Health authorities in South Africa are conducting contact tracing efforts following a hantavirus outbreak linked to the MV Hondius cruise ship, with eight confirmed cases and three fatalities, including a Dutch couple and a German national.
Image: Gustavo Fring / Pexels
South African health authorities are actively tracing contacts across the country following a hantavirus outbreak linked to the expedition cruise ship MV Hondius, as global health bodies coordinate a response to the deadly, yet geographically rare, incident.
The global tally for the outbreak stands at eight cases and three fatalities, including a Dutch couple and a German national. The outbreak involves the Andes virus, a hantavirus strain unique for its limited human-to-human transmission capability through close, prolonged contact.
National Health Department spokesperson, Foster Mohale, provided an update on South Africa's involvement.
He said the remains of the second deceased passenger, a 69-year-old Dutch woman who collapsed at OR Tambo International Airport, were repatriated to the Netherlands on Thursday.
This comes after the department issued an export permit to the family and funeral undertaker to repatriate the mortal remains, Mohale said.
The first patient, who was married to the 69-year-old woman, a 70-year-old man, passed away on arrival at St Helena Island.
Mohale said the third known case, a British national medically evacuated from the ship to a medical facility in Johannesburg, is currently in a stable but critical condition and receiving necessary medical attention.
A Dutch KLM flight attendant, who had been in contact with the woman who died from a hantavirus infection in Johannesburg, has tested negative for the virus.
The World Health Organization confirmed the negative test result on Friday, according to Reuters. The flight attendant was initially admitted to an Amsterdam hospital on Thursday with symptoms suggestive of a possible infection.
Concerning contact tracing, Mohale said approximately 50 of the 82 passengers on the Airlink flight from St Helena Island to Johannesburg have been traced, adding: “Ten of these individuals are currently under monitoring in Gauteng.”
In the Western Cape, Mohale said four people are being monitored after travelling from St Helena Island to Cape Town. One of these individuals is showing mild symptoms, including fever and sore throat.
“For now, it is too early to conclude that this person has hantavirus because the signs and symptoms are similar to those of Covid-19,” Mohale clarified. “We have taken this person for laboratory testing, and we are waiting for the results.”
He stressed the importance of public cooperation and said that despite the global nature of the outbreak, the local risk remains low. “While the risk of local transmission of this deadly virus in SA is low, the department appeals to all those who have been identified for possible exposure to this virus to cooperate with health officials conducting contact tracing,” he said.
The National Institute for Communicable Diseases (NICD) outlined the nature of Hantavirus Pulmonary Syndrome (HPS), the disease linked to the outbreak.
The virus is typically transmitted to humans through inhalation of aerosolised particles from the urine, droppings, or nesting materials of infected rodents, particularly specific species of rats and mice found in the Americas. Individuals at higher risk include farmers, forestry workers, and those who clean or occupy rodent-infested buildings in endemic areas.
The outbreak involves the Andes virus, a hantavirus strain known for its limited human-to-human transmission capability through close, prolonged contact.
The European Centre for Disease Prevention and Control noted that person-to-person transmission of ANDV has only been documented following close and prolonged contact.
“At this early stage of the investigation, with limited available information, we consider everyone on the ship to be close contacts due to the closed setting and shared social areas and activities, aligned with the precautionary principle.”
Signs of HPS are similar to other respiratory illnesses like the flu or Covid-19.
The NICD said early symptoms include fever, fatigue, muscle aches, headache, dizziness, chills, nausea, vomiting, diarrhoea, and abdominal pain in the first three to five days.
“As the disease progresses, patients may develop coughing and shortness of breath due to fluid accumulation in the lungs (pulmonary oedema) and a drop in blood pressure resulting in shock.”
As the disease advances, it can progress rapidly, sometimes within hours, leading to the severe cardio-pulmonary phase. Patients develop coughing and shortness of breath due to fluid accumulation in the lungs (pulmonary oedema) and a dangerous drop in blood pressure resulting in shock. HPS has a high case fatality rate, often between 30% and 50%.
WHO Director-General Dr Tedros Adhanom Ghebreyesus stated that while the incident is serious, the public health risk is assessed as low. However, he cautioned: “Given the incubation period, it’s possible that more cases may be reported.
karen.singh@inl.co.za