On May 8, a British national on Tristan da Cunha was identified as a new suspected case of hantavirus, health authorities said, as tracing of passengers and their close contacts continues following an outbreak linked to a luxury cruise ship that stopped at the remote South Atlantic island on April 15.
Tristan da Cunha, home to roughly 200 residents and often described as the world's most isolated inhabited island, was among the ports visited by the MV Hondius. The cruise operator has been at the center of an unfolding public health response after multiple fatalities and confirmed infections were associated with the vessel.
To date, three people have died in connection with the outbreak on the MV Hondius - identified in reports as a Dutch couple and a German national. Four additional passengers have tested positive: two British nationals, one Dutch national and one Swiss national. Those confirmed infected are receiving treatment in hospitals in the Netherlands, South Africa and Switzerland.
Separately, a Dutch woman died shortly after disembarking the ship on April 24. She was the wife of the so-called 'patient zero', a Dutch man who died aboard the vessel on April 11.
The World Health Organization said it would provide an update on suspected and confirmed case numbers later on Friday. In parallel, national public health bodies have been running investigations and laboratory testing to identify any further infections among travellers and contacts.
Dutch health authorities reported on Thursday that two people who had been in close contact with the Dutch woman before she was removed from a plane in Johannesburg on April 25 due to worsening symptoms had tested negative for the virus. Among those contacts was a flight attendant who was admitted to a hospital in Amsterdam with symptoms deemed consistent with a possible infection, the WHO said on Friday. Officials also said a third suspected case remained pending clear test results as of Friday.
Hantavirus infections are more commonly associated with exposure to rodents, but the particular strain tied to passengers from the Hondius has been noted to transmit between people in rare cases. The U.S. Centers for Disease Control and Prevention has classified the incident as a 'level 3' emergency response, which corresponds to the lowest level in its emergency activation framework.
Public health experts cited in reporting have emphasized the low probability of widespread contagion, but nonetheless authorities remain alert. Officials have urged anyone who came into contact with passengers who disembarked the Hondius before the outbreak was recognized to monitor themselves for symptoms and to seek medical advice if they develop.
Several U.S. states said they were monitoring residents who returned asymptomatic after leaving the cruise ship. Singapore also reported isolating and testing two residents who had been aboard.
Oceanwide, the cruise operator, stated on Thursday that no passengers aboard the ship were showing symptoms of a possible infection. The vessel was expected to dock in Tenerife in the Canary Islands early on Sunday, according to public information provided by the operator.
The WHO said it is preparing step-by-step guidance for the disembarkation and onward travel of the dozens of passengers who remain on board. The British health service indicated that nationals on the ship who are asymptomatic will be repatriated by air and asked to observe a 45-day isolation period on their return.
As investigations continue, public health agencies are balancing the low assessed risk of broad transmission with precautionary tracing, testing and isolation measures targeted at passengers, close contacts and the transport personnel who assisted in moving symptomatic individuals between locations.