The deadly disease outbreak has sparked an international public health response. Seven people of the 147 passengers and crew have been reported ill and three have died in what remains a fluid situationtold the WHO’s head of epidemic and pandemic preparedness and prevention, dr. Maria Van Kerkhove, to journalists in Geneva.
“One patient is in intensive care in South Africa, although we understand that this patient is recovering,” 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 emphasized 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 Cabo Verde provide support on board the ship.
“The plan is, and our highest priority is to medically evacuate these two individuals” 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 “doing well at the moment,” the WHO official said.
Spain cooperation
The ship is set to continue on to the Canary Islands. Before arriving, Dr. Van Kerkhove that the WHO is working with the 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”.
Hantavirus is carried by rodents and can cause serious illness in humans. Thousands of infections are estimated to occur each year. People usually become infected through contact with infected rodents or their urine, their excrement or their saliva.
Dr. Van Kerkhove discussed the supposed origin of the outbreak, said Dr. Van Kerkhove that the first patients, a husband and wife, boarded the boat in Argentina.
“With the timing of the incubation period for hantavirus, which can be anywhere from one to six weeks, our assumption is that they were infected from the ship,” she said. “This was an expedition boat … many of the people on board did bird watching” and “saw a lot of different wildlife.”
The cruise stopped at several islands off the coast of Africacontinued Dr. Van Kerkhove, some of which “have many rodents”.
“There may also be a source of infection on the islands for some of the other suspected cases,” she said. “However, we think there may be some human-to-human transmission among the really close contacts” such as the husband and wife and others who have shared cabins.
Previous breakout lessons
Human-to-human transmission is uncommon, but limited spread among 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.
“Typically, people will develop respiratory symptoms, so respiratory support is really important,” said Dr. Van Kerkhove and emphasized that some people require mechanical ventilation. Intensive care may be required, especially if the patient’s condition worsens.
Directing his message to the people on the boat, 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 countries of origin of the travelers.
“We hear you. We know you’re scared“, she said. “We’re trying to make sure the ship has as much information as they can … that you’re taken care of and, of course, that you get home safely.”
