Nations around the world accelerated repatriation efforts Monday for passengers from the MV Hondius cruise ship, where a deadly hantavirus outbreak has now claimed three lives and infected at least nine people, according to the World Health Organization (WHO). Among the newly confirmed cases are a French woman whose condition is deteriorating and an American passenger who tested positive while being transported in a biocontainment unit.
French Health Minister Stephanie Rist announced Monday that a French passenger repatriated from the MV Hondius tested positive for hantavirus and was hospitalized in worsening condition. The woman, one of five French nationals evacuated Sunday, developed symptoms during the flight to Paris.
"What is key is to act at the start and break the virus transmission chains," Rist told France Inter radio, highlighting a new decree to strengthen isolation measures for contact cases. Authorities have identified 22 contact cases in France; four other French passengers have tested negative.
In the United States, the Department of Health and Human Services reported that one of 17 American passengers evacuated to Nebraska tested "mildly positive" for the virus but remains asymptomatic, while another exhibited mild symptoms. Both were transported in the aircraft's biocontainment units "out of an abundance of caution." Upon landing early Monday, passengers were transferred to the University of Nebraska Medical Center, which operates a federally funded quarantine facility and specialized unit for highly infectious diseases previously used for Ebola and COVID-19 patients.
"The passenger who is going to the Biocontainment Unit tested positive for the virus but does not have symptoms," said Kayla Thomas, spokesperson for the Nebraska Medicine network.
WHO spokesperson Sarah Tyler noted Monday that lab results for the American case remain inconclusive, underscoring the complexity of confirming diagnoses during active outbreak response.
The MV Hondius, a luxury expedition cruise ship, departed Ushuaia, Argentina, on April 1. A Dutch passenger died onboard April 11, but it was not until early May that the WHO began coordinating a response to the suspected hantavirus outbreak, by which time the vessel was off the coast of Cape Verde. The ship has since been anchored near Tenerife in the Canary Islands while repatriation operations unfold.
Personnel in full-body protective gear and respirators have escorted passengers from the ship to shore in coordinated evacuations using military and government aircraft. Flights have carried travelers from more than 20 countries, with the operation expected to conclude on Monday. A Dutch aircraft arriving Monday afternoon will transport passengers originally slated for evacuation on an Australian-chartered plane, according to Spain's Health Minister Mónica García.
As of Monday, 54 passengers and crew remained onboard: 22 were expected to disembark for repatriation, while the remaining 32 will stay with the vessel as it returns to the Netherlands.
The WHO has confirmed two deaths and one probable death linked to the outbreak, with four people hospitalized—including one in intensive care in South Africa. South African health authorities reported Monday that a British man treated for hantavirus in Johannesburg is gradually improving after being evacuated from the ship on April 27.
Hantaviruses typically spread through contact with rodent droppings and are not easily transmitted between people. However, the Andes virus strain identified in this outbreak can, in rare instances, spread person-to-person. Symptoms—including fever, chills, headaches, muscle aches, gastrointestinal issues, and respiratory distress—may appear one to eight weeks after exposure. The Andes strain carries a fatality rate of 40–50%, particularly among older adults.
While there is no specific cure or vaccine for hantavirus, the WHO emphasizes that early detection and supportive treatment significantly improve survival rates. The organization recommends a 42-day quarantine period for exposed passengers and active monitoring with daily health checks, either at home or in specialized facilities, as outlined by WHO epidemic preparedness director Maria Van Kerkhove.
WHO Director-General Tedros Adhanom Ghebreyesus sought to reassure the public Sunday: "This is not another COVID. And the risk to the public is low. So they shouldn't be scared, and they shouldn't panic." Robin May, chief scientific officer at the United Kingdom Health Security Agency, echoed this assessment, describing the risk to the general public as "extremely low."
In a video message released Monday, MV Hondius captain Jan Dobrogowski praised the resilience of those onboard and called for respect for their privacy during a challenging ordeal.
"I've witnessed your caring, your unity and quiet strength amongst everybody on board — guests and crew alike — and I must commend my crew for the courage and the selfless resolve that they showed time and again in the most difficult moments," Dobrogowski said. "I could not imagine sailing through these circumstances with a better group of people, guests, and crew alike."
He added, "My thoughts are with the ones that are no longer with us, and whatever I say will not ease this loss, but I'd like you to know that they are with us every day in our hearts and our thoughts."
With robust containment measures in place and the virus's limited transmissibility between humans, officials remain confident that the outbreak can be managed without broader community spread.