Health officials in at least a dozen countries, including the U.S., are tracking dozens of passengers who traveled aboard the cruise ship at the center of a deadly hantavirus outbreak.
Those passengers have since dispersed across the world and are in five states as of Thursday afternoon: Arizona, California, Georgia, Texas, and Virginia.
Despite the widening international response, World Health Organization officials say the outbreak is not the start of a new pandemic or epidemic. “While this is a serious incident, WHO assesses the public health risk as low,” WHO Director General Tedros Adhanom Ghebreyesus said in a statement Thursday.
Weeks after the first death on April 11, 29 passengers disembarked on the remote Atlantic island St. Helena without undergoing contact tracing, cruise operator Oceanwide Expeditions said in a statement. The dead person was also removed from the vessel.
The company said it was “working to establish” the whereabouts of all those who disembarked April 24 in St. Helena and had contacted all of them. It said the number included six Americans.
Three people aboard the luxury cruise have died. There are five confirmed cases and three suspected infections, according to the WHO.
One person who was on board the MV Hondius is at home in Arizona, another is in Virginia, two are in Georgia, and an unknown number are back in California, according to authorities in those states. None have reported symptoms of the rare virus, which has an incubation period of up to six weeks. Officials say the risk to the public remains low.
The outbreak is believed to have started following a birdwatching expedition from Argentina to Cape Verde.
According to the company, 114 guests were aboard the ship on April 1 following departure from Ushuaia, Argentina. On April 15, six additional guests joined at Tristan da Cunha, between Ushuaia and St. Helena, bringing the total to 120. At this time, the deceased passenger is included in the tally.
The passengers who left the boat comprise 12 nationalities; the home countries of two people are unknown.
Dutch officials said Thursday that a hospitalized flight attendant who was not a passenger was being tested for hantavirus in the Netherlands. “I can confirm that a stewardess is in the hospital now and she is being tested for the virus,” a spokesperson for the Dutch Health Ministry told NBC News. The department did not say whether she was ill or showing symptoms of the virus, which is rare but potentially deadly.
KLM Royal Dutch Airlines said Wednesday that a Dutch woman who died after she contracted hantavirus was “briefly” on a flight from Johannesburg, South Africa, to Amsterdam and was removed from the plane before takeoff.
It is not clear whether the flight attendant was on the same flight. KLM said in a statement it does not comment on individual cases “for privacy reasons.”
WHO and national health officials have said person-to-person transmission is possible through close personal contact, such as between couples.
Dr. Martin Kriz, who has worked on the MV Hondius and its sister ship, said self-isolating aboard a small cruise of that size is nearly impossible because of sharing of spaces like lounges and dining rooms. “You can’t do much if you’re far from land,” Kriz told “NBC Nightly News” Tom Llamas. “You do what you can do.”
Cruise ships typically follow a three-tiered protocol for handling infectious outbreaks, he added. The first involves passengers’ wearing masks, and the highest level calls for passengers to isolate.
Hantavirus is typically contracted through contact with rodents. The WHO confirmed this week that the outbreak is the Andes strain of the virus, which, unlike other strains, can spread between people through close personal contact.
Health experts have said even that strain is not as easily transmitted as airborne diseases such as influenza or Covid-19.
A travel vlogger aboard the vessel recorded a video of the captain telling passengers that the ship was “not infectious” after having announced the first death. He told NBC News that passengers were “not well informed” about the unfolding situation.
Those who remain on the MV Hondius are being asked to stay in their cabins, the WHO said. Cabins are being disinfected, and anyone who shows symptoms will be isolated.
So far, the people still on the vessel have not shown any symptoms.
The ship is heading north from Cape Verde, off the western coast of Africa, to the Spanish-controlled Canary Islands. The journey is expected to last three to four days, though the leader of the islands’ regional government is reluctant to accept the ship.
Travel blogger Jake Rosmarin, who is on the MV Hondius, said on his TikTok account that everyone on the ship “is doing well and remains in good spirits.”
Spain’s Interior Ministry said that the ship was expected to arrive Sunday and that evacuations would begin Monday, “if all goes well.”
Virginia Barcones, the secretary general of civil protection and emergencies at the Interior Ministry, said at a news conference Thursday that the U.S. will send an aircraft to pick up the 17 American passengers still aboard the ship.
The Centers for Disease Control and Prevention said Wednesday night that it and the State Department were closely monitoring the status of Americans on the ship.
“The Department of State is leading a coordinated, whole-of-government response including direct contact with passengers, diplomatic coordination, and engagement with domestic and international health authorities,” the statement said.
The CDC added that the “risk to the American public is extremely low.”
The three people who have died are a Dutch couple and a German national. A British man is being treated in a hospital in South Africa.
It emerged Wednesday that a man who had left the ship was being treated in Zurich with suspected hantavirus.
Three patients were transported from the MV Hondius on Wednesday for medical treatment in the Netherlands and Germany as health officials shift their focus to locating and monitoring the dozens of people who left the ship along its voyage.
Hantavirus infection in humans is extremely rare and has never been previously recorded on a cruise ship. CDC data shows there were 890 confirmed cases in the U.S. from 1993 to 2023.
Argentine authorities said that a rodent-trapping program would take place in the city of Ushuaia, where the MV Hondius began its journey, and that they would conduct 2,500 diagnostic tests to identify the outbreak’s origin.
