The WHO and Spain agree that epidemiologists will inspect hantavirus‑hit cruise ship before deciding its destination

The World Health Organization (WHO) and Spain’s Ministry of Health have agreed that a team of epidemiologists will examine on Tuesday afternoon the condition of the 147 people on board the luxury cruise ship MV Hondius before deciding on the port where passengers will be allowed to disembark. The shipping company responsible for the vessel, which sails under the Dutch flag, is Oceanwide Expeditions.

The ship, currently anchored off Cape Verde because of a hantavirus outbreak that has caused three deaths, departed Ushuaia, in Argentina, on April 1 and was bound for Spain’s Canary Islands off the African coast. Before reaching that point, the cruise — which began on March 20 — had sailed along the Antarctic coast and visited several Atlantic islands, including Tristan da Cunha and Saint Helena.

Two sick passengers and the close contact of a confirmed case are expected to be evacuated by air in the coming hours, according to a Situation Report published by the Spanish Health Ministry. The first two will be taken to the Netherlands and the third to Germany. The Dutch Foreign Ministry has said it is coordinating the medical evacuation with the cruise operator.

“This intervention aims to assess the condition of the people on board, determine whether there are additional symptomatic individuals, and identify high‑ and low‑risk contacts. This will inform decisions on repatriation procedures and the ship’s route,” the Health Ministry said on the social network X.

The WHO, which early this morning raised the number of people affected by the outbreak to seven — one of whom has already recovered — had said the ship would head to the Canary Islands once the two sick passengers were evacuated. The Spanish Health Ministry later clarified in a statement that if that evacuation takes place, “there would be no clinical reason” for the vessel to call at the Spanish islands “unless new symptomatic cases appear during the journey.” In that scenario, it added, “care would be justified under the principle of providing assistance.”

“Based on the epidemiological data collected from the ship during its stop in Cape Verde, the most appropriate port of call will be determined. Until then, the Ministry of Health will not make any decision, as we have already informed the WHO,” the ministry said.

Maria Van Kerkhove, the WHO’s director for epidemic and pandemic prevention and preparedness, said in Geneva that the organization is “working with the Spanish authorities” and assumed that the Canary Islands “will welcome the ship to do a full epidemiologic investigation, full disinfection of the ship, and of course to assess the risk of the passengers.” Spain’s Ministry of Health, however, has reiterated through a spokesperson that this has not yet been decided.

Fernando Simón, director of Spain’s Coordination Center for Health Alerts and Emergencies (CCAES), said Tuesday morning in an interview with Catalunya Ràdio: “It is not certain that the ship will arrive in the Canary Islands. It sails under the Dutch flag, and all parties involved are still discussing the possibility that, instead of stopping in the Canary Islands — the closest port to Cape Verde — it may go directly [to the Netherlands]. These decisions are being made in the coming hours.”

In any case, Simón added, if the ship were to reach Spanish shores, it would do so with no sick passengers on board, since anyone showing symptoms “would be evacuated by air.” Even so, the CCAES director recalled that the Canary Islands “fortunately have a high‑level treatment unit for patients with high‑risk infections, where they can receive top‑level care without endangering healthcare workers or posing any risk of contagion.”

Canary Islands want the ship to go to the Netherlands

The premier of the Canary Islands, Fernando Clavijo, said in Brussels that while awaiting the technical meetings underway to determine the ship’s destination, he has spoken with Spanish Health Minister Mónica García, and agrees with her that “the reasonable thing” would be for the ship not to call at the Canary Islands but instead “be attended to where it is” and then proceed directly to its place of origin, the Netherlands.

“From the outset, we believe the ship should be attended to where it is, where the outbreak was detected. We don’t want to get ahead of events, but if there is no danger to people’s lives, then care can perfectly well be provided there and the ship — which sails under the Dutch flag — can then head to the Netherlands,” Clavijo told a group of journalists after a meeting with Transport Commissioner Apostolos Tzitzikostas.

Manuel Domínguez, vice premier of the Canary Islands government, also addressed the issue in an interview with La Radio Canaria, ahead of a meeting to which the regional government has been summoned. “We’ll see what we demand from the Canary Islands. First of all, if the stop does not have to be in the Canary Islands, all the better, because there may well be other resources on the mainland. But if it does have to be here, then [the care will be provided] with every guarantee imaginable,” he said.

The WHO released additional information early Tuesday morning on the condition of those affected and the evolution of the outbreak. “Seven cases (two laboratory confirmed cases of hantavirus and five suspected cases) have been identified, including three deaths, one critically ill patient and three individuals reporting mild symptoms,” the organization said in a statement.

Of the three symptomatic individuals who, according to the WHO’s overnight update, remain on board — of Dutch and British nationality — one has already recovered, according to the information available.

The other two require “urgent medical care,” Oceanwide Expeditions said in a statement on Tuesday at midday. They present “acute respiratory symptoms, one mild and one severe,” according to the statement.

Regarding the origin of the infection, the WHO considers the most plausible hypothesis to be that the initial infections occurred off the ship during the South American leg of the trip taken by the first two people who died, and that subsequent person‑to‑person transmission of the pathogen took place on board. This, however, must be confirmed by ongoing investigations.

“Illness onset occurred between 6 and 28 April 2026 and was characterized by fever, gastrointestinal symptoms, rapid progression to pneumonia, acute respiratory distress syndrome and shock,” the WHO added in its statement. “Further investigations are ongoing. The outbreak is being managed through coordinated international response, and includes in-depth investigations, case isolation and care, medical evacuation and laboratory investigations.

Catalonia’s regional government has reported that five of the 14 Spanish nationals on board reside in the region. The statement released notes that “two of the deceased passengers had traveled through South America before boarding the cruise,” although “the extent of the passengers’ contact with local wildlife during the trip or before embarkation is unknown.” According to health sources, this trip could help explain the origin of the outbreak.

Hantavirus is a pathogen typically carried by rodents and can be transmitted to humans through inhalation of particles from the saliva, feces or urine of infected animals. Person‑to‑person transmission has only been demonstrated in one of the 24 strains known to infect humans — the so‑called Andes virus. This variant was identified in 1996 in Argentina and is predominant in some regions of the country. In Argentina, the average case‑fatality rate in recent years has been around 18.5%.

According to information provided by the WHO, the first case was a man — who had traveled through South America with his partner — who began developing “fever, headache and mild diarrhea” on April 6 while on board. Five days later, he “developed respiratory distress and died on board the same day.” No microbiological tests were performed, and his body was transferred from the vessel to the British overseas territory of Saint Helena on April 24.

The second case was his companion, a woman who began experiencing gastrointestinal symptoms on April 24. Her condition “subsequently deteriorated during a flight to Johannesburg, South Africa, on April 25. She later died upon arrival at an emergency department on April 26,” and two days later, “the case was subsequently confirmed by PCR with hantavirus infection,” the WHO said. An investigation has been launched to trace the contacts of the passengers on that flight to South Africa.

A third case is a man who went to the ship’s doctor on April 24 with fever, difficulty breathing, and signs of pneumonia. Three days later, as his condition worsened, he was evacuated to South Africa, where he is currently hospitalized in an intensive care unit. A PCR test also confirmed hantavirus infection last Saturday.

The individual classified as “case 4” is a woman with pneumonia who also died on Saturday and had developed symptoms on April 28, mainly fever and general malaise. “Three suspected cases have reported high fever and/or gastrointestinal symptoms and remain on board,” the WHO said, adding that “medical teams in Cabo Verde are evaluating the patients and collecting additional specimens for testing.”

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