MV Hondius hantavirus outbreak

Dutch health authorities moved the cruise ship MV Hondius into a secured area of Rotterdam port on May 18 after a multi-country outbreak of Andes hantavirus linked to the vessel. The Dutch public health institute RIVM said 27 people — crew members and medical personnel — were still on board when the ship moored at about 10:30 a.m. local time and would disembark in phases into a special quarantine area. The European Centre for Disease Prevention and Control said the outbreak had reached 12 reported cases by May 18, including nine confirmed, two probable and one inconclusive, with three deaths. The World Health Organization has described the event as a multi-country cluster tied to cruise travel and said international contact tracing is continuing. ### How many cases have officials actually confirmed? The ECDC said on May 18 that 12 cases had been reported in connection with the outbreak, including nine confirmed infections, two probable cases and one inconclusive case. It said no new deaths had been reported since its previous update and kept the death toll at three. (rivm.nl) The WHO said in its May 13 outbreak notice that 11 cases had been reported at that point, including eight laboratory-confirmed cases, two probable cases and one inconclusive case, with three deaths. The later ECDC update added a presumptively positive Canadian passenger, which the agency said should be classified as confirmed. (ecdc.europa.eu) ### Why are officials calling this Andes virus, not just hantavirus? The WHO said on May 6 it confirmed that the virus involved was Andes virus, a hantavirus variant. The agency said all laboratory-confirmed cases in the cluster were confirmed for Andes virus infection. The CDC said the outbreak involved severe acute respiratory illness among passengers and crew on a ship in the Atlantic and noted that hantavirus disease can be severe and fatal. (who.int) U.S. health officials told clinicians to be alert for imported cases while adding that the risk of broad spread in the United States was considered “extremely unlikely” at that time. (cdc.gov) ### Where did the outbreak start, and what are investigators looking at? The WHO said the working hypothesis, based on information available as of May 13, was that the first case acquired the infection before boarding the ship through exposure on land. It said investigations with authorities in Argentina and Chile were continuing to determine the source of the outbreak and the circumstances of exposure. (cdc.gov) The CDC said MV Hondius departed Ushuaia, Argentina, on April 1 and traveled through the South Atlantic, including stops in Antarctica, South Georgia Island, Tristan da Cunha, Saint Helena and Ascension Island. The agency said the ship carried 147 people — 86 passengers and 61 crew — from 23 countries, and that the extent of wildlife contact before or during the expedition was unknown. (who.int) ### What happened to passengers before the ship reached Rotterdam? The Dutch government said on May 12 that all passengers had already been repatriated before the vessel returned to the Netherlands. It said Dutch passengers who arrived in the Netherlands would remain in home quarantine for the coming weeks under monitoring by the municipal health service, or GGD. (cdc.gov) RIVM said passengers and crew on the second and third repatriation flights all tested negative for Andes virus, and said 26 people arriving at Eindhoven airbase were screened and tested by the GGD, with samples examined by RIVM and Erasmus MC. It also said repatriated Dutch passengers remained subject to mandatory home quarantine for six weeks regardless of those initial negative results. (government.nl) ### What is happening now in Rotterdam? RIVM said the 27 people who arrived aboard the ship on May 18 would be accommodated in a special quarantine area in Rotterdam port after controlled disembarkation. The agency said the vessel would undergo cleaning after arrival. Oceanwide Expeditions, the ship’s operator, said earlier in the outbreak that it had activated its highest-level response plan, including isolation measures, hygiene protocols and medical monitoring. (rivm.nl) The company said on May 4 that it was working with the WHO, RIVM and Dutch authorities as symptomatic cases were identified aboard the vessel. ### What should readers watch next? RIVM said it is posting updates on testing, quarantine and the ship’s handling on its hantavirus information page. The ECDC said its outbreak page is updated daily, including weekends, and WHO said international contact tracing through national focal points is continuing. (rivm.nl) (oceanwide-expeditions.com)