News from MV Hantavirus Hondius continues at a steady, if grim, clip. In our last dispatch we established the facts: that on April 1, a Dutch couple boarded a cruise ship in Argentina unaware that they had been infected with a rare form of hantavirus that can be transmitted human-to-human. The husband died on board on April 11; his wife disembarked with her late husband’s body on the remote South Atlantic island of St. Helena on April 24; the next day the wife flew to South Africa where she then passed away. By May 2, a third person died on board (where the body still remains), a fourth person was flown to South Africa in critical condition, and the ship identified three passengers experiencing “mild” symptoms. Those three passengers — including the ship’s doctor, oy — were evacuated on Wednesday to receive specialized treatment in Europe.

Meanwhile, 100+ remaining passengers and crew are stuck in quarantine on the ship. So far so awful. Then yesterday we learned this: when the ship docked in St. Helena on April 24, the Dutch wife and her late husband’s body were not the only passengers to disembark. 30-40 passengers total left the cruise ship that day, flying on to at least 12 different countries that are now scrambling to contact trace.

The ship’s operator said Thursday that a total of 30 passengers — including the deceased Dutch man and his wife — left the vessel at St. Helena. The Dutch Foreign Ministry has put the figure at about 40. The company had not previously said publicly that dozens more people left the ship on April 24. The stop was the scheduled end of the cruise for some passengers.

It wasn’t until May 2 that health authorities first confirmed hantavirus in a ship passenger, the WHO says. That was in a British man evacuated from the ship to South Africa three days after the St. Helena stop. He was tested in South Africa and is in intensive care there.

It emerged Wednesday that a man tested positive for hantavirus in Switzerland after he disembarked at St. Helena, though his precise movements in between aren’t clear.

On Thursday, Singaporean health authorities said they were monitoring two men who got off the ship at St. Helena, flew to South Africa and then home. The two men, who arrived in Singapore at different times, were being isolated and tested, officials said.

Authorities in St. Helena, the volcanic British territory in the South Atlantic where passengers disembarked, said they were monitoring a small number of people who were considered “higher risk contacts.” Those contacts were being told to isolate for 45 days, the St. Helena government said.

The Dutch health ministry said Thursday that a flight attendant on a plane briefly boarded by an infected cruise passenger in South Africa was showing symptoms of hantavirus and would be tested in an isolation ward at an Amsterdam hospital. The cruise passenger, the Dutch woman whose husband died on the ship, was too ill to take the international flight to Europe and was taken off the plane in Johannesburg, where she died.

If the dutch flight attendant tests positive, she could be the first known person not on the MV hondius to become infected in the outbreak.

…A French citizen with “benign symptoms” is in isolation and undergoing medical tests, after being identified as a contact case linked to the ship passenger who flew April 25 from St. Helena to Johannesburg and was confirmed to have hantavirus, the French Health Ministry said in a statement Thursday.

…Tests have confirmed that at least five people who were on the ship were infected with a hantavirus found in South America, called the Andes virus. The only hantavirus thought to spread human-to-human, it can cause a severe and often fatal lung disease called hantavirus pulmonary syndrome.

[From HuffPost]

So let me get this straight: by May 2, the cruise ship company finally knew they were dealing with an outbreak of hantavirus. But it took them another five days to report that oh, by the way, over a week ago 30-40 passengers got off the boat and flew all over the world after the first person died? Five days in contact tracing is a huge setback. I do believe I’m mathematically accurate in saying that a delay like that makes things exponentially worse for health officials trying to isolate and contain the spread. My hope is that the cruise ship actually reported their disembarked passengers much sooner, and that it’s just that the news reached us, the greater public, days later. WHO still emphatically insists that there’s no cause for wider alarm, saying, “We believe this will be a limited outbreak if the public health measures are implemented and solidarity is shown across all countries.” The second half of that statement may not be as reassuring as WHO thinks it sounds.