WHO suspects human-to-human hantavirus transmission on cruise ship Hondius as Spain disputes Canary Islands docking deal

The World Health Organization said on May 5 it suspects limited human-to-human transmission of hantavirus among close contacts on the MV Hondius, a Dutch-operated polar-expedition cruise ship anchored in the Atlantic off Cape Verde with 147 people on board. As of May 4 the agency had logged seven cases — two laboratory-confirmed and five suspected — including three deaths and one patient critically ill in intensive care in Johannesburg.

"We do believe that there may be some human-to-human transmission that is happening among the really close contacts," Maria Van Kerkhove, the WHO's acting director for epidemic and pandemic preparedness and prevention, told reporters in Geneva. She said the index case was probably infected before boarding, citing a hantavirus incubation period of one to six weeks. "Our assumption is that they were infected off the ship," she said.

The first cases were a Dutch couple. The 70-year-old husband developed fever, headache and mild diarrhea on April 6, deteriorated and died on board on April 11. His 69-year-old wife disembarked at Saint Helena on April 24 with gastrointestinal symptoms, flew to Johannesburg on April 25 and died on arrival at the hospital emergency department on April 26. Hantavirus infection was confirmed by PCR on May 4, and WHO has launched contact tracing for passengers on the April 25 St Helena-Johannesburg flight.

A German national died on board on May 2; cause of death has not been established, according to ship operator Oceanwide Expeditions. A British passenger is in intensive care in Johannesburg, and two crew members — one British, one Dutch — require urgent medical care, the operator said. Three of the identified cases are no longer on the ship and four remain on board.

WHO described the illness as "characterised by fever, gastrointestinal symptoms, rapid progression to pneumonia, acute respiratory distress syndrome and shock," with symptom onset between April 6 and April 28. Passengers have been asked to remain in their cabins while disinfection and other public-health measures are carried out, and no additional symptomatic cases have been reported since.

Hantaviruses are primarily acquired through contact with the urine, faeces or saliva of infected rodents. No evidence of rodents has been found on board, Van Kerkhove said; the ship's multiple stops along the African coast may have exposed passengers to wildlife. Sequencing in South Africa is underway, with the Andes virus among the working assumptions — the only hantavirus species so far observed to transmit between humans, and one previously documented only in Chile and Argentina.

"The risk to the wider public is low. It's not a virus that spreads like influenza or COVID-19. It is very different," Van Kerkhove said.

The agency told reporters Spain had agreed the Hondius would proceed to the Canary Islands for evacuation of patients and a full investigation. Spain's health ministry rejected the account on X, saying it would take "no decision" on the docking until "the epidemiological data" had been analysed. The vice-president of the Canary Islands regional government, Manuel Dominguez, told Radio Canaria he would prefer the ship to dock on Spain's mainland: "If this stop did not have to happen in the Canaries, well so much the better."

The MV Hondius, operated by Oceanwide Expeditions, was on a weeks-long polar cruise from Ushuaia in Argentina to Antarctica and onward toward Cape Verde, with 23 nationalities aboard including British, Spanish and American passengers and Philippine crew. WHO is coordinating with authorities in Cape Verde, the Netherlands, South Africa, Spain and the UK, alongside the ship's operator, while contact tracing and virus sequencing continue.