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The outbreak of this deadly disease has triggered an international public health response. Seven people out of 147 passengers and crew were reported sick and three people died in a situation that is still changing, WHOhead 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 that this patient is improving,” he said, while two patients still on 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 precautionary measure, passengers are asked to remain in their cabins while disinfection and other public health measures are carried out. A medical team from Cabo Verde provided support on board.
“The plan is, and our top priority is to medically evacuate these two people” to ensure that they receive the necessary treatment, he stressed.
No other patients showed symptoms on the plane. The third suspected case reported to have had a mild fever was “currently doing well”, WHO officials said.
Spanish Collaboration
The ship will continue its journey to the Canary Islands. Ahead of its arrival, Dr Van Kerkhove said that WHO was working closely with Spanish authorities who “have said that they will welcome the ship to carry out a full epidemiological investigation, full disinfection of the ship, and of course to assess the risk to the passengers”.
Hantaviruses are carried by rodents and can cause severe disease in humans. Thousands of infections are estimated to occur each year. People usually become infected through contact with infected rodents or through their urine, feces, or saliva.
Discussing the suspected origins of this outbreak, Dr Van Kerkhove said that the first patients, a husband and wife, boarded the ship in Argentina.
“With the incubation period for hantavirus being between one and six weeks, our assumption is that they contracted it from the ship,” he said. “This was an expedition ship…a lot of people on board were bird watching” and “saw a lot of different wildlife.”
The cruise stops at several islands off the coast of AfricaDr Van Kerkhove continued, some of them “have a lot of rodents”.
“There may be a source of infection on these islands as well for some other suspected cases,” he said. “However, we believe that there may be human-to-human transmission occurring between very close contacts” such as husbands and wives and other people sharing a cabin.
Lessons from past outbreaks
Human-to-human transmission of infection is rare, but limited spread has been reported among close contacts in previous outbreaks of Andean virus, which is part of the hantavirus group.
There is no specific treatment for hantavirus other than supportive care.
“Typically, people will experience respiratory symptoms, so respiratory support is very important,” said Dr Van Kerkhove, stressing that some people require mechanical ventilation. Intensive treatment may be necessary, especially if the patient’s condition worsens.
Directing his message to the people on the ship, representing more than 20 countries, the WHO official said: “We just want you to know that we are working closely with the ship operator” and with the travellers’ countries of origin.
“We hear you. We know you’re scaredhe said. “We try to make sure that the ship has as much information as they can…that you are looked after and of course, you get home safely.”
