The deadly disease outbreak has triggered an international public health response. Seven people out of 147 passengers and crew were reported ill and three died in a situation that remains fluid.WHO Director of Epidemic and Pandemic Preparedness and Prevention Dr. Maria Van Kerkhove told reporters in Geneva.
“One patient is in intensive care in South Africa, although we understand his condition is improving,” she said, while two patients still on board the ship, which is currently off the coast of Cabo Verde, are being prepared for medical evacuation to the Netherlands for treatment.
Dr Van Kerkhove stressed that the situation was being closely monitored. As a precaution, passengers have been asked to remain in their cabins while disinfection and other public health measures are implemented. Medical teams from Cape Verde provide support on board the ship.
“The plan is, and our top priority is, to medically evacuate these two people” to ensure they receive the necessary care, she insisted.
There are no other symptomatic patients on board. A third suspected case, who reported a mild fever at one point, is “currently doing well”, the WHO official said.
Spanish cooperation
The ship is expected to continue its route towards the Canary Islands. Ahead of the arrival, Dr Van Kerkhove said the WHO was working with Spanish authorities who “said they would welcome the ship to do a full epidemiological investigation, a full disinfection of the ship and, of course, to assess the risk of the passengers”.
Hantaviruses are carried by rodents and can cause serious illness in humans. It is estimated that thousands of infections occur each year. People usually become infected through contact with infected rodents or through their urine, feces, or saliva.
Addressing the suspected origins of the outbreak, Dr Van Kerkhove said the first patients, a husband and wife, boarded the boat in Argentina.
“With the incubation period for hantaviruses, which can be anywhere from one to six weeks, our hypothesis is that they were infected off the ship,” she said. “It was an expedition ship…a lot of people on board were bird watching” and “seeing a lot of different wildlife.”
The cruise stopped at several islands off the coast of Africa.continued Dr Van Kerkhove, some of whom “have a lot of rodents”.
“There could also be a source of infection on the islands for some of the other suspected cases,” she said. “However, we believe there could be human-to-human transmission among very close contacts,” such as husband and wife and others sharing cabins.
Lessons from past epidemics
Transmission of infection between people is rare, but limited spread has been reported among close contacts in previous outbreaks of the Andes virus, which is part of the hantavirus group.
There is no specific treatment for hantavirus other than supportive care.
“In general, people develop respiratory symptoms, so respiratory support is very important,” said Dr. Van Kerkhove, emphasizing that some people need mechanical ventilation. Intensive care may be necessary, especially if patients’ condition deteriorates.
Addressing her message to those on board the ship, where more than 20 nationalities are represented, the WHO official said: “We just want you to know that we are working with the operators of the ship” and with the travelers’ countries of origin.
“We hear you. We know you’re scared“, she said. “We try to make sure that the ship has as much information as possible… that you are taken care of and of course, that you get home safely.”
