A cruise ship with a hantavirus outbreak has left Cape Verde after three passengers were evacuated, including two in serious condition now in the Netherlands. The ship, MV Hondius, is heading to Spain's Canary Islands.
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Two people in a serious condition who were evacuated from a cruise ship with a confirmed outbreak of deadly hantavirus have arrived in the Netherlands for treatment, operator Oceanwide Expeditions has said.
A third passenger in a stable condition was on board an evacuation flight that has been delayed, the operator added.
The MV Hondius is now sailing towards Spain's Canary Islands after being anchored for three days near Cape Verde, an archipelago nation off the West African coast.
The three evacuees were British, Dutch and German. Oceanwide Expeditions said the German evacuee was "closely associated" with a German woman who died on board the ship on 2 May.
Meanwhile, two US states have confirmed to the BBC that they are monitoring three passengers who had returned to the US after disembarking earlier. All are currently not displaying symptoms.
Georgia's public health department said two residents were being monitored and were in good health, showing no signs of infection.
Arizona's health department said one resident who was being monitored, but was not symptomatic.
The World Health Organization (WHO) has also confirmed a man who had travelled back to Switzerland after disembarking the ship tested positive for hantavirus and is receiving care at a hospital in Zurich.
"The patient had responded to an email from the ship's operator informing the passengers of the health event," World Health Organization chief Tedros Adhanom Ghebreyesus said in a statement.
A total of 146 people from 23 different countries remain aboard the MV Hondius under "strict precautionary measures", Oceanwide Expeditions said.
In its latest update, the World Health Organization (WHO) said eight cases of hantavirus - three confirmed and five suspected - have so far been identified in people who were on the ship.
South African health authorities have said the Andes strain of hantavirus - prominent in Latin America, where the cruise originated - was found in two of the confirmed patients after tests were carried out by the country's National Institute for Communicable Diseases.
Experts have observed the Andes strain spreading between human patients in previous outbreaks. South Africa says efforts to trace all contacts remain underway.
Three people who were aboard the ship have died since it set sail from Argentina a month ago. Officials have said that one of the deceased had the virus, while the other two deaths are under investigation.
One of the deaths include a Dutch woman who left the MV Hondius when it stopped at the island of St Helena on 24 April. Her husband died on board on 11 April, but is not a confirmed case.
The Dutch woman travelled to South Africa, where she died on 26 April. WHO official Dr Maria Van Kerkhove told the BBC that health experts were carrying out contact tracing on the flight she took.
The MV Hondius experienced a hantavirus outbreak, leading to the evacuation of three passengers.
The evacuated passengers are from Britain, the Netherlands, and Germany.
Two passengers are in serious condition and receiving treatment in the Netherlands, while a third is stable but delayed in evacuation.
Yes, two US states are monitoring three passengers who returned after disembarking, but none are currently showing symptoms.
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KLM Airlines on Wednesday issued an advisory saying the woman had also briefly been aboard one of their flights from Johannesburg to Amsterdam on 25 April before the crew decided not to let her fly due to her medical condition.
The third fatality - a German woman - is not a confirmed case either. Her body remains on the ship.
None of the three people who were medically evacuated on Wednesday have tested positive for hantavirus so far, but two are showing symptoms. Spain's health minister earlier said the British man was a doctor but the BBC later understood that was not correct.
It comes as the UK's Health Security Agency said two British people were self-isolating at home in the UK after potential exposure to the virus on the ship. They left the vessel earlier in its journey and did not have symptoms.
Hantavirus typically spreads from rodents, but health experts believe that in this case, it may have passed between humans that were in close contact.
Testing to confirm whether other people on the ship have contracted the virus is ongoing. Health officials have stressed that the risk of transmission to the wider public is low.
The vessel had been anchored near Cape Verde before it set off towards the Canary Islands on Wednesday.
Spanish authorities agreed to the move, but the Canary Islands' president has opposed the plan and demanded an urgent meeting with Spain's prime minister.
"I cannot allow [the boat] to enter the Canaries," Fernando Clavijo told Spain's Onda Cero radio. "This decision is not based on any technical criteria and nor have we been given enough information."
Spain's Health Ninister Mónica García said that everyone on board will undergo a medical assessment when they arrive in Tenerife and, if fit to travel, those from abroad will be repatriated to their home countries.
Spaniards, meanwhile, will be sent to a defence hospital in Madrid to quarantine.
The evacuation would "avoid contact" with Canary Island citizens and that there would be "no risk" to them when it arrives in Tenerife in the coming days, Garcia said.
Dr Van Kerkhove said the way hantavirus is transmitted "is very different than COVID and flu".
"We're not talking about casual contact from very far away from one another," she said, but "really physical contact".