A British man who was admitted to a hospital in Johannesburg after contracting hantavirus aboard a luxury cruise ship is gradually improving, a South African health ministry spokesperson said on Monday.
"The British patient is clinically improving but still ill," spokesperson Foster Mohale told Reuters. "This means his condition is improving, gradually so."
The man was medically evacuated to South Africa on April 27 after presenting with fever, shortness of breath, and signs of pneumonia. He disembarked from the hantavirus-hit cruise ship MV Hondius at Ascension Island in the Atlantic Ocean.
Andes Hantavirus Identified on Ship
Hantaviruses are rodent-borne viruses that can infect people and cause illness. The strain identified on the ship is the Andes hantavirus, which typically circulates in Argentina and Chile. The MV Hondius set off from Argentina and was carrying mostly British, American, and Spanish passengers.
It comes as a French woman and two Americans tested positive or showed symptoms of hantavirus Monday as nations around the world scrambled to repatriate passengers from the cruise ship and quarantine or isolate them.
Passengers from the ship began flying home aboard military and government planes Sunday after the vessel anchored in the Canary Islands. Personnel in full-body protective gear and breathing masks escorted travelers from ship to shore in Tenerife in an effort continuing Monday.
French and American Cases
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 Sunday to Paris from the MV Hondius. She developed symptoms on the flight to Paris, Rist told public broadcaster France-Inter.
One of the 17 American passengers evacuated from the ship and flown to Nebraska also tested positive for hantavirus but is not showing symptoms, and another had mild symptoms, U.S. health officials said late Sunday. The flight landed early Monday morning and stopped near awaiting buses and police vehicles.
The Americans will first be taken to the University of Nebraska Medical Center, which has a federally funded 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," said Kayla Thomas, a spokesperson for Nebraska Medicine hospital.
Global Response and WHO Advice
The World Health Organization recommended close monitoring of former passengers, and many countries quarantined them. WHO Director-General Tedros Adhanom Ghebreyesus stressed that the general public should not worry 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 said Sunday.
Hantavirus usually spreads from rodent droppings and is not easily transmitted between people. However, the Andes virus detected in this outbreak may be able to spread between people in rare cases. Symptoms usually appear between one and eight weeks after exposure.
WHO recommends that passengers' home countries "have active monitoring and follow-up, which means daily health checks, either at home or in a specialized facility," said Maria van Kerkhove, the organization's top epidemiologist.
Numerous countries have said their people will be quarantined or hospitalized for observation. Australia is sending a plane, expected to arrive Monday, to evacuate its people and those from nearby countries, such as New Zealand and unspecified Asian countries, said Spanish Health Minister Mónica García. Dutch Foreign Minister Tom Berendsen said a second Dutch flight Monday would bring back more passengers from the Netherlands and other nations.
Deaths and Symptoms
Three people have died since the start of the outbreak: a Dutch couple and a German national. Hantavirus infection can rapidly progress and become life-threatening. Early symptoms include fever, chills, muscle aches, and headache. "Early in the illness, you really may not be able to tell the difference between hantavirus and having the flu," said Dr. Sonja Bartolome of UT Southwestern Medical Center in Dallas.
Symptoms of hantavirus pulmonary syndrome usually appear one to eight weeks after contact with an infected rodent. As the infection progresses, patients may experience chest tightness as the lungs fill with fluid. The other syndrome caused by hantavirus, haemorrhagic fever with renal syndrome, usually develops within a week or two after exposure.
Death rates vary depending on the hantavirus strain. Hantavirus pulmonary syndrome is fatal in nearly 40% of infected people, while the death rate for haemorrhagic fever with renal syndrome ranges from 1% to 15% of patients, according to the CDC.
