A French woman and an American have tested positive for the hantavirus as passengers from the cruise ship hit by a deadly outbreak have disembarked and are preparing to quarantine.
Passengers from the ship began flying home aboard military and government planes Sunday after the MV Hondius anchored in the Canary Islands. Personnel in full-body protective gear and breathing masks escorted the travellers from ship to shore in Tenerife, an effort that continued Monday.
The World Health Organization (WHO) recommended close monitoring of the former passengers and the many countries quarantining them.
The planes arriving in Tenerife were to fly out passengers from more than 20 countries in an evacuation effort that was due to wrap up on Monday.
Three people have died since the outbreak began and six people have been infected, WHO spokesperson Sarah Tyler told The Associated Press Monday. She said one person from the U.S. showed inconclusive lab results.
The ship’s captain, Jan Dobrogowski, issued a nearly three-minute video message Monday praising passengers and crew for their perseverance.
“I’ve decided to take this time to thank every single guest and crew member on board here as well as our colleagues back home,” Dobrogowski began. “The past few weeks have been extremely challenging to us all, as I’m sure you know. What moved me the most was your patience, discipline and also kindness that you showed to each other.”
The captain said he witnessed everyone’s “caring, unity and quiet strength” on the MV Hondius during the hantavirus outbreak.
“I must commend my crew for the courage and the selfless resolve that they showed time and again in the most difficult moments,” he said. “I could not imagine sailing through these circumstances with a better group of people, guests and crew alike.”
Dobrogowski said in a situation like the hantavirus outbreak, “every image and every word can be taken out of context,” which can be “very painful to the people on board.”
“As the captain of Hondius, my job is to lead my crew, take care of my guests and see the ship safely to port. Our responsibility does not end with our arrival in the Canaries. We’ve all been a part of this voyage and I wish nothing more to everybody, guests and crew alike, to be able to go home safely and in good health,” he added.
Dobrogowski asked for “privacy and respect to our guests and their families and the crew members during this difficult time.”
“We’ve sailed through this together across the sea and now we hope to see everybody safely at home,” he concluded his video message.
British Columbia’s top doctor said the four passengers returning home from the hantavirus-hit cruise ship remain in a “critical period” on Sunday, but stressed she would not call them “patients” as they are not considered infected.
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Dr. Bonnie Henry told reporters they will be monitoring the four passengers and ensuring they are cared for during the minimum isolation period of 21 days.
“We know as well the incubation period of this strain of the virus can be as long as six weeks, so we’re at actually a critical period,” she said. “We know the median incubation period is about 15 to 18 days, so we’re still in a period of time when we may see more cases arise.”
She added the four people had exposure to the virus but have shown no symptoms.
“So we treat them as contacts, we are hoping that none of them are infected and that none of them will develop disease,” she added.
Henry said that she does not expect the four Canadians to “be in contact with the public during this arrival process or during their isolation period.”
According to Henry, the 21-day isolation period goes back to the last potential contact with somebody who had the virus, which is believed to be May 6.
The French woman tested positive for hantavirus and her health worsened in the hospital overnight, French Health Minister Stephanie Rist said Monday.
The woman was among five French passengers repatriated on Sunday. She developed symptoms on the flight to Paris, Rist told public broadcaster France-Inter.
The four other French passengers from the ship tested negative, but will be retested, Rist added. Health authorities said they have so far identified 22 hantavirus contact cases in France, according to France 24.
One of 17 American passengers evacuated from the ship and flown to Nebraska also tested positive for hantavirus but is not showing any symptoms and another had mild symptoms, U.S. health officials said on Sunday.
The flight landed in the early hours of Monday morning and passengers were transferred to awaiting buses and driven away from the airport.
The American passengers will be taken to the University of Nebraska Medical Center, which has a quarantine facility, to assess whether they have been in close contact with any symptomatic people and their risk levels for spreading the virus.
“One passenger will be transported to the Nebraska Biocontainment Unit upon arrival, while other passengers will go to the National Quarantine Unit for assessment and monitoring. The passenger who is going to the Biocontainment Unit tested positive for the virus but does not have symptoms,” Kayla Thomas, a spokesperson for the Nebraska Medicine network, told The Associated Press.
