Health authorities have reassured the public not to panic following the deaths of three individuals associated with a rat virus outbreak on a cruise ship. The World Health Organization has advised against imposing travel restrictions despite the emergence of hantavirus, typically transmitted through rodent droppings, as experts investigate the source of infection. Among the deceased were a married couple, with a British man currently in critical condition in South Africa.
The outbreak occurred on the MV Hondius, en route from Argentina to Cape Verde, carrying 149 passengers and crew members. The British patient, aged 69, was airlifted to Johannesburg and is now in stable but critical condition, diagnosed with a variant of hantavirus by Oceanwide Expeditions.
Investigations are ongoing into the three fatalities, suspected to be linked to hantavirus, pending confirmation through laboratory tests. The first death took place on the ship on April 11, involving a 70-year-old Dutch man who was repatriated alongside his 69-year-old spouse, who later succumbed to illness. A third fatality, a German passenger, occurred on the vessel recently.
Dr. Michael Head, a senior research fellow at Southampton University specializing in global health, highlighted the unusual nature of hantavirus outbreaks on cruise ships, noting that person-to-person transmission of the virus is uncommon. He suggested that the Andes strain of the virus, prevalent in South America, may be responsible for this outbreak, with previous reports indicating the possibility of person-to-person transmission.
The cruise ship, measuring 353 feet and commissioned in 2019, appears to have been stationary off the coast of Cape Verde for over 24 hours. Oceanwide Expeditions confirmed that two crew members, one British and one Dutch, are currently experiencing acute respiratory symptoms, necessitating urgent medical attention. No other symptomatic individuals have been identified, with 23 British nationals on board, 19 of whom are passengers.
Hantavirus, transmitted by rodents and inhaled through dried droppings, can lead to severe illnesses such as Hantavirus Pulmonary Syndrome (HPS) and Haemorrhagic Fever with Renal Syndrome (HFRS). While HPS initially presents flu-like symptoms, its progression to respiratory issues can result in a high fatality rate. HFRS is more severe, affecting the kidneys and causing symptoms like low blood pressure, internal bleeding, and kidney failure.
Dr. Liam Brierley from the MRC-University of Glasgow Center for Virus Research emphasized that hantaviruses are primarily transmitted through inhaling aerosolized particles from rodent droppings. He noted that person-to-person transmission is extremely rare, typically occurring in specific circumstances with the Andes virus strain. Therefore, these cases likely stem from a single exposure point to rodents.
Dr. Hans Henri Kluge, WHO Europe’s regional director, expressed urgency in addressing the hantavirus incident on the cruise ship, emphasizing that infections are uncommon and linked to rodent exposure. He reassured the public that the risk of transmission between individuals is low, urging against panic or travel restrictions.
Treatment options for hantavirus are limited, with medical professionals focusing on symptom management and supportive care as the immune system combats the infection. Therapies may include oxygen support, antiviral medications, mechanical ventilation, and dialysis.
Dr. Charlotte Hammer, an Assistant Professor and infectious disease epidemiologist at Cambridge University, pointed out the possibility of rodents boarding the ship, potentially causing infections. She also highlighted the likelihood of infections occurring during the ship’s stop in Argentina due to the virus’s prolonged incubation period of up to eight weeks.
Prof. Paul Hunter, an infectious disease expert at the University of East Anglia, explained that hantavirus is typically transmitted from rodents to humans through airborne particles of feces and urine. While some evidence suggests person-to-person transmission, its occurrence remains uncertain, with minimal risk of an outbreak affecting the UK or other European regions.