The 18 Americans who were aboard the hantavirus-stricken cruise ship Hondius arrived back in the U.S. on Monday, and two of them are in biocontainment units in Omaha, Nebraska, and Atlanta.

Those two Americans traveled in the plane’s biocontainment units “out of an abundance of caution,” the Department of Health and Human Services said in a statement.

Most of the Americans were taken to a facility in Nebraska, but two, a passenger on the ship and a close contact, were taken to Emory University Hospital in Atlanta, officials said.

Officials at the Centers for Disease Control and Prevention and at Emory said Monday that the system was working as intended.

“We have been preparing for years for viruses such as Andes viruses,” said Dr. Aneesh Mehta, chief of infectious disease services at Emory University Hospital.

Since the ship, the MV Hondius, departed Argentina on April 1, there have been seven confirmed cases of hantavirus and three others identified as possible. Three of the 10 people have died.

The luxury cruise ship arrived early Sunday at the island of Tenerife, the largest of Spain’s Canary Islands off West Africa, where passengers started repatriating to their home countries. Passengers received health screenings upon arrival in Spain, the country’s Health Ministry said in a statement.

A little more than two dozen crew members remained on board Monday to continue to the Netherlands.

“Let me be crystal clear: the risk of hantavirus to the general public remains very, very low. The Andes variant of this virus does not spread easily, and it requires prolonged close contact with someone who is already symptomatic,” said Dr. Brian Christine, HHS’ assistant secretary for health.

Americans treated in Omaha and Atlanta

U.S. health officials said 16 of the Americans would be treated at the Administration for Strategic Preparedness and Response Regional Emerging Special Pathogen Treatment Center at the University of Nebraska Medical Center/Nebraska Medicine (UNMC) in Omaha.

The two other passengers were taken to Emory University’s Serious Communicable Diseases unit in Atlanta, with one receiving care in the biocontainment unit for mild symptoms. The other passenger is the person’s significant other and is being monitored because they were in close contact with the symptomatic person, Emory University said.

The American passengers range in age from the late 20s to the early 80s.

Of the 18 Americans, two are from California; three are from New York; two are from New Hampshire; one from North Carolina; one from Oregon; three from Utah; and one from Washington state, officials said.

Dr. Brendan Jackson, the CDC’s acting director of high-consequence pathogens and pathology, said at a news conference Monday that it is relatively normal for people in quarantine to show symptoms during isolation and that officials are being “very liberal” with how they are describing symptoms.

Having symptoms does not necessarily mean a patient has contracted hantavirus, Jackson said. Hantavirus usually requires very close contact and symptoms for a patient to pass it on.

Jackson said the decision to send two passengers to Atlanta was “contingency planning” to keep spaces open at Omaha’s UNMC should they need more room.

At UNMC, 15 patients are in the quarantine unit, and one is in the biocontainment unit, said Dr. Michael Wadman, medical director of the National Quarantine Unit.

Dr. Angela Hewlett, medical director of the Nebraska Biocontainment Unit, said Monday that it is being used for patients who are well but need to be monitored. She described it as “more like a hotel than a patient care space.”

In the unit, which is equipped like an intensive care unit, patients can range from well and stable to critically ill. The one Hondius passenger in biocontainment at UNMC is doing well and does not have symptoms, Hewlitt said.

Hondius passengers will stay at UNMC for a few days for assessments and next steps, but a full 42-day monitoring period will be required for all of those who were on the ship, Jackson said. Patients may be able to go home during that period, but only if they have support to isolate at home.

One traveler, Jake Rosmarin, posted from his quarantine room “to let everyone know I’m okay and feeling well.” He wrote on Instagram that the “repatriation flight was smooth” and that he arrived safely in Nebraska. A photo of his room showed that it has no windows but appeared to have a spin bike and a smart TV.

“It’s been a very long few days, but hopefully I can start giving more updates again soon,” Rosmarin wrote. “Thank you again to everyone who has been supportive throughout all of this; it truly means a lot.”

In a video shared Monday morning, Jan Dobrogowski, the captain of the Hondius, thanked passengers and crew members, acknowledging the difficult weeks they have faced on board.

“At sea, people depend on each other,” Dobrogowski said. “There’s no readily available risk services standing by to come to your house in an emergency, so perseverance is an expected quality, perhaps; but I’ve seen, I’ve witnessed, way more, way more this time around.”

Dobrogowski took time to thank the crew for their “courage and their selfless resolve that they showed time and again in the most difficult moments.”

He expressed condolences for those whose lives were lost and asked for privacy for himself, his crew and the guests on the voyage.

Other passengers being evacuated

The Dutch-flagged Hondius departed Argentina on April 1 with almost 150 on board on a nature sightseeing mission via some of the world’s most remote points.

A Dutch passenger died at sea 11 days later. His body was taken off the ship as it stopped at the remote Atlantic island of St. Helena. The passenger’s wife traveled from there to Johannesburg, South Africa, where she died in a hospital days later.

A World Health Organization investigation is underway to pinpoint the origin of this outbreak, with particular attention placed on a bird-watching trip in southern Argentina, which the first passenger to die took part in before joining the cruise.

American and global health officials have stressed throughout the outbreak that the risk to the wider public is low and that transmission is limited to close contact.

All passengers and a “limited” number of crewmembers had disembarked from the Hondius by Monday, and the ship, with 27 crewmembers remaining on board, is sailing to Rotterdam in the Netherlands, Oceanwide Expeditions said. It is scheduled to arrive there May 17, it said.

A woman who was among five French passengers repatriated Sunday to Paris has tested positive for hantavirus, and her health worsened in the hospital overnight, French Health Minister Stephanie Rist said Monday.

One Spanish national who was on the cruise ship and disembarked Sunday has tested preliminarily positive, the Spanish Health Ministry said Monday. That person has no symptoms and is in good condition, it said.

The U.K. government said 20 British nationals, a German citizen who is a U.K. resident and a Japanese passenger were being kept in a hospital in northwest England for 72 hours and will be asked to isolate at home for 45 days. None are showing any symptoms.

The Swiss Federal Office of Public Health said that one person is being treated after testing positive and that the person’s wife is self-isolating as a precaution. In addition, a Swiss crewmember is also in quarantine in the Netherlands, and another Swiss national is self-isolating in Switzerland.

Tests have confirmed that two of the three people who died had hantavirus. In the case of the first person who died onboard on April 11, no microbiological tests were performed, and his is considered a probable case, the WHO has said.

CORRECTION (May 12, 2026, 11:12 p.m. ET): A previous version of this article misspelled the last name of the medical director of the Nebraska Biocontainment Unit. She is Dr. Angela Hewlett, not Hewlitt.