Hantavirus Outbreak on Cruise Ship Leaves Three Dead, Three Ill

Key facts

• Three people died aboard the MV Hondius: two Dutch nationals and one German.
• Two crew members (British and Dutch) and one close contact are being evacuated from the ship.
• The ship has 88 passengers and 59 crew from 23 nationalities.
• Hantavirus causes hantavirus pulmonary syndrome (HPS) with a mortality rate of about 30%.
• Four Canadians are among those on board.
• The ship was traveling from Ushuaia, Argentina to the Cape Verde archipelago.
• WHO suspects initial infection occurred before boarding, with possible human-to-human transmission.

Ship Quarantined Off Cape Verde After Fatal Hantavirus Outbreak

A Dutch-flagged cruise ship, the MV Hondius, remains anchored near Praia, the capital of Cape Verde, after a hantavirus outbreak killed three people and left three others ill. The vessel, carrying 88 passengers and 59 crew members from 23 nationalities, has been immobilized since Sunday as health authorities work to contain the situation. The fatalities include a Dutch couple and a German woman, according to the World Health Organization (WHO). Two crew members—one British and one Dutch—are experiencing symptoms and require urgent medical care, while a third person who had close contact with a deceased passenger has developed a mild fever.

Evacuation Plan for Ill Crew Members

The two sick crew members and the close contact will be disembarked at the port of Praia in the coming hours, then transported by ambulance to the airport for evacuation to the Netherlands, said Ann Lindstrand, WHO representative in Cape Verde. The patients are in stable condition and do not require hospitalization, she added. The ship's operator, Oceanwide Expeditions, confirmed that the two crew members "currently require urgent medical care" and that the person close to the passenger who died on May 2 will also be evacuated. The company stated that no new symptomatic cases have been identified aboard.

Uncertain Destination After Evacuation

The ship's next port of call remains unclear. Oceanwide Expeditions said it plans to head to Gran Canaria or Tenerife in the Canary Islands, a three-day voyage. However, WHO indicated that discussions are ongoing among health authorities in Spain, the Netherlands, Cape Verde, and the WHO, and the ship might sail directly to the Netherlands. "The initial plan was for the boat to leave here for the Canary Islands and the port of Tenerife," Lindstrand said, "but it may perhaps go directly to the Netherlands."

Hantavirus: A Rare but Deadly Pathogen

Hantaviruses are a family of viruses carried by wild rodents, particularly rats and mice, which shed the virus in urine, saliva, and droppings. Humans become infected by inhaling dust or aerosols contaminated with these excretions, or more rarely through a bite or direct contact. The virus causes hantavirus pulmonary syndrome (HPS), a severe respiratory disease that can lead to rapid lung failure. "The virus is present in the urine, saliva, and feces of rodents. Humans can become infected by inhaling dust or aerosols from contaminated excretions," explained Dr. Donald Vinh, a microbiologist and infectious disease specialist at McGill University Health Centre. The mortality rate for HPS is about 30%, and there is no specific treatment or antiviral drug.

Possible Transmission Pathways Under Investigation

WHO officials suspect that the initial infections occurred before boarding, with subsequent human-to-human transmission. "One or more first cases were infected outside the ship by the virus, and then there was human-to-human transmission," said Maria Van Kerkhove, WHO director of epidemic and pandemic prevention and preparedness. However, she emphasized that close contact is required for transmission and the risk to the general public is low. Dr. Vinh noted that human-to-human transmission of hantavirus is extremely rare, with only the Andes virus in South America suspected of occasional person-to-person spread. "If you look at all the studies, it's not conclusive. We thought there were human-to-human transmissions, but it turned out to be outbreaks from a common animal source," he said.

Previous Hantavirus Outbreaks in Canada

in Quebec in the last 20 years, one in 2004 and another in 2016. Dr. Vinh diagnosed the 2016 outbreak, which involved three Canadian army members who had trained in Alberta and became severely ill upon returning to Quebec. All three survived after intensive care, including two who required intubation. In Canada, the Sin Nombre virus is the predominant strain, carried by white-footed mice in wooded areas where deer are present. Four Canadians are currently aboard the MV Hondius, though their status has not been disclosed.

Ongoing Investigation and Outlook

WHO has launched an investigation to determine the origin of the outbreak and the deaths. The agency is working with health authorities in Spain, the Netherlands, and Cape Verde to coordinate the ship's next steps. While the immediate focus is on evacuating the ill and ensuring the ship can resume its journey, the incident underscores the persistent threat of zoonotic diseases in travel settings. Dr. Vinh emphasized that early hospitalization during the flu-like initial phase can save lives through intensive care and mechanical ventilation. "If people present to the hospital in the initial phase, which resembles the flu but quickly degenerates into pulmonary syndrome, we can probably save them with intensive care and a respirator," he said.

The bottom line

• Hantavirus is a rodent-borne virus causing severe respiratory illness with a 30% mortality rate.
• The MV Hondius outbreak has killed three and sickened three others, with two crew members evacuated.
• Human-to-human transmission is rare but suspected in this case; WHO is investigating.
• No specific treatment exists; early intensive care is critical for survival.
• Four Canadians are aboard the ship, but their health status is unknown.
• The ship's final destination remains uncertain, with options including the Canary Islands or the Netherlands.