在疑似汉坦病毒爆发中心的一艘游轮上，至少有三人正等待医疗疏散。
截至周一，MV Hondius上报告了7例病例，其中2例为实验室确认病例，5例为疑似病例。在这七人中，有三人死亡，包括一对来自荷兰的夫妇，其中一人已被确认感染了汉坦病毒。
该船目前在佛得角海岸，医疗小组一直在评估两名工作人员和一名死亡患者的密切接触者。
佛得角官员告诉ABC新闻，他们正在检查这三名患者需要什么样的护理，然后将他们转移到救护车上，然后飞往荷兰。
这个过程预计需要几个小时，首先是上岸，之后船只可能会在夜间离开，可能在美国东部时间上午12点至凌晨3点之间。据佛得角官员称，该船预计将驶往西班牙的特内里费岛，西班牙卫生部门将接管进一步的调查，包括实验室检测和临床评估，特别是对老年乘客。
船上的美国乘客杰克·罗斯玛林告诉美国广播公司新闻，船上所有剩余的乘客仍然“精神状态良好”，“希望这种情况很快得到解决。”
“安全措施已经到位，包括社交距离和掩蔽。乘客也可以选择直接送餐到他们的客舱，”他说。“允许进入外甲板呼吸新鲜空气，而目前限制在室内公共区域如休息室聚集。”
世界卫生组织(世卫组织)的一名流行病学家表示，疫情可能会在人与人之间传播。
世卫组织传染病流行病学家、流行病与疫情管理主任玛丽亚·范·克霍夫(Maria Van Kerkhove)在周二的新闻发布会上说，“我们确实认为，在真正密切接触的人之间，丈夫和妻子之间，以及与人共住一个房间的人之间，可能正在发生某种人际传播。”。
“所以，我们的假设是已经发生了，这就是为什么我们正在操作和使用这艘船，以确保任何有症状的人，任何照顾病人的人，都穿着完整的个人防护设备，”她补充说。
Van Kerkhove指出，汉坦病毒通常不会在人与人之间传播，因为这是一种“啮齿动物感染”根据世卫组织的说法，患者通常在接触啮齿动物的尿液、粪便或唾液时被感染。
Van Kerkhove补充说，最初患病的病人可能是在登船之前就被感染了。
根据疾病控制和预防中心的说法，汉坦病毒感染的症状有时在接触病毒八周后才会出现。
根据Van Kerkhove的说法，世卫组织正在根据疑似爆发的汉坦病毒株是安第斯病毒的假设开展工作，该病毒在历史上已被证明有可能在人与人之间传播，尽管测序仍在进行中。
世卫组织在其网站上表示，MV Hondius上的疾病发生在4月6日至4月28日之间，患者出现发烧、胃肠道症状，迅速发展为肺炎、急性呼吸窘迫综合征和休克。
“疫情正通过协调的国际应对措施得到控制，包括深入调查、病例隔离和护理、医疗后送和实验室调查，”世卫组织在帖子中写道。
世卫组织总干事谭德塞·盖布雷苏斯博士在周六的一篇帖子中写道，全球人口的感染风险很低，该机构将继续监控局势并提供更新。
案件时间表
根据世卫组织和南非卫生官员的说法，第一例疑似汉坦病毒病例发生在一名来自荷兰的70岁男性乘客身上，他于4月6日出现发烧、头痛和轻度腹泻症状。
4月11日，该乘客出现呼吸窘迫，并于当天在船上死亡。4月24日，他的遗体从船上被转移到英国领土圣赫勒拿岛。据世卫组织称，没有对该男子进行微生物测试。
卫生官员说，也是在4月24日，这名男性乘客的69岁妻子出现了胃肠道症状。世卫组织说，4月25日，在飞往南非约翰内斯堡的航班上，她的健康状况迅速恶化，第二天在到达急诊室时死亡。
5月4日星期一，实验室检测确认妻子感染了汉坦病毒。
3 people waiting to be medically evacuated from cruise ship at center of suspected hantavirus outbreak
At least three people are waiting to be medically evacuated from a cruise ship at the center of asuspected hantavirus outbreak.
As of Monday, there have been seven cases reported aboard the MV Hondius, of which two are laboratory-confirmed and five are suspected. Among those seven, there have been three deaths, including a married couple from the Netherlands, one of whom has been confirmed to have been infected with hantavirus.
The ship is currently off the coast of Cape Verde and medical teams have been assessing two staff members and a close contact of one of the deceased patients.
Cape Verde officials told ABC News they are checking on what care the three patients need before transferring them to ambulances and then on flights to the Netherlands.
The process is expected to take several hours, with disembarkation happening first, after which the ship could leave overnight, likely between 12:00 a.m. ET and 3:00 a.m. ET. The vessel is expected to sail to the Spanish island of Tenerife in Spain, where Spanish health authorities will take over further investigations, including lab testing and clinical assessments, particularly for older passengers, according to Cape Verde officials.
Jake Rosmarin, an American passenger on the ship, told ABC News that all the remaining passengers on board remain "in good spirits" and "are hopeful that this situation will be resolved soon."
"Safety measures are in place, including social distancing and masking. Passengers also have the option to have meals delivered directly to their cabins," he said. "Access to the outer decks is permitted for fresh air, while gathering in indoor common areas such as the lounge is currently restricted."
