The World Health Organization (WHO) believes human-to-human transmission of the hantavirus has occurred on a cruise ship in the Atlantic, WHO epidemiologist Maria Van Kerkhove told a press conference in Geneva on Tuesday.
Three passengers of the Hondius cruise ship - which is currently anchored off Cape Verde with around 150 passengers and crew on board - have died in the suspected outbreak.
The victims are an elderly Dutch couple and a German national. The WHO currently suspects a total of seven infections with the virus, with laboratory tests ongoing.
Earlier, the WHO posted on X: "Hantavirus infections are typically linked to environmental exposure (exposure to infected rodents' urine or faeces)." But Van Kerkhove said transmission between people was possible with the Andes variant suspected in the cases.
The WHO believes that the chain of infection began with the Dutch couple who could have become infected before boarding.
Van Kerkhove pointed out that many passengers on the liner had taken trips to watch wild animals and similar activities.
She suggested further infection could have taken place in confined spaces aboard the Hondius, but did not rule out infection from rodents on islands visited during the cruise.
Dutch operator Oceanwide Expeditions insisted there were no rats aboard the ship, which was sailing from Argentina to Cape Verde when passengers were taken ill.
The Netherlands are leading efforts to evacuate the remaining passengers and crew, as the cruise ship is sailing under the Dutch flag.
According to the Dutch Foreign Ministry, three people who have fallen ill, including a Dutch national, are to be evacuated from the Hondius and flown to the Netherlands "as soon as possible."
Dutch authorities are working closely with the shipping company and the Cape Verdean authorities and are also in contact with the passengers’ countries of origin, the ministry said.
According to the tour operator, two crew members require urgent medical assistance. Apart from the cases already reported, there are no new suspected cases.
Van Kerkhove said that discussions were under way with the Spanish authorities regarding the possibility for the ship to dock in the Canary Islands.
However, the Health Ministry Madrid denied this on X, saying the outcome of a planned medical screening of those on board would determine further decisions, including repatriation measures and the ship’s onward route.
Hantavirus can cause fever and severe respiratory illness in humans. Infection typically occurs through exposure to the urine, droppings or saliva of infected rodents. Human-to-human transmission is rare, according to the WHO.
People are usually infected by inhaling disturbed dust, for example when cleaning a dusty shed or attic, or through bites. An outbreak on a ship is unusual.
