Hantavirus Suspected Aboard m/v Hondius Cruise Ship; One Lab-Confirmed Case, Five Suspected, Three Deaths

The World Health Organization says it is supporting and coordinating an international public health response to a suspected hantavirus outbreak on the Dutch-flagged cruise ship m/v Hondius in the Atlantic, with one lab-confirmed case, five suspected cases and three deaths linked to the event. WHO has stressed that the risk to the wider public “remains low” and that there is “no need for panic or travel restrictions.”

WHO said on May 3-4 that it was “aware of and supporting a public health event involving a cruise vessel sailing in the Atlantic Ocean,” not serving as the sole operational lead. Patient care, evacuations and port decisions are being handled by national authorities, the ship’s operator and affected countries. WHO said, “To date, one case of hantavirus infection has been laboratory confirmed, and there are five additional suspected cases. Of the six affected individuals, three have died and one is currently in intensive care in South Africa.” Director-General Tedros Adhanom Ghebreyesus said the agency “is facilitating medical evacuation of two symptomatic passengers, conducting a full risk assessment, and supporting affected people onboard.”

The vessel is the m/v Hondius, an expedition cruise ship operated by Oceanwide Expeditions. In a May 4 update, the company said it was “still dealing with a serious medical situation on board the m/v Hondius, which is currently off the coast of Cape Verde.” Oceanwide said there were 149 people on board.

The voyage departed Ushuaia, Argentina, in late March and was headed toward the Canary Islands by way of South Atlantic islands. As of Monday, Cape Verde authorities had boarded the ship and assessed patients but had not authorized disembarkation, Oceanwide said. The company said Dutch authorities were coordinating repatriation planning and that it was considering the Canary Islands as possible disembarkation points.

Oceanwide’s timeline shows the first passenger became ill on April 11 and later died. The body was removed at St Helena on April 24. That passenger’s wife became ill on April 27 and later died. Another passenger became seriously ill on April 27, was medically evacuated to Johannesburg and is now in intensive care. Oceanwide said a “variant of hantavirus” was identified in that patient. Another passenger died on May 2. As of May 4, two crew members remained on board with acute respiratory symptoms and required urgent medical care.

The operator cautioned that not all of the deaths have been definitively tied to the same outbreak. Oceanwide said it had not yet confirmed whether the first two deaths were connected to the current medical situation, and that the cause of the May 2 death had not yet been established.

South Africa’s National Institute for Communicable Diseases, the country’s public health laboratory and disease response agency, and the Department of Health said the evacuated patient in Johannesburg tested positive for hantavirus. They said contact tracing is underway in the Johannesburg area for possible exposure during the transfer.

Hantaviruses are rodent-borne viruses. In the Americas, they can cause hantavirus cardiopulmonary syndrome, a severe respiratory illness. Health authorities say sequencing and further laboratory work are ongoing. One reason that work matters is that Andes virus, found in parts of Argentina and Chile, is the hantavirus most associated with documented limited person-to-person transmission in past outbreaks. Investigators have not said this outbreak is Andes virus, but the ship’s departure from Ushuaia helps explain the focus on tracing and sequencing.

Tedros said “rapid, coordinated action is critical to contain risks and protect public health.” For now, WHO Europe’s public message is that the risk beyond those directly exposed remains low, with no travel restrictions recommended.