Two cruise passengers have tested positive for hantavirus after being evacuated home from the Canary Islands, following assurances that no one on the vessel had any symptoms.
The US Department of Health and Human Services confirmed on Sunday that one of the 17 repatriated Americans had tested mildly positive for the Andes strain of the lethal rat-borne disease, while a second had shown mild symptoms.
A French passenger who was evacuated from the MV Hondius also tested positive for the illness after she developed symptoms while on a chartered flight from Tenerife to Paris.
Her condition is deteriorating, French Health Minister Stephanie Rist said on Monday, adding that her condition in hospital worsened overnight.
Spain insisted it took ‘all measures’ to prevent hantavirus spreading from evacuees on the cruise ship hit by the virus who left the Canary Islands.
‘From the start, all the measures adopted have aimed at cutting the possible chains of transmission… all measures for prevention and control of transmission have been applied,’ the Spanish health ministry said in a statement.
Spain, the World Health Organisation (WHO), and the cruise company Oceanwide Expeditions had previously insisted none of the more than 140 people who were then on the Hondius had shown symptoms of the virus.
In the UK, 20 Britons have arrived at Arrowe Park Hospital in Merseyside where they will begin 45 days of self-isolation, after landing in Manchester on a chartered Titan Airways flight from Tenerife.
The bus carrying the British passengers and crew being repatriated from the MV Hondius makes its way to Arrowe Park Hospital on May 10, in Birkenhead, England
A British National, repatriated after a prolonged stay on the cruise ship, arrives by coach at Arrowe Park Hospital in Wirral, where passengers are expected to stay for up to 72 hours
A drone view of Arrowe Park Hospital, where the evacuated passengers will self-isolate, and that was used for the UK’s first Covid cases in January 2020
More than 90 of the passengers and crew of the Hondius were sent home on Sunday, while the last 24 guests still on board the ship are set to be evacuated on Monday afternoon.
All of the passengers were escorted Sunday from the ship to shore by personnel in full-body protective gear and breathing masks.
On Monday, the 17 American nationals arrived at the University of Nebraska Medical Centre – which has a federally funded quarantine facility – where medics will assess whether they have been in close contact with any symptomatic people and their risk levels for spreading the virus.
One of the American passengers tested positive for the hantavirus but is not showing any symptoms, while another has minor symptoms.
‘One passenger will be transported to the Nebraska Biocontainment Unit upon arrival, while other passengers will go to the National Quarantine Unit for assessment and monitoring,’ said Kayla Thomas, a spokesperson for the Nebraska Medicine hospital that will help care for the passengers.
‘The passenger who is going to the Biocontainment Unit tested positive for the virus but does not have symptoms,’ she added.
The medical school also has a special unit for treating people with highly infectious diseases that was used early in the pandemic for Covid-19 patients and previously for Ebola patients.
WHO recommended close monitoring of the former passengers, and many countries quarantined them.
The 20 Britons will spend 72 hours at Arrowe Park Hospital before being asked to self-isolate for a further 42 days at home.
Strict infection control measures were in place throughout the journey to the hospital, with passengers, crew, drivers and medical teams all wearing PPE.
Some of the passengers waved to cameras as they were transported from the ship to the airport at Granadilla Port in Tenerife, and they could be seen again in facemasks and blue gowns on the coach arriving at the hospital near Liverpool.
One German national, who is a UK resident, and a Japanese passenger are also being monitored there.
The Arrowe Park site, close to the village of Upton, was used to house British citizens returning from Wuhan, China, at the start of the Covid-19 pandemic six years ago.
A man waves as British passengers disembark from the MV Hondius and head by coach to the airport at Granadilla Port in Tenerife
Three people have died since the outbreak began – a Dutch couple and a German national – and five people who left the ship earlier were infected.
A British national who was previously hospitalised with hantavirus in South Africa after falling ill on the cruise is ‘clinically improving’, a health ministry spokesperson said.
‘The British patient is clinically improving but still ill,’ the spokesperson Foster Mohale told Reuters. ‘This means his condition is improving, gradually so.’
The man was medically evacuated to South Africa on April 27 after presenting with a fever, shortness of breath and signs of pneumonia.
He disembarked from the hantavirus-hit cruise ship at Ascension Island in the Atlantic Ocean.
A second British man with a confirmed case of the virus is receiving treatment in the Netherlands, while a third is being treated for a suspected case on the remote Atlantic island of Tristan da Cunha, where the ship stopped in mid-April.
WHO Director-General Tedros Adhanom Ghebreyesus has stressed that the general public should not be worried about the outbreak, insisting: ‘This is not another Covid. And the risk to the public is low. So they shouldn’t be scared, and they shouldn’t panic.’
Hantavirus usually spreads from rodent droppings and is not easily transmitted between people, but the Andes virus detected in the cruise ship outbreak may be able to spread between people in rare cases.
Symptoms usually show between one and eight weeks after exposure.
WHO is recommending that passengers’ home countries ‘have active monitoring and follow-up, which means daily health checks, either at home or in a specialized facility,’ said Maria van Kerkhove, the organisation’s top epidemiologist.
Numerous countries have said their people will be quarantined or hospitalised for observation.
Australia is sending a plane, expected to arrive Monday, to evacuate its people and those from nearby countries, such as New Zealand, and unspecified Asian countries, Spanish Health Minister Mónica García said, who added that the evacuation flight was expected to be the last to leave Tenerife.
Dutch Foreign Minister Tom Berendsen said a second Dutch flight Monday would bring back more passengers from the Netherlands and other nations.
Berendsen said the evacuation operation ‘is based on concern for the passengers. But also concern for public health, and we try to do that in the best way’.
The cruise set sail from Ushuaia in Argentina on April 1, destined for Cape Verde, and counted 88 passengers and 59 crew members, with 23 nationalities onboard.
The Argentine government’s leading hypothesis is that the Dutch couple who later died contracted the virus during a birdwatching outing at a garbage dump in Ushuaia, a town known as ‘the end of the world’.
The first two cases ‘travelled through Argentina, Chile and Uruguay on a birdwatching trip which included visits to sites where the species of rat known to carry the virus was present,’ WHO said.
Around 40 per cent of hantavirus cases result in death, according to the US Centers for Disease Control.
Early symptoms can include fatigue, fever, muscle aches and intense headaches.
They are not usually spread person-to-person and are typically only transferred via bodily fluids and close contact.
