3 Dead in Cruise Ship Hantavirus Outbreak, but Public Health Risk Remains Low
Three people have died and several others have become sick on a Dutch cruise ship in what officials believe is a hantavirus outbreak. The MV Hondius, a cruise liner run by Oceanwide Expeditions, is currently anchored in waters near Praia, Cape Verde, a small group of islands off the coast of West Africa. Local officials have refused to let the ship dock because they fear the suspected outbreak could spread to land.
A married Dutch couple and a German national who were passengers on the ship have died. A British passenger was evacuated and is now receiving medical treatment in South Africa. That person was the first to receive a confirmed diagnosis of hantavirus infection.
According to the World Health Organization, seven cases of hantavirus have been identified so far. Two of those are confirmed laboratory cases, and five are suspected cases. At this point, two of the three deaths have been linked to hantavirus. The WHO is managing the outbreak and says the risk to the general public remains low.
Hantavirus infections in humans are rare. A recent high-profile case involved the death of Betsy Arakawa, wife of actor Gene Hackman, who was found dead in their New Mexico home in April 2024. Her death was blamed on hantavirus, while Hackman died of Alzheimer’s disease.
Although hantavirus infection is uncommon, it is often deadly. Early symptoms tend to be vague and flu-like. People usually catch the virus through contact with rodent urine or droppings. While one specific strain of the virus can spread from person to person, such cases are extremely rare.
Dr. Steven Bradfute, a professor at the University of New Mexico Health Sciences Center who studies hantavirus, said the situation on the cruise ship is unusual. He told Healthline that normally doctors see isolated cases, so hearing about multiple infections on one ship was unexpected.
Roughly 150 people, including passengers and crew from more than 20 countries, are still on board. The ship may head next to the islands of Las Palmas or Tenerife, farther north along the African coast, in hopes that passengers can leave the ship and get medical screening.
Oceanwide Expeditions released a statement on May 4 saying the company is working closely with local and international authorities. The statement says strict safety measures are in place on the ship, including isolation, hygiene rules, and medical monitoring. All passengers have been told what is happening and are receiving support. The company is also staying in close contact with those directly affected and their families.
The incubation period for hantavirus is 1 to 8 weeks after exposure. This long window may have made it harder for investigators to trace the outbreak and assess public health risks.
The MV Hondius, which sails under the Dutch flag, left Ushuaia in southern Argentina about three weeks ago on a long expedition cruise. Its route included stops in Antarctica, the Falkland Islands, and Cape Verde.
A 70-year-old Dutch man died on April 11 after developing fever, headache, and stomach pain. On April 24, his body was taken off the ship in Saint Helena, a British territory in the South Atlantic. His wife, a 69-year-old Dutch woman, also left the ship to accompany his body home. After leaving, she started showing signs of illness during her trip back. She later died at O. R. Tambo International Airport in South Africa while trying to return to the Netherlands.
On April 27, the same day the Dutch woman died, a British passenger on the MV Hondius became seriously ill after the ship left St. Helena. That passenger was moved to South Africa and treated in Johannesburg. The patient is in critical but stable condition. This was the first laboratory-confirmed hantavirus case linked to the outbreak.
The situation on the ship got worse. A German national died on May 2. Few details are available, and neither Oceanwide Expeditions nor the WHO has confirmed the cause of death.
Two crew members, one British and one Dutch, have also reported symptoms that could be hantavirus. One case is described as mild, the other as severe. Both reportedly need urgent medical care. No other passengers with symptoms have been found so far.
Bradfute said it is possible someone caught the infection in Argentina, got on the boat, and spread it to others. It is also possible that passengers caught the virus from rodents already on the ship. The specific strain that can spread person to person, called Andes Virus, is found in Argentina, where the cruise began.
Hantavirus is part of a group of related viruses that can cause serious illness in humans. It usually spreads through contact with urine, droppings, or saliva from wild rodents like mice and rats. The virus can also spread when people breathe in contaminated dust or particles stirred into the air, especially in closed or poorly ventilated spaces.
Symptoms vary by region and virus type. In North and South America, “New World” hantaviruses are most common. Early symptoms include fever, body aches, and vomiting. The illness can then progress to a severe respiratory disease called hantavirus pulmonary syndrome (HPS).
In early 2024, several deaths linked to HPS made news in the United States. Three people died in the rural area of Mammoth Lakes, California.
Dr. Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City, explained that in the United States, the main virus is Sin Nombre virus, the most common cause of HPS. He said exposure is typically linked to infected deer mice and to breathing in dust from rodent urine, droppings, saliva, or nesting material. Most U.S. cases happen in western states, especially west of the Mississippi River, though occasional cases occur elsewhere.
HPS affects the lungs, causing fluid buildup that makes breathing hard. As oxygen levels drop, other organs can start to fail. HPS is often deadly, with about 40% of infected people dying. Some estimates put the death rate as high as 50 to 60%.
Glatter said the early signs of HPS can be misleading. Patients usually start with a short period of fever, muscle aches, tiredness, headache, and sometimes stomach problems. The danger is that the illness can quickly turn into cough, shortness of breath, fluid in the lungs, shock, and rapid breathing failure.
Early warning signs of hantavirus may include low platelet counts, dehydration, high white blood cell counts, and mildly elevated liver enzymes.
“Old World” hantaviruses are found mainly in Europe and Asia. Unlike New World viruses, these can cause a different severe illness called hemorrhagic fever with renal syndrome (HFRS). HFRS can lead to internal bleeding, low blood pressure, and acute kidney failure. The death rate for HFRS ranges from less than 1% to about 15%, depending on the virus strain.
Glatter noted that severe Old World viruses like Hantaan and Dobrava can have much higher death rates than milder ones like Puumala or Seoul virus. New World HPS viruses in the Americas can have death rates in the 30 to 40% range, and sometimes higher in specific South American outbreaks.
There are no approved vaccines or treatments for HPS. Instead, doctors provide supportive care, mainly by supplying oxygen to the blood. In severe cases, patients may need to be connected to an ECMO machine, which pumps and oxygenates the blood outside the body.
Despite the scary reputation of hantavirus, Bradfute stressed that infection is both preventable and rare. He said panicking is not helpful, and noted that there have not been huge hantavirus outbreaks like flu or COVID because these viruses simply do not spread well. Glatter added that most hantaviruses do not spread from person to person, and CDC cruise guidance focuses mainly on stomach, respiratory, and death reporting, not hantavirus as a typical risk on ships.
Source: Healthline
