Hantavirus Cluster Linked To Cruise Ship Travel, Multi-Country
ARGENTINA, ARGENTINA — Before boarding the cruise ship, the Dutch couple had taken a bird-watching trip through Argentina, Chile, and Uruguay, visiting sites where the species of rat known to carry the Andes strain of the virus was present, according to the World Health Organization.
The source of the outbreak has not been confirmed, but the Argentine government is looking into whether infections began in the country. Health authorities across the globe are racing to trace dozens of people who disembarked from a cruise ship before an outbreak of hantavirus was detected, and anyone who has been in close contact with them since.
One Argentinian guest remains on board the boat. Contact tracing of passengers which disembarked in St Helena is ongoing; passengers have been contacted and advised to self-monitor for symptoms. Additionally, passengers who travelled on the same flight from St Helena to South Africa with one of the cases who was subsequently confirmed have been contacted.
Case 1: An adult male who boarded the ship on 1 April, after more than three months of travel in Argentina, Chile, and Uruguay. Developed symptoms on 6 April and died onboard on 11 April. No microbiological tests were performed. He is considered a probable case.
Case 2: An adult female, who was a close contact of case 1, who travelled and boarded the ship with him, went ashore at Saint Helena on 24 April with gastrointestinal symptoms. She subsequently deteriorated on a flight to Johannesburg, South Africa, on 25 April. She died on 26 April in a Johannesburg clinic. On 4 May, she was subsequently confirmed through PCR testing with hantavirus infection.
Case 3: An adult male who developed symptoms on 24 April. He was disembarked and medically evacuated from Ascension Island on 27 April and is currently hospitalised in an Intensive Care Unit (ICU) in Johannesburg, South Africa. PCR testing confirmed hantavirus infection on 2 May, and Andes virus was confirmed through sequencing.
Case 4: An adult female, with onset of symptoms (fever and general malaise) on 28 April, later presenting with pneumonia, died on 2 May. A post-mortem sample was collected and sent to the Netherlands with the evacuated patients, where it was confirmed to be Andes virus.
Case 5: An adult male, working as the ship doctor, reported onset of symptoms on 30 April, including fever, fatigue, muscle pain, and mild respiratory symptoms. His samples confirmed PCR positivity for Andes virus on 6 May. The case was medically evacuated to the Netherlands on 6 May and is currently stable in isolation.
Case 6: An adult male, working as a ship guide. Onset of symptoms was reported on 27 April with mild respiratory and gastrointestinal symptoms. Laboratory samples confirmed PCR positivity for Andes virus on 6 May. The case was medically evacuated to the Netherlands on 7 May and is currently stable in isolation.
Case 7: An adult male, who disembarked in St Helena on 22 April and flew back to Switzerland on 27-28 April, through South Africa and Qatar. He started experiencing symptoms on 1 May after arrival in Switzerland, where he immediately self-isolated and reported to local public health authorities. He is currently hospitalised and in isolation in Switzerland. His samples confirmed PCR positivity for Andes virus on 5 May.
Case 8: An adult male who disembarked in Tristan da Cunha on 14 April. Onset of symptoms was reported on 28 April with diarrhoea and two days later with fever. He is currently stable and in isolation. He is currently a probable case until laboratory confirmation.
One case previously reported as suspected has now been reclassified as a non-case after testing negative for the Andes virus through PCR and serology. Nevertheless, monitoring continues until the end of their incubation period from the last exposure.