Experts have warned the first 'generation-three' cases of hantavirus - which sees cruise passengers pass the disease on to the public - are likely just days away. So far, no cases have been confirmed in people who were not on board the MV Hondius, but a contact case in Brittany has been transferred to hospital.
Experts have warned the first 'generation-three' cases of hantavirus - which sees cruise passengers pass the disease on to the public - are likely just days away.
So far, no cases have been confirmed in people who were not on board the MV Hondius, so there is no evidence that the rat-borne virus has spread beyond the confines of the ship. But that may change, following the transfer of a contact case in Brittany, northwestern France, to hospital on Tuesday morning.
The potential case was identified in Concarneau, a commune in the Finistère department of Brittany, and they have been sent to the University Hospital of Rennes for further checks.
'For now, this remains only a contact case, a person who has been in contact with someone carrying the virus. So there is no need to panic, we are only talking about a single case which has been contained,' said Quentin Le Gaillard, mayor of the Breton port city.
While no one has tested positive who wasn't already on the ship, the long incubation period of the virus means that it is impossible to know whether passengers who disembarked early on April 24 have passed on the disease. According to Dr Steven Quay, all generation-two cases – those involving people who developed symptoms after contact with 'patient zero', Leo Schilperoord, 70 – took an average of 22 days to become sick.
That means generation-three cases – involving anyone who contracts the infection from the passengers – should start showing up around May 19, if the same incubation period of approximately three weeks remains true, he said. Passengers of the hantavirus-stricken cruise ship MV Hondius walk toward buses in the port of Granadilla de Abona on the island of Tenerife in Spain's Canary Islands on May 11.
The bus carrying the British passengers and crew being repatriated from the MV Hondius makes its way to Arrowe Park Hospital on May 10, in Birkenhead, England. So far, three people - Dutch national Mr Schilperoord, his 69-year-old wife Miriam, and a German woman - have died after travelling on the Hondius, two of whom were confirmed to have contracted the virus.
It comes as World Health Organisation (WHO) chief Tedros Adhanom Ghebreyesus said 'our work is not over' to contain the lethal virus, following evacuations over the weekend.
'There is no sign that we are seeing the start of a larger outbreak,' Ghebreyesus told a joint news conference in Madrid with Spanish Prime Minister Pedro Sanchez. 'But of course the situation could change, and given the long incubation period of the virus, it's possible we might see more cases in the coming weeks,' Ghebreyesus said.
He added that the world can expect to see more cases due to the level of interaction among passengers before the infection was confirmed. In previous outbreaks of the Andes strain of hantavirus in Argentina - the strain that is transmissible between humans - the peak time for symptom onset was 22 to 28 days.
'We now have 10 hantavirus cases, one apparent patient zero and nine human-to-human generation two cases,' Dr Quay said. 'May 19 is a good date to watch for... If cases continue beyond that point they will probably be generation-two to generation-three cases.
' Before the outbreak was identified, some 29 cruise passengers disembarked from the Hondius on Saint Helena on April 24 - the destination marking the end of the first leg of the trip. Those who disembarked included Mrs Schilperoord, the wife of patient zero, as well as a Swiss national now in hospital in Zurich who tested positive for hantavirus.
The Dutch woman went on to board an Airlink flight to Johannesburg on April 25, carrying 82 passengers and six crew members. But by that point, she was severely ill. She then briefly boarded a second flight to Amsterdam, before being asked to exit the plane before takeoff. Mrs Schilperoord died upon arrival at the emergency department of Johannesburg hospital on April 26.
Health authorities are rushing to identify any potential contact cases who may have contracted the virus on the two flights. A British national who disembarked from the MV Hondius at the British Overseas Territory of Tristan da Cunha, in the South Atlantic, is also suspected of having the disease.
The passengers left the vessel before it had become clear they may be carriers of the lethal virus, and may have come into contact with hundreds of people over the past two weeks
Hantavirus Cruise Ship Passengers Contact Case Incubation Period Symptoms Outbreak World Health Organisation Tedros Adhanom Ghebreyesus Interaction Among Passengers Argentina Andes Strain Symptom Onset Generation-Two Cases Generation-Three Cases
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