, as the WHO said in a statement about the latest outbreak, there have been reported cases of human-to-human transmission of the Andes virus, a type of hantavirus responsible for many cases of illness in South America.

“This ship came from Argentina, that’s why we wonder if it’s a normal type [of hantavirus]or is it the kind that can be spread from person to person?” said CBS News medical correspondent Dr. Céline Gounder on Tuesday.

The largest outbreak of the Andes strain was in Argentina in 2018, resulting in 34 cases and 11 deaths, Gounder said. But, person-to-person transmission requires “long-term contact,” he said, adding, “this is not an epidemic type of virus.”

He also emphasized that hantavirus remains rare, with fewer than 900 cases in 30 years in the US.

The cruise operator, Oceanwide Expeditions, said a 70-year-old Dutch man died on the ship on April 11. The man’s wife, 69, died about two weeks later in South Africa, after disembarking, officials said. According to the South African Ministry of Health, the wife’s blood was found to be positive for hantavirus. A British passenger who was flown from Hondius to South Africa on April 27 was also tested positive, authorities said, and health officials described him as critically ill.

There are at least four other suspected cases, Van Kerkhove said, including another fatal virus in a German passenger whose body was on board. At least three others were ill, according to Oceanwide Expeditions and Ann Lindstrand, the WHO representative in the African islands of Cape Verde. On Monday, Cape Verde sent medical teams to help the crew of Hondius but prevented the ship from entering its ports due to health problems.

Lindstrand told CBS News that officials strongly believe the three sick people have hantavirus and said they will all be flown out of Hondius by helicopter on Tuesday.

He admitted that the virus may have entered the ship and said that no rats were found on Hondius. The traps on the ship would show their signals if they were there, he said.

Lindstrand wanted to ease fears of cruise ships, which have rarely been linked to hantavirus despite being common sites for other types of outbreaks, such as norovirus. Asked how much of a threat hantavirus is, he said: “Not really.”

“we hear”

The ship was expected to head to Spain’s Canary Islands after the sick passengers were evacuated. Spain’s Ministry of Health told CBS News in a statement that its epidemiologists will inspect the ship Tuesday afternoon “to assess the condition of the people on board, see if there are many people with symptoms, and identify any high-risk or low-risk people,” “which will help inform decisions about repatriation procedures and the ship’s route.”

Passengers and crew may be kept on the boat for up to eight weeks, Lindstrand said, as the incubation period for the virus may not be that long. However, he admitted that such “stressful” circumstances may exist.

Another passenger, travel writer Jake Rosmarin, touched on that in an emotional social media video shared Monday, saying, “There’s a lot of uncertainty, and that’s the hardest part. What we want right now is to feel safe, clear and get home.”

Officials realized that the situation was frightening for those on board.

“We heard about a few people on the boat,” Van Kerkhove said at a press conference on Tuesday. “We just want you to know that we are working with the ship’s management. We are working with the countries you come from. We hear you. We know you are afraid.”