Two cases of the deadly hantavirus have been confirmed, and five are suspected among people who fell ill on a cruise ship being held in the Atlantic near Cape Verde, the World Health Organization (WHO) says.
Among the seven cases, three people have died, one was critically ill and three have mild symptoms, the WHO said in a statement late on Monday.
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At least 147 passengers and crew are still stuck on the MV Hondius, which is carrying mostly British, American and Spanish passengers on a trip that set off from Argentina in March and is now off the coast of West Africa.
The three fatalities were a Dutch couple and a German national, officials said, and a British national was evacuated from the ship from Ascension and was being treated in South Africa.
The UN health body, however, reiterated its advice that the risk to the wider public is low for the virus, which only rarely passes between humans.
On Tuesday, the WHO said it was trying to trace people on a flight between the island of Saint Helena and Johannesburg taken by the Dutch woman who died of the hantavirus.
“Contact tracing for passengers on the flight has been initiated,” it said.
Despite the deadly outbreak, “the atmosphere on board MV Hondius remains calm, with passengers generally composed,” the ship’s operator, Oceanwide Expeditions, said in a statement late on Monday.
It said it was working on getting the passengers screened and disembarked and was considering sailing to Spain’s Las Palmas or Tenerife.
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The WHO said on Tuesday that Spain would “welcome” the ship, which would enable an investigation and assessment of the risk to the remaining passengers.
The WHO’s epidemic and pandemic preparedness and prevention director, Maria Van Kerkhove, told reporters the ship would head for the Canary Islands.
“We’re working with Spanish authorities who … have said that they will welcome the ship to do a full investigation, a full epidemiologic investigation, full disinfection of the ship and, of course, to assess the risk of the passengers that are actually on board.”
The operator also said Dutch authorities were preparing a medical evacuation of two symptomatic people on board along with a person associated with a guest who died on Saturday.
The first stricken passenger, the Dutch man, died on April 11 as the ship steamed towards Tristan da Cunha.
His body remained on board until April 24 when it “was disembarked on St Helena, with his wife accompanying the repatriation”, Oceanwide Expeditions said.
The health of his wife, who had gastrointestinal symptoms when she left the ship, later deteriorated during a flight to Johannesburg. She died upon arrival at an emergency department on April 26, the WHO said.
Another passenger, a Briton, became “seriously ill and was medically evacuated to South Africa”, the company said.
South African authorities have confirmed that the British patient who is being treated in a Johannesburg hospital tested positive for the hantavirus. The Netherlands has confirmed the virus in the Dutch woman who died.
Data from maritime analytics provider MarineTraffic shows the ship had been visiting some of the most remote places on Earth, including Tristan da Cunha, an island in the South Atlantic between Argentina and South Africa.
The hantavirus is largely transmitted through contact with the urine, faeces or saliva of infected rodents, according to the WHO. Symptoms include fever, gastrointestinal symptoms, a rapid progression to pneumonia, acute respiratory distress syndrome and shock.
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