CAPE TOWN, South Africa (AP) — A Dutch cruise ship with nearly 150 people aboard, including 17 Americans, was waiting for help off the coast of Cape Verde in the Atlantic Ocean on Monday after a suspected outbreak of the rare hantavirus killed three passengers and left at least three others seriously ill, the World Health Organization and the ship's operator said.
The MV Hondius, which was on a weekslong polar cruise from Argentina to Antarctica and then several isolated islands in the South Atlantic, had requested help from local health authorities on Sunday after making its way to the island of Cape Verde off the coast of West Africa, but no one has yet been allowed to disembark, the company operating the cruise said.
There are 88 passengers — including one who has died — and 61 crew members, two of whom are sick, onboard, the operator said Monday. The passengers include 17 Americans, 19 from the U.K. and 13 from Spain, among other nationalities.
The three passengers to die were from the Netherlands and Germany. The German remains on board. A British man is in intensive care in South Africa.
A 70-year-old Dutch man who presented with fever, headache, abdominal pain and diarrhea was the first victim and died onboard on April 11, the ship's Netherlands-based operator Oceanwide Expeditions said in a statement giving new details. His body was taken off the vessel nearly two weeks later on the British territory of Saint Helena, some 1,200 miles (1,900 kilometers) off the African coast, and was awaiting repatriation.
His 69-year-old wife was transferred to South Africa at the same time but collapsed at a Johannesburg airport and died at a nearby hospital, the South African Department of Health said.
The ship then sailed on to Ascension Island, another isolated Atlantic outpost about 800 miles (1,300 kilometers) to the north, where a sick British man was taken off the ship and evacuated to South Africa on April 27. He later tested positive for hantavirus, a rare infection spread by rodents that can cause serious respiratory illness or hemorrhagic fever, the South African health department said.
He is in a critical condition and is now in intensive care in a South African hospital, where he is being kept isolated, authorities said.
A third passenger died onboard on Saturday and was identified as a German national. The body is still on the ship, the cruise operator said. It specified that the three deaths are not yet confirmed to be hantavirus as the only person confirmed to have the virus is the man in intensive care in South Africa.
WHO said that while only one hantavirus case was confirmed through tests, the other five cases were suspected to be hantavirus.
The cruise ship is asking Cape Verde for help
Two crew members still onboard the Hondius — one British, one Dutch — need urgent medical care, Oceanwide said, adding it was still awaiting permission from local authorities in Cape Verde on Monday to evacuate passengers and crew members. The company said it was considering moving to one of the Spanish islands of Las Palmas or Tenerife if it couldn't get people off the ship in Cape Verde.
The World Health Organization had said Sunday that it was working with local authorities and the ship's operators to conduct a "full public health risk assessment" and was trying to coordinate the evacuation of the two sick people from the ship.
"Detailed investigations are ongoing, including further laboratory testing, and epidemiological investigations," WHO said. "Medical care and support are being provided to passengers and crew. Sequencing of the virus is also ongoing."
The Dutch Foreign Ministry said it was also exploring the possibilities of evacuating some people from the ship.
A Dutch organization called On Behalf of the Family issued a comment from relatives of a Dutch couple who they said were on the cruise and had died in April.
"The beautiful journey they experienced together has been abruptly and definitively cut short. ... We wish to bring them home and commemorate them in peace and privacy," the statement said, without identifying the family.
Hantavirus is rare and not often spread person to person
Hantaviruses, which are found throughout the world, are a family of viruses spread mainly by contact with the urine or feces of infected rodents like rats and mice. They gained attention after actor Gene Hackman's wife, Betsy Arakawa, died from hantavirus infection in New Mexico last year. She was not immediately found and her ailing husband died around a week later from heart disease.
READ MORE: What is hantavirus, the infection that killed Betsy Arakawa in New Mexico?
In rare cases, hantavirus infections can be spread between people, WHO said. There is no specific treatment or cure, but early medical attention can increase the chance of survival.
Hantaviruses cause two serious syndromes, according to the U.S. Centers for Disease Control and Prevention: hantavirus pulmonary syndrome, affecting the lungs, and hemorrhagic fever with renal syndrome, affecting the kidneys.
"While severe in some cases, it is not easily transmitted between people," Dr. Hans Henri P. Kluge, WHO Regional Director for Europe, said in a statement Monday. "The risk to the wider public remains low. There is no need for panic or travel restrictions."
The weekslong cruise started in Argentina
South Africa's Department of Health said the ship had left Ushuaia in southern Argentina for a cruise that included visits to Antarctica, the Falkland Islands, South Georgia and other isolated islands in the South Atlantic.
While Oceanwide Expeditions didn't say exactly which cruise the ship was on, it advertises 33-night or 43-night "Atlantic Odyssey" cruises on the 107-meter (351-foot) -long Hondius on its website that follow that route.
The Hondius has 80 cabins and a capacity of 170 passengers, the company said. It typically travels with around 70 crew members, including a doctor, it said.
Though there was no information from authorities on the possible source of the suspected outbreak, a previous hantavirus outbreak in southern Argentina in 2019 killed at least nine people. It prompted a judge to order dozens of residents of a remote town to stay in their homes for 30 days to halt the spread.
South Africa's National Institute for Communicable Diseases, meanwhile, was conducting contact tracing in the Johannesburg region to identify if other people in South Africa were exposed to the infected cruise ship passengers. The 69-year-old woman who died was trying to catch a flight back home to the Netherlands at Johannesburg's main international airport, regarded as the busiest in Africa, when she collapsed.
"There is no need for (the) public to panic," South Africa's health department said, adding WHO was "coordinating a multicountry response with all affected islands and countries to contain further spread of the disease."
AP writer Mike Corder in The Hague, Netherlands, contributed.