Hantaviruses are a family of viruses that are usually carried and spread by rodents. People can become infected when exposed to the urine, feces, or saliva of infected animals or, more rarely, if they are bitten by an infected animal. One type of hantavirus, known as Andes virus, can be transmitted from person to person, although such cases are rare. The specific type of hantavirus involved in the cruise ship incidents has not yet been announced.
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Hantaviruses can cause two serious forms of infection: hantavirus pulmonary syndrome (HPS) and hemorrhagic fever with renal syndrome (HFRS). The first form can appear up to eight weeks after exposure to the virus; it begins with fever, chills, and fatigue and can progress to dangerous organ failure and respiratory problems. The second form usually manifests within two to four weeks and causes fever, headache, gastrointestinal symptoms, kidney dysfunction, and, in some cases, internal bleeding.
HPS is considered more deadly than HFRS, with a mortality rate of approximately 38% in patients who develop respiratory symptoms. The mortality rate of HFRS varies depending on the type of virus, ranging from 1% to 15%.
Treatments for hantavirus infections focus on treating symptoms, as there is no specific treatment that eliminates the virus.
So far, only one of the cases of illness linked to the cruise has been confirmed to be due to hantavirus infection, according to the company managing the trip, Oceanwide Expeditions. The company, which organizes exploration expeditions to polar and subantarctic regions, described the situation in statements it issued on May 3 and 4.
The affected vessel is the MV Hondius, which departed Ushuaia, Argentina, on April 1, carrying a total of 147 people, including 88 passengers and 59 crew members. After departure, it crossed the South Atlantic, making stops at the Antarctic continent, South Georgia, Nightingale Island, Tristan da Cunha, Saint Helena and Ascension Island. It is currently off Cape Verde. On April 6, a passenger developed fever, headache and mild diarrhoea and died at sea five days later from respiratory distress. The exact cause of death was not immediately determined and no laboratory tests were performed.
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On April 24, the deceased passenger and his wife, both Dutch nationals, disembarked in St. Helena to await repatriation to the Netherlands. At that time, the woman was experiencing gastrointestinal symptoms. The following day, she boarded a flight to Johannesburg, South Africa, but her condition deteriorated and she died on arrival at the emergency department on April 26. By May 4, laboratory tests had confirmed that the cause of her illness was hantavirus, according to the World Health Organization.
These two passengers had previously traveled to South America, including Argentina, before boarding the MV Hondius.
Meanwhile, on April 24, another passenger developed symptoms including fever, shortness of breath and signs of pneumonia. He was rushed from Ascension Island to South Africa for treatment as his condition deteriorated. The passenger, a British national, remains in an intensive care unit in Johannesburg and is in a “critical but stable condition.” Laboratory tests confirmed he has been infected with hantavirus.
Meanwhile, on the MV Hondius, another passenger died on May 2 after developing a fever on April 28 and her condition progressed to pneumonia before she died. Subsequently, three other people on the ship developed fever or gastrointestinal symptoms.
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Maria Van Kerkhove, acting director of the World Health Organization's pandemic preparedness and response, provided an update on the situation on May 4. She said the patient in intensive care is improving, and two people who have fallen ill on the ship are being prepared to be transported to the Netherlands for treatment. The third person who had symptoms is no longer showing any symptoms. Based on the available information about the case and what is known about hantaviruses, WHO assesses that the overall risk to the general public remains low.
