Hantavirus is likely to be transmitted from person to person on a cruise ship, says the WHO

The World Health Organization said on Tuesday it believed there had been a rare human-to-human transmission of the hantavirus on a cruise ship in the middle of this diseasethree people have died after falling ill.

“We believe that there may be some person-to-person transmission that occurs between people who are really close [on board],” Maria Van Kerkhove, WHO epidemiologist, said at a press conference on Tuesday. “Husband and wife, people sharing rooms, etc. So, again, our assumption is that it has happened.”

The ship, with nearly 150 people on board, was waiting for help off the coast of Cape Verde in the Atlantic Ocean after the African island refused to dock at the airport due to public health concerns. However, the Spanish government said on Tuesday the ship could sail to the Canary Islands for a “full investigation” and “complete disinfection.”

In addition to the three dead – two of whom died on the boat and the third died shortly after disembarking – there are four other suspected cases of the virus, one of whom is a British national who was removed from the boat and is now in intensive care in South Africa, according to the WHO.

Hantavirus is usually spread by contact with rodents, but the WHO said it believed the virus had been transmitted from another person on the stricken ship, where passengers were told to stay in their cabins as much as possible. The search for the people who were traveling on the plane with the 69-year-old passenger has also begun.

A Dutch woman, whose husband died on a boat two weeks ago, got off the boat with “abdominal symptoms” on April 24 and died two days later, after her condition “worsened on the flight to Johannesburg,” the WHO said. “Communication tracing of passengers on the plane has been initiated,” it added.

Van Kerkhove, director of epidemiology and preparedness and prevention of the WHO, told reporters on Tuesday that the Spanish authorities “said they will receive the ship to do a full investigation, a full investigation of the epidemic, the complete disinfection of the ship and …

Spain’s Ministry of Health told CBS News that its pathologists will examine the ship Tuesday afternoon.

“This intervention aims to assess the condition of the people on board, to find out if there are many people with symptoms, and to identify any people who are at high or low risk,” said the Ministry in a statement. “This will help inform decisions about repatriation procedures and ship routing.”

The WHO said on Tuesday that the current plan is to evacuate the two sick passengers to the Netherlands, and then the ship continues to Spain’s Canary Islands.

The passengers face eight weeks of solitary confinement

Ann Lindstrand, the WHO representative in Cape Verde, told CBS News’ Ramy Inocencio on Tuesday that there is no risk of a pandemic threat with hantavirus, given the low chance of person-to-person transmission.

He confirmed that three people would be flown to the Netherlands sometime on Tuesday, adding that the condition of the patients was “reassuring,” adding that they were recovering and stable, as they had been attended by medical teams from Cabo Verde on board the ship in the past few days.

He said the Spanish and Dutch authorities are “discussing a lot” what will happen next to the passengers on board.

“If there is a need for quarantine, that will be the decision of the health authorities in Spain or Holland at that time, in close cooperation with WHO advice,” Lindstrand said.

Quarantine, if necessary, can be for two months, since the incubation period for hantavirus is between one and eight weeks, he added, “eight weeks is the longest period of quarantine.” Lindstrand said she was in contact with a volunteer doctor on board who told her passengers they were “really fine,” though they were anxious to know their next port of call.

The MV Hondius, a Dutch ship on a week-long voyage from Argentina to Antarctica and several remote islands in the South Atlantic, requested help from local health authorities after heading to Cape Verde, off the West African coast. But no one is allowed to disembark, said Netherlands-based operator Oceanwide Expeditions.

Cape Verde’s Ministry of Health said on Monday it would not allow the ship to dock at the airport due to public health concerns, adding that it would remain in open waters near the coast.

Hantavirus is a rodent-borne disease that is spread by contact with rodents or their urine, saliva or feces. The WHO said that although it is rare, the Andes strain of hantavirus can spread between people. When people contract the virus, it has a fatality rate of up to 50%.

It is not clear how the outbreak started, and the WHO said it was investigating while working to coordinate the evacuation of the two sick members. Another sick person – a British man who fled to South Africa on April 27 – tested positive for the virus and is in critical condition, authorities said.

The body of one of the dead passengers, a German national, is still on board, according to a statement from Oceanwide Expeditions. A 70-year-old Dutch man died on the ship on April 11, and his wife, 69, died later in South Africa after leaving the ship, officials said. His blood was later found to be infected, said South Africa’s health minister.

Of the remaining 87 passengers, 17 are American, 19 are from the UK and 13 are from Spain, according to Oceanwide Expeditions. Sixty-one crew members were also on board.

A detailed investigation is ongoing

The WHO said it was working with local authorities and Oceanwide on a “comprehensive assessment of the public health risk.”

“Detailed investigations are ongoing, including laboratory tests, and epidemiological investigations,” the WHO said. “Passengers and crew are being provided with medical assistance and support.”

Lindstrand told the AP that there may have been a new case on the ship, in a person showing mild flu-like symptoms, that health workers are still investigating.

The ship left Ushuaia in southern Argentina on April 1, according to Argentine provincial authorities. Health officials there confirmed that none of the passengers had symptoms of hantavirus when the Hondius departed.

But because symptoms can appear eight weeks after exposure, “passengers may have contracted the disease if they found it in the country or elsewhere in the world,” Juan Facundo Petrina, director of epidemiology in Tierra del Fuego state, told AP in an interview from Ushuaia.

He mentioned that the province had never seen hantavirus cases, but diseases have broken out in other provinces of Argentina, leading to the death of 28 people across the country last year, according to the Ministry of Health.

Oceanwide Expeditions is advertising a 33-night or 43-night “Atlantic Odyssey” cruise aboard the ship.

It has 80 cabins, holds 170 passengers, and usually carries a crew of about 70, including a doctor, the company said.