Deadly hantavirus outbreak at sea: What we know about the deaths and new infections

Oceanwide Expeditions reports that it is continues to deal with "a serious medical situation" aboard polar‑expedition cruise ship MV Hondius which is currently anchored off the coast of Cape Verde. The operators added that 149 people remain in quarantine on board the ship, including 17 Americans.

The voyage set off on March 20 from the port terminal in Ushuaia — the southernmost city in Argentina — before charting a course toward Cape Verde, with the Canary Islands as its final destination.

Fatalities on cruise ship just weeks after setting sail

Six passengers on board the Class 6 Cruise Ship fell ill with suspected hantavirus infection - three of them have died and one is currently in intensive care, according to the World Health Organization.

The first victim, a 70-year-old Dutch national, died on board on April 11. The body was repatriated on April 24. Three days later, the 69-year-old wife of the deceased, also a Dutch national, started to feel unwell and subsequently passed away.

On April 27, a 69-year-old Briton, was medically evacuated to to Johannesburg, where he is currently being treated in intensive care.

On Saturday May, 2, a third passenger, a German national, also died. Oceanwide Expeditions’ latest update, issued on this afternoon, added that two crew members - one British, the other Dutch, both required urgent medical care after suffering “acute respiratory symptoms, one mild and one severe”.

The company reports that strict precautionary measures are in process on board Hondius, including isolation measures, hygiene protocols and medical monitoring.

For now, and until the results of autopsies are known, the only confirmed case of hantavirus is the passenger who is currently undergoing treatment in Johannesburg.

Preparations are underway for possible medical repatriation of the two crew members. One of the options being considered is for the cruise ship to sail to the port of Santa Cruz in the Canary Islands where passengers would disembark for medical screening.

What is hantavirus? What is the death rate in humans?

Hantaviruses infect lung cells and typically spread to humans who inhale particles from the urine, droppings, or saliva of infected rodents - rats, mice and voles being the usual carriers. The WHO notes that “hantavirus infections are usually linked to environmental exposure (contact with urine or feces from infected rodents). Although rare, hantavirus can spread between people and can cause severe respiratory illness requiring close monitoring, supportive care, and rapid response.”

In Europe, Germany and Finland report were hantavirus is most prevalent, accounting for over 60.5% of cases in the region in 2023 (0.4 cases per 100 000 population). A total of 890 cases of hantavirus disease have been reported in the United States since surveillance began in 1993.

In the United States, the Centers for Disease Control and Prevention estimate that hantavirus pulmonary syndrome (HPS) carries a mortality rate of roughly 40%. There are currently no approved treatments or vaccines for this zoonotic virus.

Hantavirus symptoms

Early symptoms often include fatigue, fever, and muscle aches. About a week later, many patients develop a cough and shortness of breath.

Historically, hantavirus strains in Europe and Asia have caused hemorrhagic fever with renal syndrome, while strains in the Americas have led to hantavirus cardiopulmonary syndrome — a severe and sometimes fatal respiratory illness.

While infections are rare, periodic spikes can occur due to ecological factors. In Europe, the most common “Old World” hantaviruses include:

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