Human-to-human transmission of hantavirus suspected by cruise ship but low public risk, says WHO

*Seven cases have been confirmed or suspected, three people have died

*Cape Verde does not allow the ship to dock

* Authorities working on evacuation plans

* Person-to-person transmission is rare

* Hantavirus is often spread by contact with infected rats (Adds company comments on evacuating sick people in the fifth section and talks about going to the Canary Islands in the seventh)

LONDON/GENEVA/AMSTERDAM, May 5 (Reuters) – The World Health Organization said on Tuesday it suspected a rare human-to-human transmission of the deadly hantavirus occurred between close relatives on a luxury cruise ship hit by seven confirmed or suspected cases.

Human-to-human transmission is rare, and the UN health organization has reiterated that the risk to the wider public is low because the disease is usually spread through contact with infected rodents.

A Dutch couple and a German national died, while a British national was evacuated from the ship and is in intensive care in South Africa, officials said.

Two crew members required urgent medical attention, said the operator of the Dutch-flagged MV Hondius, Oceanwide Expeditions. Another person on board the alleged culprit reported having a mild fever.

DASHES PREPARE TO GET THROUGH MEDICINE

The Dutch Ministry of Foreign Affairs said it is preparing to transport three people with medical aid to the Netherlands on a ship currently leaving Cape Verde. The island country in the Atlantic near West Africa was supposed to be the final destination but did not allow the ship to put passengers ashore due to the outbreak of the disease.

Oceanwide Expeditions said on Tuesday that two special medical flights were en route to Cape Verde for evacuation, adding that it did not have an exact timeline.

It was not clear when and where the other approximately 150 people still on board would disembark, although the company said it was negotiating with Gran Canaria and Tenerife authorities to stay there. The two Canary Islands are located within three days of sailing from Cape Verde, it said.

The Ministry of Health in Spain said previously that it does not see the need for the ship to stop in the Canary Islands if all the sick people are removed from Cape Verde, unless new cases appear. A spokesman for the department declined to comment and the head of the Canary Islands regional government said the only logical thing was for the ship to return to the Netherlands.

‘WE KNOW YOU’RE AFRAID,’ SAID WHO

Humans often become infected with hantavirus through contact with infected rodents or their urine, feces or saliva.

However, limited spread among close contacts has been observed in other previous outbreaks of the Andes strain, which has spread in South America, including Argentina, and WHO believes it may be involved in this. Testing is ongoing. The Hondius left Ushuaia in southern Argentina in March.

The WHO said it had been told there were no rats on board.

“We believe that there is a possibility of person-to-person transmission that occurs between people who are very close, husband and wife, people who share bedrooms,” Maria Van Kerkhove, director of epidemiology and pandemic preparedness and prevention at the WHO, told reporters in Geneva.

Van Kerkhove said that the focus now is to get out the two sick passengers who are still on board and the ship continues to the Canary Islands.

“We heard about a few people on the boat,” Van Kerkhove said earlier. “We want you to know that we are working with the captains of the ship. We are working with the countries you are coming from. We hear you, we know you are afraid,” he said, adding that they are working hard so that people can return home safely.

The UN health organization said its working assumption is that in the first cases a Dutch couple, who joined a ship in Argentina after traveling to that country, were infected before entering the trip.

Some cases may have contracted the virus while on bird-watching trips to islands where birds and rodents live as part of the cruise, it said.

THE JOURNEY BEGAN IN SOUTH ARGENTINA

The Hondius is carrying many British, American and Spanish passengers on a luxury cruise from southern Argentina in late March. The cruise visited the Antarctic peninsula and South ⁠Georgia and Tristan da ⁠Cunha – some of the most remote islands in the world.

The tour is marketed as an Antarctic nature tour, with ticket prices ranging from 14,000 to 22,000 euros ($16,000 to $25,000).

The first passenger to be hit, a Dutch man, died on April 11. His body remained until April 24, when it was “disembarked at St Helena, with his wife accompanying the repatriation”, Oceanwide Expeditions said.

His wife, who had stomach symptoms at the time of landing, later collapsed during the flight to Johannesburg. He died on arrival at the emergency department on April 26, the WHO said, adding that contact tracing is ongoing for passengers on that flight.

South African authorities have confirmed that a British patient, who is being treated at a Johannesburg hospital, has tested positive for hantavirus. The Netherlands confirmed the virus in a Dutch woman who died.

The National Institute for Communicable Diseases of South Africa is working on the sequence of the virus, as there may be results on Wednesday, said Van Kerkhove.

Argentina continues to have the most cases in the Americas, WHO said in December, with a mortality rate of 32%, higher than the average and other strains of the virus.

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