Eighteen American passengers evacuated from the MV Hondius – the Dutch cruise ship at the center of a deadly international hantavirus outbreak – are now under medical supervision in specialized biocontainment facilities in the United States.
One passenger has tested positive for the virus, a second is experiencing symptoms and the remaining 16 are asymptomatic but are being closely monitored. Federal health officials emphasize that the risk to the general public remains extremely low.
How the Americans got home
The passengers disembarked from the MV Hondius in Tenerife, Spain’s Canary Islands, on May 10 and were repatriated via a U.S. State Department medical flight, which landed early Monday morning at Offutt Air Force Base in Omaha, Nebraska. Sixteen of the eighteen – including fifteen US citizens and one US and British citizen – were transported directly into the country. University of Nebraska Medical Center National Quarantine Unitthe nation’s main federal quarantine facility. The remaining two passengers, of which one couple showed symptoms, were transferred to the hospital Biocontainment Unit at Emory University Hospital in Atlanta.
Dr. Angela Hewlett, medical director of the Nebraska Biocontainment Unit, told CNN that the facility is used for patients who are healthy but need to be monitored, describing it as “more like a hotel than a patient care space.” She added that the unit – equipped as an intensive care unit – can care for patients ranging from healthy and stable to seriously ill, and that she is “strongly” encouraging all passengers to stay for the full monitoring period.
The virus: what makes this outbreak unusual
The responsible pathogen is the Andean hantavirusa species found mainly in South America and, crucially, the only known hantavirus that can be transmitted from human to human. All other hantavirus strains spread exclusively through contact with infected rodents or their feces. The European Center for Disease Prevention and Control confirmed on Tuesday it was reported that as of May 12, 11 cases have been reported worldwide – nine confirmed and two probable – and three deaths have been recorded.
The WHO’s working hypothesis is that the index case, the first passenger to become ill, most likely acquired the infection before boarding through environmental exposure during activities in Argentina. Current evidence points to subsequent human-to-human transmission on board, given the documented epidemiological links of some subsequent cases to the index case during his illness.
The mortality rate from hantavirus pulmonary syndrome is 30 to 40 percent, and there is no specific treatment or cure beyond supportive care, according to infectious disease specialist Dr. Krista Debbink. It can take four to 42 days for symptoms — including fever, myalgia, chills, gastrointestinal complaints and rapidly progressive respiratory failure — to appear after exposure, a period that makes monitoring all 150 passengers and crew from 23 countries a global public health undertaking.
The timeline of the outbreak
The MV Hondius departed Ushuaia, Argentina, on April 1 for a 33-day expedition voyage. The first passenger died on April 11. His body was brought ashore in St Helena on April 24, where his wife disembarked before dying two days later in a Johannesburg hospital. A third passenger also died on board. Hantavirus was not confirmed as the cause until May 2, when tests on a critically ill patient who had been evacuated to South Africa returned positive results. At that point, thirty passengers had already disembarked in St Helena – all of whom are now being contacted by the UK Health Security Agency.
The CDC classified the outbreak as a Level 3 emergency assistancethe highest level of activation, and deployed infectious disease experts to coordinate with international partners in monitoring guidance distributed to state and local health departments across the country.
What officials say
WHO Director-General Dr Tedros Adhanom Ghebreyesus said at a press conference on Sunday: “Based on scientific assessment and based on evidence, the risk to the public is low.” However, he warned that “given the long incubation period of the virus, it is possible we will see more cases in the coming week.”
Nebraska Governor Jim Pillen addressed residents directly, saying at a news conference on Monday, “We’re glad you’re here. We’re going to make sure you get the best possible, world-class care,” while adding, “No one poses a public health risk by simply walking out the front door onto the streets of Omaha.”
What travelers need to know
That’s according to the CDC routine trips can continue as usual and that the outbreak poses no meaningful risk to the American public. The Hantavirus does not spread in the conventional sense of the word and is not transmitted through casual contact. The Andean strain requires close, prolonged exposure to an infected individual.
Passengers or travelers who have been on board the MV Hondius since April 5 and develop symptoms – in particular fever, muscle pain, fatigue or breathing difficulties – should contact your local health department immediately and disclosing their travel history before seeking personalized care.
