Hantavirus outbreak | 2 suspected cases found in Spain, remote Tristan da Cunha

Testing has determined that the Hondius outbreak is the first of its kind documented on a ship.

AMSTERDAM: Health experts raced to contain a potential spread of hantavirus as two suspected cases emerged on Friday far from the luxury cruise liner where the outbreak started.

The latest reports involved a man who fell ill after leaving the ship and a woman who became sick after sitting near an infected ⁠cruise passenger on a plane.

The occurrences reported by health officials thousands of miles apart — one in Spain, the other on the remote South Atlantic island of Tristan da Cunha — are ⁠separate from the World Health Organization's tally of eight people who became ill aboard the Dutch-flagged ship MV Hondius.

Three of those people ‌have died. WHO officials said on Friday six of the eight ​suspected cases have been confirmed as hantavirus, a potentially fatal disease typically carried and spread by rodents.

CRUISE SHIP BOUND FOR CANARY ISLANDS

The announcements of new cases far from the vessel fuelled concern about a wider spread of the virus, although WHO officials have repeatedly said the risk to the public at large is not high and the virus is not transmitted 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," Anais ⁠Legand, WHO technical officer for viral threats, said in an online briefing.

Testing has determined that the Hondius outbreak, the first of its kind documented on a ship, involves the Andes virus, the only hantavirus species known to be capable of limited transmission between humans, through close and prolonged contact, according to the WHO.

The U.N. health body puts the fatality rates among infected people in the United States at up to 50%.

The ship was carrying 147 passengers and crew when a cluster of ⁠severe respiratory illnesses among passengers ‌was first reported to the WHO on Sunday.

By then, 34 other passengers had departed the vessel, which first sailed from Argentina in March with stops in the Antarctic and other locations before heading north to waters off Cape Verde west of Africa. The vessel was ‌briefly held there this week after news of the outbreak emerged.

Four patients remained hospitalized on Friday in South Africa, the Netherlands and Switzerland.

Oceanwide, the cruise operator, said on Thursday there were no people with symptoms of a ⁠possible infection remaining on the vessel.

The Hondius was en route on Friday to Tenerife in the Canary Islands, and was expected to dock there early on Sunday. Arriving passengers and crew will be screened before disembarking under guidelines still being finalised by the ‌WHO and other health agencies.

Oceanwide said 17 U.S. citizens were aboard.

Health officials will meet passengers returning to the United States and transport them ‌on a "medical repatriation flight" to Omaha, where they will be quarantined at the University of Nebraska, the U.S. Centers for Disease Control and Prevention said ‌on Friday.

STRANGERS ON A PLANE

A 32-year-old woman in the southeastern Spanish province of Alicante was diagnosed with symptoms consistent with a hantavirus infection and was being tested, ‌Spanish health authorities said.

She was briefly sitting on a plane two rows behind a Dutch woman who had contracted the virus on the Hondius, Spanish Secretary of State for Health Javier Padilla told reporters. The woman left the flight in Johannesburg feeling ill before it took off on April 25 and later died at a hospital.

A British man was suspected of having the disease on Britain's Tristan ⁠da Cunha, the nation's Health ⁠Security Agency said. Officials said he was a passenger on the Hondius, which was at the island from April 13 to April 15.

The three people who have died following the outbreak were a Dutch couple and a German national. Four others confirmed to be infected — two Britons, a Dutch person and a Swiss national — were still being treated at hospitals in the Netherlands, South Africa and Switzerland.

Britain's Health Security Agency did not go into further detail about the British passenger on Tristan da Cunha identified with suspected symptoms. But the case illustrated how infectious diseases could potentially spread far in the era of modern travel.

Tristan da Cunha, home to only around 200 people, is halfway between South Africa and South America. It is the world's remotest inhabited island, more than 1,500 miles (2,400 km) and a six-day boat ride from St Helena, its nearest inhabited neighbour.

The Spanish woman ​has "mild respiratory symptoms" and had been to a hospital where she would be tested for the virus, according to a statement on the regional health department's website.

The ​CDC has classified the hantavirus outbreak as a "level 3" emergency response, the ​lowest level of emergency activation.

Other experts have stressed the low probability of a widespread contagion, but the outbreak has put authorities on high alert as they urge all who have been in contact with passengers who left the ​Hondius to watch out for possible symptoms.