Nebraska Medicine and the University of Nebraska Medical Center were asked by federal partners to receive and monitor U.S. citizens from the cruise ship.
“We are prepared for situations exactly like this,” said Michael Ash, MD, CEO of Nebraska Medicine. “Our teams have trained for decades alongside federal and state partners to make sure we can safely provide care while protecting our staff and the broader community. We are proud to support this national effort.”
John Lowe, director of the Global Center for Health Security, said that their role is to “provide a controlled, safe environment where people can be monitored and, if needed, cared for using the highest safety standards.”
“We work closely with national partners to ensure every step, from transport, to monitoring, to potential treatment, is handled with precision and care,” he added.
Ash said that the public should know that these facilities “were specifically designed to prevent exposure to the public.”
“There is no risk to the community from people being cared for in these units,” he added.
The WHO recommends a 42-day quarantine and “active monitoring” of high-risk contacts.
“Current evidence does not support routine laboratory testing of contacts for outbreak control (or public health response) or the quarantine of low-risk contacts,” the organization’s advice added. “Low-risk contacts should undertake passive self-monitoring and seek medical evaluation if symptoms occur. Recommendations are dynamic and will be adapted as more evidence emerges.”
Hantavirus usually spreads from rodent droppings and is not easily transmitted between people. But the Andes virus detected in the cruise ship outbreak may be able to spread between people in rare cases. Symptoms — which can include fever, chills and muscle aches — usually show between one and eight weeks after exposure.
WHO Director-General Tedros Adhanom Ghebreyesus said Sunday that the general public should not be worried about the outbreak.
“This is not another COVID. And the risk to the public is low. So they shouldn’t be scared, and they shouldn’t panic,” he added.
WHO is recommending that passengers’ home countries “have active monitoring and follow-up, which means daily health checks, either at home or in a specialized facility,” said Dr. Maria Van Kerkhove, the organization’s top epidemiologist.
When asked last week if the hantavirus outbreak is comparable to the “early days or weeks of the coronavirus pandemic,” Van Kerkhove said, “This is not coronavirus.”
“This is a very different virus. We know this virus. Hantavirus has been around for quite a while. There’s a lot of detail that we know,” she said on Thursday. “I want to be unequivocal here: this is not SARS-CoV-2. This is not the start of a COVID pandemic. This is an outbreak that we see on a ship.”
Van Kerkhove said the outbreak took place in a “confined area.”
“We have five confirmed cases so far. We completely understand why these questions are coming and we are trying to provide all of the information that we can,” she continued. “We’re grateful for all of those who are asking these types of questions but this is not the same situation we were in six years ago.”
Hantavirus doesn’t spread the same way as COVID-19, according to Van Kerkhove.
“Most hantaviruses don’t transmit between people at all. Most hantaviruses are transmitted from rodents or their feces or their saliva in their droppings to people. And only this one particular virus, the Andes virus, which has been identified here, we’ve seen some human-to-human transmission,” Van Kerkhove explained.
“There’s a lot that is being done right now to be able to minimize the risk even further,”Van Kerkhove added.
Those passengers in contact with or caring for suspected cases should “wear a higher level of personal protective equipment,” she added.
Van Kerkhove said the number of cases may rise as contact tracing continues, but the Andes hantavirus usually only spreads through close human-to-human contact.
“This is not COVID, this is not influenza; it spreads very, very differently,” she said.
The Andes strain is found in South America, primarily in Argentina and Chile, according to the WHO. To date, it is the only type of hantavirus in which human-to-human transmission has been confirmed, usually through close contact, such as by sharing a bed or sharing food, experts say.
Death rates vary based on which hantavirus causes the illness. Hantavirus pulmonary syndrome is fatal in about 35 per cent of people infected, while the death rate for hemorrhagic fever with renal syndrome varies from one per cent to 15 per cent of patients, according to the CDC.
Since 1989, there have been 109 confirmed cases and 27 deaths in Canada due to a hantavirus infection, the government of Canada reports.
—With files from Global News’ Sean Previl and The Associated Press