By Kara Fox, CNN
(CNN) — Health authorities across several countries are racing to trace and contain an outbreak of the hantavirus after the World Health Organization (WHO) said Thursday that five confirmed infections had been identified among people connected to the cruise ship MV Hondius.
Three people – a Dutch couple and a German national – have died since the vessel departed Argentina last month. The first suspected case was a 70-year-old Dutchman, who suddenly fell ill on the ship with a fever, headache, abdominal pain and diarrhea, South Africa’s Health Department told CNN. He died on board on April 11.
Meanwhile, a total of 146 people from 23 different countries – including 17 Americans – are still aboard the vessel under “strict precautionary measures,” operator Oceanwide Expeditions said Thursday.
While at least 30 passengers disembarked at the remote South Atlantic island of Saint Helena in late April and several critical cases were air-evacuated to Europe this week, those remaining passengers are scheduled to arrive in Spain’s Canary Islands this weekend before they are flown back to their respective home countries.
Spanish authorities said in their latest update that the ship will arrive in Tenerife around noon local time (7:00 a.m. ET) on Sunday.
Speaking to CNN from onboard the virus-stricken ship, Stephen Kornfeld – a physician who was holidaying on the cruise – described how he had to jump into action after the crew doctor fell ill. “Over 12 to 24 hours, it became clear that there were a number of people sick and that they were getting sicker. And I sort of fell into the role of becoming the ship doctor,” he told CNN’s Erin Burnett.
Dr Kornfeld, who has spent the past five weeks on the boat, said most passengers have had little to no contact with those displaying symptoms of infection. “People on the boat have been in quarantine and isolation for three, four weeks, so I’m feeling pretty good most people will get off the boat relatively rapidly,” he said.
The situation has captured international attention as some passengers had disembarked and dispersed across multiple countries before the outbreak was fully understood, prompting some to draw comparisons to the early days of the Covid-19 pandemic.
Oceanwide said Thursday that they were working to “establish details of all passengers and crew who embarked and disembarked on various stops of m/v Hondius since March 20,” amid concern for the global spread of the virus.
WHO said on Thursday that while it expects more cases to emerge, it does not anticipate a large epidemic anywhere similar to Covid, and underlined that there is no evidence of a widespread transmission risk.
The outbreak has been linked to the Andes strain of hantavirus, a rare but potentially severe virus that in some cases can spread between humans through close contact.
It’s not yet clear how the outbreak occurred. But WHO is working on the assumption that the Dutch couple who died were infected off the ship, possibly while sightseeing in Argentina before joining the cruise.
The first two cases “traveled through Argentina, Chile and Uruguay on a bird-watching trip which included visits to sites where the species of rat known to carry the virus was present,” Ghebreyesus told reporters Thursday.
As the Hantavirus typically incubates for one to six weeks before patients start presenting symptoms, it is likely they fell ill some time after they were infected, according to health officials.
Argentina is now reconstructing the route taken by the Dutch couple before they boarded the MV Hondius in Ushuaia on April 1, in an effort to determine the source of infections.
The country’s health ministry said that, so far, no cases related to the cruise ship outbreak have been identified in Argentina. It also said that no cases of the hantavirus had been recorded in Ushuaia in recent decades.
However, the virus is endemic in some areas of the country and Argentine authorities have found the couple, after arriving in Argentina on November 27, crossed back and forth over the border with neighboring Chile on several occasions before joining the cruise.
On January 31, the couple re-entered Argentina from Chile through the province of Neuquén, in the Sur region, and also visited Misiones in northeastern Argentina. Both places have in the past been identified by the WHO as areas where hantavirus is endemic.
On March 13, the pair left Argentina for Uruguay by land, before returning on March 27 to travel to Ushuaia, where the cruise departed on April 1.
The ministry said technical teams will travel to Ushuaia to trap and test rodents in areas linked to the couple’s route as part of the investigation.
Argentina, which announced last year that it would withdraw from the WHO, will send biological material and laboratory reagents to Spain, Senegal, South Africa, the Netherlands and the United Kingdom to support the diagnosis and study of the cases.
WHO said in a post to social media that it is “working with relevant countries to support international contact tracing, to ensure that those potentially exposed are monitored and that any further disease spread is limited.”
Here’s what we know about some of the countries where cruise ship passengers are either being treated for hantavirus or monitored for potential infection.
This story has been updated with additional developments.
CNN’s Pau Mosquera, Brenda Goodman, Vasco Cotovio, Marlon Sorto, Lauren Kent, Caitlin Danaher, Niamh Kennedy, Max Feliu and Gonzalo Zegarra contributed reporting.
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