Two suspected hantavirus cases reported in Spain and Tristan da Cunha

Madrid: Health authorities moved Friday to contain a possible wider spread of hantavirus after two suspected cases were identified far from the cruise ship where the outbreak was first detected, with one case reported in Spain and another on the remote South Atlantic island of Tristan da Cunha.

According to the World Health Organisation, the new suspected infections are separate from its tally of eight people who fell ill aboard the Dutch-flagged MV Hondius. Three of those patients have died. WHO officials said Friday that six of the eight suspected cases linked to the ship have been confirmed as hantavirus.

The latest reports involved a man who became ill after leaving the vessel and a woman who developed symptoms after sitting near an infected cruise passenger on a plane. The developments raised concern about broader transmission, although WHO officials have continued to say the risk to the wider public remains low and that the virus does not spread easily.

Based on the dynamics of this outbreak, based on how it is spreading and not spreading amongst the people on the ship, the people who have disembarked, as well, we continue to consider the risk as low for the general population.

WHO technical officer for viral threats Anais Legand said in an online briefing.

Cases under investigation in Spain and Tristan da Cunha

Spanish health authorities said a 32-year-old woman in Alicante province had symptoms consistent with hantavirus infection and was undergoing testing. Spanish Secretary of State for Health Javier Padilla told reporters that she had briefly been seated two rows behind a Dutch woman who contracted the virus on the Hondius.

Padilla said the Dutch woman left the flight in Johannesburg feeling unwell before takeoff on April 25 and later died in hospital.

In a statement posted on the regional health department's website, authorities said the Spanish woman had mild respiratory symptoms and had gone to a hospital where she would be tested for the virus.

Britain's Health Security Agency also said a British man was suspected of having the disease on Tristan da Cunha. Officials said he had been a passenger on the Hondius, which was at the island from April 13 to April 15. The agency did not provide further details about his condition.

Tristan da Cunha has a population of about 200 people and is described as the world's remotest inhabited island. It lies more than 1,500 miles, or 2,400 kilometres, and a six-day boat journey from St Helena, its nearest inhabited neighbour.

Outbreak linked to Andes virus

WHO said testing had shown the outbreak on the Hondius involved the Andes virus, the only hantavirus species known to be capable of limited person-to-person transmission through close and prolonged contact. The UN health body said fatality rates among infected people in the United States can reach 50%.

The Hondius was carrying 147 passengers and crew when a cluster of severe respiratory illnesses among passengers was first reported to the WHO on Sunday. By that time, 34 other passengers had already left the ship.

The vessel had sailed from Argentina in March and made stops in Antarctica and other locations before heading north to waters off Cape Verde, west of Africa. It was briefly held there earlier this week after the outbreak became known.

Four patients remained in hospital Friday in South Africa, the Netherlands and Switzerland. The three people who died were a Dutch couple and a German national. Four others confirmed to be infected — two Britons, a Dutch national and a Swiss national — were still receiving treatment in hospitals in the Netherlands, South Africa and Switzerland.

Oceanwide, the cruise operator, said Thursday that no one with symptoms of a possible infection remained on board. The ship was travelling Friday to Tenerife in the Canary Islands and was expected to dock early Sunday. Passengers and crew are to be screened before disembarking under guidelines still being finalised by the WHO and other health agencies.

Oceanwide said 17 US citizens were on board. The US Centers for Disease Control and Prevention said Friday that passengers returning to the United States would be met by health officials and taken on a medical repatriation flight to Omaha, where they would be quarantined at the University of Nebraska.

The CDC has classified the outbreak as a level 3 emergency response, the lowest level of emergency activation. Other experts have also stressed that the likelihood of widespread contagion is low, but authorities remain on alert and are urging anyone who had contact with passengers who left the Hondius to monitor for possible symptoms.