The MV Hondius, with nearly 150 people on board, including a New Zealander, was expected to dock in Spain's Tenerife, in the Canary Islands off the coast of northwest Africa, within three days, Spain's health minister said on Wednesday, adding that those still on board were not presenting any symptoms of the disease.
Once in Tenerife, if they were still healthy, all non-Spanish citizens will be repatriated to their countries, Monica Garcia told a news conference in Madrid.
The 14 Spanish passengers will be quarantined in a military hospital in Madrid, she said. The duration of the quarantine will depend on when they potentially had contact with the virus, she said, adding that it has a 45-day incubation period.
Three people - a Dutch couple and a German national - have so far died in the outbreak.
A total of eight people - including a Swiss citizen who has returned home and is being treated in Zurich - are suspected to have contracted the virus, with three of them confirmed by laboratory testing, the World Health Organisation said.
Argentina's health ministry will carry out rodent trapping and analysis in the southern city of Ushuaia, the origin point of the cruise ship hit by the outbreak, it said in a statement.
Officials are reconstructing the itinerary of the Dutch citizens who travelled in Argentina and Chile and later presented symptoms of hantavirus on the cruise, the statement said.
No associated cases have been found in Argentina.
EVACUATIONS
South Africa confirmed that it had identified among the victims the Andean strain of the virus that can - in rare cases - spread among humans through very close contact.
"This is the only (hantavirus) strain that is known to cause human-to-human transmission, but such transmission is very rare and... only happens due to very close contact," South Africa's health ministry said.
Nevertheless, some Tenerife residents said they were worried about the ship docking there. "People are scared," said Margarita Maria, 62, adding that the boat should go elsewhere in Spain.
The Dutch Foreign Ministry said these people included a Dutch person, a German and a Briton and that they would be transported to specialised hospitals in Europe.
One of the aircraft transporting two patients from Cape Verde to Amsterdam was due to stop in Morocco to refuel, but Morocco refused to allow the aircraft to land, and the plane was instead refuelling at the airport in Gran Canaria, Spain's health ministry said.
While in Gran Canaria, the on-board doctor reported a problem with the patient’s life support system, and the patient is now connected to the airport's electrical supply, awaiting the arrival of a new aircraft to continue the journey, the ministry said.
Two of those evacuated presented acute symptoms, the ship's operator Oceanwide Expeditions said. The third person was closely linked to the German passenger who died on the ship on May 2. The Dutch ministry said that person was possibly infected with the virus.
The ship set off from the southern tip of Argentina on April 1 and travelled to some of the most remote places on earth, including the British island of Saint Helena.
The Dutch government said in a letter to parliament that around 40 people disembarked at Saint Helena, including the Swiss national who has since developed symptoms.
Cape Verde had been intended as the ship's final destination, but the archipelago nation off West Africa has not allowed the passengers to come ashore because of the outbreak.
Meanwhile, British health authorities said on Wednesday they had advised two people to self‑isolate after they had returned to Britain from the cruise.
The UK Health Security Agency also said that none of the British citizens onboard the Hondius had reported symptoms, but added they were being closely monitored.
People in at least three US states were being monitored for potential hantavirus infections, though none had shown signs of illness, the New York Times reported.
Georgia is monitoring two residents, while California is monitoring an undisclosed number of residents who had also been on the ship, the newspaper said. The Georgia and California departments of public health did not immediately respond to requests for comment.
The Arizona Department of Health Services said in an emailed statement to Reuters that it was monitoring one resident who was a passenger on the ship and that the individual was not symptomatic.
How the MV Hondius journey has developed
'VERY, VERY DIFFERENT TO COVID'
Since the start of the outbreak, the WHO has said the risk to the wider public from a virus usually transmitted by rodents is low and it stressed on Wednesday that this remained the case.
"So when we say close contact (for human-to-human transmission), we mean very close physical contact, whether it's sharing a bunk room or sharing a cabin, providing medical care, for example, (that is) very, very different to Covid and very different to influenza," Maria Van Kerkhove, WHO director of epidemic and pandemic management, told Reuters.
Van Kerkhove said the WHO was working with countries to follow up with passengers who left the boat at Saint Helena in the south Atlantic, before it reached Cape Verde.
South Africa has identified 65 people who have been in contact with people with confirmed or suspected hantavirus cases, and other countries have identified 12, the WHO's South Africa representative Shenaaz El-Halabi told Reuters.
'OUR DAYS HAVE BEEN CLOSE TO NORMAL'
It was billed as an Atlantic odyssey to some of the most remote islands in the world. Instead, the cruise was left stranded off Cape Verde with passengers in their cabins, medics in protective suits tending to the sick and the ship's operator seeking a safe port.
Passengers, some of whom have been aboard since March 20, have reported moods swinging between fear and boredom: empty lounges, quiet decks, hot drinks, face masks, medical checks, and the uncertainty of not knowing when and how their journey will end.
Passenger Kasem Hato told Reuters the ship's captain was keeping people updated and that those on board had been advised to limit close contact with other passengers and use hand sanitiser regularly.
"People are taking the situation seriously but without any panic, trying to keep social distancing and wearing masks to be safe," he said.
"Our days have been close to normal, just waiting for authorities to find a solution, but morale on the ship is high and we’re keeping ourselves busy with reading, watching movies, having hot drinks, and that kind of things."
Jake Rosmarin of the United States became one of the best-known faces on the ship after posting an emotional video from his cabin on Instagram fretting over the uncertainty passengers faced.
Later he struck a calmer note. “I’m feeling well, getting some fresh air, and continuing to be well fed and taken care of by the crew,” he said in a follow-up post.
Turkish YouTuber Ruhi Cenet, who departed the ship at Saint Helena on April 24, was more critical. He said after the first passenger died on April 11, passengers were told he was not infectious, so they continued socialising and taking meals together.
With quicker isolation measures "I think this problem could have been small before spreading too much," he told Reuters from Istanbul.
Oceanwide said in a statement on Wednesday that information relayed by the ship's captain was accurate at the time, and he had followed proper health and safety standards following a death at sea.
