The World Health Organization (WHO) has indicated that there may have been rare human-to-human transmission of hantavirus on the MV Hondius cruise ship, where three passengers have died. The virus is typically spread from rodents, but in this case, the WHO noted that it could have spread among passengers with “really close contacts” aboard the vessel.

Cruise Ship Aboard for a Month

The MV Hondius set sail from Argentina on its voyage across the Atlantic Ocean approximately a month ago. It is currently anchored near Cape Verde, off Africa’s west coast. The ship’s operator, Oceanwide Expeditions, stated that two crew members—one British and one Dutch,are due to be medically evacuated by aircraft to the Netherlands after displaying acute respiratory symptoms. A person linked to a German national who died is also scheduled for evacuation.

Medical Teams Board the Ship

Medical teams from Cape Verde, supported by the WHO, have boarded the ship to assist with the suspected cases. According to WHO spokesperson Tarik Jasarevic, testing is underway for other passengers and crew members showing symptoms. Images from the cruise ship show workers in hazmat suits on a smaller vessel alongside the ship.

Some 149 people from 23 countries remain aboard under “strict precautionary measures,” Oceanwide Expeditions said. Aside from the crew member due to be evacuated, there are 22 other British nationals aboard the ship.

“We do believe that there may be some human-to-human transmission that is happening among the really close contacts,” WHO official Dr. Maria Van Kerkhove said. She added that the WHO suspects the first person to fall ill may have contracted the virus before boarding the ship.

Confirmed and Suspected Cases

According to the latest WHO update, seven cases of hantavirus have been identified—two confirmed and five suspected. The two confirmed cases are a Dutch woman who died and a 69-year-old UK national who was evacuated to South Africa for treatment. The woman’s husband also died but was not a confirmed case, nor was the German national who passed away on 2 May.

In a statement, the Dutch couple’s family said: “The beautiful journey they experienced together was abruptly and permanently cut short.” They added, “We are still unable to comprehend that we have lost them. We wish to bring them home and commemorate them in peace and privacy.”

Investigators are working under the assumption that the Andes strain of the virus, which is found in South America where the cruise began, is present in the two confirmed cases. Van Kerkhove noted that there were no rats on board and that disinfection was underway. Those with symptoms or caring for patients were wearing full personal protective equipment.

“Our working hypothesis is that there’s probably a couple of different types of transmission that might be happening,” Van Kerkhove told BBC Breakfast on Tuesday. She explained that the cruise had visited multiple islands, some of which have rodent populations, which typically spread the virus through their faeces, saliva, or urine.

The WHO said Spain has granted permission for the vessel to dock in the Canary Islands, where a risk assessment and further medical monitoring could take place. However, Spain’s health ministry has downplayed speculation that it will take in the ship.

In a statement, the ministry said, “Depending on epidemiological data gathered from the boat as it travels past Cape Verde, the most appropriate next stop for it will be decided. Until then, the health ministry will not take a decision, as we have explained to the WHO.” A spokesman for Spain’s health ministry told the BBC it had not yet received a request for the boat to stop at the Canaries but added that Spanish authorities are prepared to take charge of the situation if that changes. That would include providing medical attention, analysis, and disinfection. They would not say whether passengers would be allowed to disembark.

Though they cannot yet leave the ship, one passenger told the BBC on Monday that the mood on the vessel was “pretty good.” “Hopefully the other patients on board will be tested soon and then we’ll know what’s going on,” the passenger said, asking to remain anonymous. Another passenger, travel vlogger Jake Rosmarin, said in a social media post: “There’s a lot of uncertainty, and that’s the hardest part. All we want right now is to feel safe, to have clarity and to get home.”