The deadly disease outbreak has triggered an international public health response. Seven people out of 147 passengers and crew have fallen ill and three have died in what remains a fluid situation.Head 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 he is improving,” he said, while two patients still on board the ship, which is currently off the coast of Cape Verde, are preparing for a medical evacuation to the Netherlands for treatment.
Dr. Van Kerkhove stressed that the situation is being closely monitored. As a precautionary measure, passengers have been asked to remain in their cabins while disinfection and other public health measures are carried out. Medical teams from Cape Verde provide support on board the ship.
“The plan is, and our top priority is, to medically evacuate these two individuals” to ensure they receive the required care, he insisted.
There are no other symptomatic patients on board. A third suspected case who at one point reported a mild fever “is currently fine,” the WHO official said.
Spain cooperation
The ship will continue its journey to the Canary Islands. Ahead of its arrival, Dr. Van Kerkhove said the WHO is working with Spanish authorities, who “have said they will welcome the ship for a full epidemiological investigation, a full disinfection of the ship and, of course, assessing the risk to 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 their urine, droppings, or saliva.
Discussing the alleged origins of the outbreak, Dr Van Kerkhove said the initial patients, a husband and wife, boarded the ship in Argentina.
“Given the incubation period of hantavirus, which can be one to six weeks, we assume they were infected outside the ship,” he said. “This was an expedition ship…many of the people on board were birdwatching” and “seeing a lot of different wildlife.”
The cruise stopped at several islands off the coast of Africa.Dr. Van Kerkhove continued, some of which “have a lot of rodents.”
“There could be some source of infection on the islands as well for some of the other suspected cases,” he said. “However, we believe there may be some person-to-person transmission among really close contacts,” such as husband and wife and others who have shared cabins.
Lessons from past outbreaks
Transmission of infection between people is rare, but limited spread between close contacts has been reported in previous outbreaks of the Andes virus, which is part of the hantavirus group.
There are no specific treatments for hantavirus other than supportive care.
“Normally, people develop respiratory symptoms, so respiratory support is really important,” Dr. Van Kerkhove said, noting that some people need mechanical ventilation. Intensive care may be required, especially if the patients’ condition deteriorates.
Addressing her message to people aboard 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 ship operators” and with the travelers’ countries of origin.
“We hear you. We know you are afraid” he said. “We’re trying to make sure the ship has as much information as possible… that you’re taken care of and, of course, that you get home safely.”
