Human-to-human transmission is the suspected cause of a lethal hantavirus outbreak aboard an Atlantic cruise ship that has left three passengers dead and several others ill. The World Health Organisation (WHO) cautioned on Tuesday. While the virus typically jumps from rodents to humans, evidence suggests a rare instance of spread between individuals in close contact on the MV Hondius. This development follows a month-long voyage across remote islands, leaving the vessel stationary off the coast of Cape Verde as drone footage captures the isolated ship awaiting emergency medical evacuations.

World Health Organisation Issues Precautionary Warning

Dr Maria Van Kerkhove, WHO’s director for epidemic and pandemic preparedness and prevention, stated that officials cannot ignore the possibility of the virus jumping between people. “We do know that some of the cases had very close contact with each other and certainly human-to-human transmission can’t be ruled out, so as a precaution, this is what we are assuming,” Van Kerkhove told reporters. She clarified that the risk to the general public remains low. “The risk to the general public is low,” Van Kerkhove said. “This is not a virus that spreads like the flu or like COVID. It’s quite different.” She noted that suspected transmission would likely occur between very close contacts like married couples.

Fatality Toll and Current Cases

The outbreak has claimed the lives of a Dutch couple and a German national. Currently, seven cases have been identified, consisting of two confirmed and five suspected infections. A British national is receiving intensive care in South Africa, where his condition is reportedly improving. Two crew members, one British and one Dutch, are also exhibiting acute respiratory symptoms. The first suspected fatality occurred on April 11, when a 70-year-old Dutchman died on board after suffering fever, headache, abdominal pain, and diarrhoea. His 69-year-old wife later died at a hospital after collapsing at an airport. On May 2, a German national presenting with pneumonia died on board. A seventh person reported a mild fever but is now feeling well.

Emergency Medical Evacuations Underway

Two specialised aircraft are travelling to Cape Verde to evacuate the symptomatic crew members and a person “associated with” the deceased German passenger. These patients will be transported to the Netherlands for urgent treatment. “The plan is to medevac those two individuals. That's in the works; that's underway,” Van Kerkhove confirmed. Once these evacuations are complete, the vessel intends to sail toward the Canary Islands—either Gran Canaria or Tenerife—which will take three days. The ship is currently anchored off Praia after Cape Verde refused its request to dock.

Tracing the Source of Infection

The MV Hondius departed from Ushuaia, Argentina, on April 1, visiting Antarctica and remote locations including Tristan da Cunha and St. Helena. Health experts believe the initial infections likely occurred off the ship. “This was an expedition boat, and many people were doing birdwatching, things with wildlife,” Van Kerkhove noted. She added that rodents live in these remote areas and there “could be some source of infection on the islands as well.” While hantavirus is typically spread via rodent urine, faeces, or saliva, the Andes variant is known for limited person-to-person transmission. The WHO said passengers developed symptoms between April 6 and 28, including “fever, gastrointestinal symptoms, rapid progression to pneumonia, acute respiratory distress syndrome and shock.” The virus is highly lethal, with the CDC noting that approximately 38% of people who develop respiratory symptoms may die.

Life Under Quarantine Off Cape Verde

The ship remains anchored with 148 people on board, including 17 Americans. Passengers are following strict isolation protocols, medical monitoring, and social distancing. Travel vlogger Jake Rosmarin described the sombre mood on board via social media. “What’s happening right now is very real for all of us here. We’re not just a story. We’re not just headlines,” Rosmarin said. He later added, "All we want right now is to feel safe, to have clarity, and to get home." Rosmarin noted that "Oceanwide Expeditions and the crew have been doing everything within their ability to keep passengers safe, informed, and as comfortable as possible during this time."

Families Grieve Amid Global Response

The family of the deceased Dutch couple expressed their profound shock. “The beautiful journey they experienced together was abruptly and permanently cut short,” the family stated. 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.” The company confirmed the virus was identified in the female Dutch passenger who died on April 27. Additionally, a British national fell sick on April 27 after the ship left Saint Helena and was evacuated from Ascension Island.

Next Steps for the MV Hondius

The Spanish Health Ministry is preparing to send epidemiologists to assess the ship. A full disinfection and investigation will be conducted. Van Kerkhove emphasised that the WHO is monitoring the situation closely. “We have heard from people on the ship, we hear you, we know you are scared,” she said. The operator continues to manage the crisis under its "SHIELD response plan" while the international community conducts contact tracing for those on the flight to Johannesburg with the Dutchwoman.

The situation remains a complex logistical and medical challenge as authorities balance the urgent need for clinical intervention with the necessity of strict quarantine. As the MV Hondius prepares for its transit to Spanish waters, the focus shifts to the clinical outcomes of those in intensive care and the definitive viral sequencing results from the WHO. For the families involved and the passengers still isolated at sea, the priority remains a safe return to a shore that currently feels worlds away.