It comes as an epidemiologist at the World Health Organization (WHO) said there may be some person-to-person spread in the outbreak.
"We do believe that there may be some human-to-human transmission that's happening among the really close contacts, the husband and wife, people who've shared cabins, [et cetera]," Maria Van Kerkhove, an infectious disease epidemiologist and director of Epidemic and Pandemic Management at the WHO, said during a press conference Tuesday.
"So again, our assumption is that has happened, and that's why we are operating and working with the ship to make sure that anyone who is symptomatic, anyone caring for patients, is wearing full personal protective equipment," she added.
Van Kerkhove noted that hantaviruses normally don't transmit from person to person because it's a "rodent infection." Patients typically become infected when they come into contact with rodent urine, droppings or saliva, according to the WHO.
The initial patients who fell ill may have become infected before they boarded the ship, Van Kerkhove added.
Symptoms of hantavirus infections sometimes do not start until eight weeks after contact with the virus,according tothe Centers for Disease Control and Prevention.
The WHO is working under the assumption that the strain of hantavirus in the suspected outbreak is the Andes virus, which historically has been shown to potentially transmit between people, although sequencing is still ongoing, according to Van Kerkhove.
In aposton its website, the WHO said the onset of illnesses aboard the MV Hondius occurred between April 6 and April 28, with patients experiencing fever, gastrointestinal symptoms, rapid progression to pneumonia, acute respiratory distress syndrome and shock.
"The outbreak is being managed through coordinated international response, and includes in-depth investigations, case isolation and care, medical evacuation and laboratory investigations," the WHO wrote in the post.
WHO Director-General Dr. Tedros Ghebreysus wrote ina post on XTuesday that the infection risk to the global population is low and that the agency will continue to monitor the situation and provide updates.
Timeline of cases
The first suspected hantavirus case occurred in a 70-year-old male passenger from the Netherlands who developed fever, headache and mild diarrhea on April 6, according to the WHO andSouth African health officials.
On April 11, the passenger developed respiratory distress and died on board the ship the same day. His body was removed from the ship to the British territory of St. Helena on April 24. No microbiological tests were performed on the man, according to the WHO.
Also on April 24, the male passenger's 69-year-old wife developed gastrointestinal symptoms, health officials said. Her health rapidly declined while on a flight to Johannesburg, South Africa, on April 25 and she died upon arrival to an emergency department the next day, the WHO said.
On Monday, May 4, laboratory testing confirmed that the wife was infected with hantavirus.
Health workers have begun working to identify anyone who may have come into contact with the couple. According to the WHO, the couple had traveled in South America, including Argentina, before they boarded the cruise ship on April 1.
During Tuesday's press conference, Van Kerkhove said officials suspect the couple was infected with hantavirus before boarding the ship.
"The initial patients, the initial case and his wife, they joined the boat in Argentina. And with the timing of the incubation period of hantavirus, which can be anywhere from one to six weeks, our assumption is that they were infected off the ship, perhaps doing some activities there," she said.
A British passenger started developing symptoms on April 24, including shortness of breath and signs of pneumonia, according to the WHO and South African health officials.
His condition worsened and he was medically evacuated from Ascension, another British territory, to South Africa on April 27, where he is currently hospitalized in an intensive care unit. Laboratory testing confirmed hantavirus infection over the weekend, the WHO said.
Another passenger, an adult female, began experiencing symptoms on April 28, including a general feeling of being unwell, according to the WHO. She later presented with pneumonia and died on May 2. Oceanwide Expeditions, which operates the cruise ship,previously revealedthat the patient was a German national.
In addition, there are three suspected cases currently onboard the MV Hondius reporting high fever and/or gastrointestinal symptoms, the WHO said. The ship is currently off the coast of Cape Verde, where medical teams in the area are evaluating the patients and collecting additional specimens for testing, according to the WHO.
Van Kerkhove said the highest priority is to medically evacuate the symptomatic individuals onboard the ship so they receive the care they need.
"The plan now is for the ship to continue on to the Canary Islands. We're working with Spanish authorities who will welcome the ship, have said that they will welcome the ship, to do a full investigation, a full epidemiological investigation, full disinfection of the ship, and of course to assess the risk of the passengers that are actually on board," she said.
"The medical evacuation of two individuals currently requiring urgent medical care, and the individual associated with the guest who passed away on 2 May, will occur using two specialized aircraft that are en route to Cape Verde," Oceanwide Expeditions said in astatementTuesday.
"From here, the patients are to be medically evacuated to the Netherlands," the statement continued, noting that there currently was no "exact timeline" for the evacuation.
The company added that once the guests have been safely transferred and are in transit to the Netherlands, the ship will proceed to the Canary Islands.
"[T]he hospital has already prepared an area with isolation capacity, should it be necessary," Angela Gomes, Cape Verde's national director of health, said in a statement Tuesday. "A dedicated team has been formed, with doctors, infectious disease specialists, nurses and laboratory technicians, to support patients on board and, if necessary, also on land."
The Spanish Ministry of Health said Spain will host the MV Hondius vessel in the Canary Islands in compliance with "international law and the humanitarian spirit."
Once there, crew and passengers will be examined, treated and transferred to their respective countries, the ministry said.
Following this same logic, and as part of the operation, the Government has also accepted a formal request from the Government of the Netherlands to take in the doctor from the MV Hondius, who is in serious condition and will be transported to the Canary Islands on a hospital plane today.
