The World Health Organization insisted that there is a minimal risk from the hantavirus to the general public, as countries prepared to repatriate passengers stuck on a cruise ship hit by a deadly outbreak.

Three passengers from the MV Hondius - a Dutch husband and wife and a German woman - have died while others have fallen sick with the rare disease, which usually spreads among rodents.

The only hantavirus species which can transmit from person to person - Andes virus - has been confirmed among those who have tested positive, fueling international concern.

The Dutch-flagged vessel, which has around 150 people on board, is expected to arrive in the Spanish Canary Island of Tenerife on Sunday. Special flights will take passengers to their home countries.

Fear in Tenerife

Nevertheless, the news was stirring fears that hospitals and health centers on Tenerife would have to be locked down, said a nurse who asked not to be identified.

"It will be just like Covid... People are worried about their children, elderly relatives and the vulnerable," the nurse said, adding that the islands' quarantine protocol for viruses, if one was declared, would affect schools and healthcare centers.

All the passengers left on board the ship were not presenting symptoms of the disease and would be repatriated to their countries, while the 14 Spaniards on board would be flown to a hospital in Madrid to quarantine, Spanish Health Minister Monica Garcia said.

Some residents complained that the Canaries' status as a safe destination meant it always had to shoulder responsibilities other tourist markets shirk.

"Tourist destinations competing with the Canary Islands in the international market, such as Morocco, have not been taken into account, and the decision has been made to bring the cruise ship to the Canary Islands – there must be a reason for that," said Jorge Marichal, president of Tenerife's hotels association, Ashotel.

Madrid has failed to communicate what was expected of the archipelago, which was making it difficult to assuage the tourism industry, said the regional government's tourism minister, Lope Afonso.

Some Canarians worried it could have an impact on Pope Leo's scheduled visit to the Canaries in June.

"Can you imagine the Pope with hantavirus? That's a headline we don't want," local comedian Omayra Cazorla said on Instagram.

Risk remains low

Meanwhile, WHO spokesman Christian Lindmeier told reporters, "This is a dangerous virus, but only to the person who's really infected, and the risk to the general population remains absolutely low." 

He said a picture was emerging from MV Hondius where "even those who have been sharing cabins don't seem to be both infected in some cases," when one has fallen sick.

"That shows you again, luckily, apparently, the virus is not that contagious that it easily jumps from person to person," he said.

The WHO has said there were five confirmed and three suspected cases of the virus. There are no suspected cases on the ship, however, an update on this will be issued later.  

Spain finds suspected case

Spanish authorities said a woman had been tested for suspected hantavirus after traveling on the same flight as a Dutch woman who stayed on the MV Hondius cruise ship and later died from the virus.

The woman has "symptoms mainly related to coughing while she was in her family home" in the eastern city of Alicante, Spanish secretary of state for health Javier Padilla told journalists.

She was placed in "an isolation room" in hospital, which carried out a PCR test that will be analysed at the National Microbiology Centre, said Padilla. Those results "we hope to have in the first 24 hours," he added.

"We must say this is a pretty unlikely case, a person was found who was two rows behind the person who died with hantavirus," said Padilla.

Flight attendant tests negative

Cruise operator Oceanwide Expeditions said 30 passengers, including the first fatality, disembarked at the remote British island of Saint Helena on April 24.

A flight left there for Johannesburg the next day, setting off a chain of contact tracing not only on that connection but on onward travel to the rest of the world.

A flight attendant on the Dutch flag carrier KLM who came into contact with an infected passenger from the cruise ship and later showed mild symptoms, tested negative for hantavirus, the WHO said.

The passenger - the wife of the first person to die in the outbreak - had briefly been on a plane bound from Johannesburg to the Netherlands on April 25, but was removed before take-off. She later died in a Johannesburg hospital.

Lindmeier said the flight attendant testing negative was "good news," as it showed that someone could come into contact with an infected person and still not catch the virus.

"It's not spreading [like] anything close to how Covid was spreading," he added.

US President Donald Trump said he had been briefed on the alert, telling reporters: "It's very much, we hope, under control."

Passengers reassured

The MV Hondius, which has also been used for polar expeditions, left Ushuaia on the southern tip of Argentina on April 1 for a cruise across the Atlantic Ocean to Cape Verde.

Three suspected cases, including two crew who later tested positive, were evacuated from Cape Verde to the Netherlands.

YouTuber Kasem Ibn Hattuta, who is traveling on the Hondius, said passengers were reassured that doctors had joined the ship before sailing for Tenerife.

"We finally left Cape Verde which was a relief for everyone on board, especially knowing that our sick colleagues are finally getting the medical care they need," he said in a statement.

"Everyone is keeping a high spirit, people are smiling and taking the situation calmly," he said, adding that people were wearing masks indoors and keeping their distance from others.

Repatriation plans

The MV Hondius has cleared the Mauritanian coast as it heads for the Canary Islands.

The Spanish government said the first passengers will be repatriated on Sunday, after its arrival.

Spanish authorities have said the ship will anchor off Tenerife and will not be allowed to dock. Passengers will be transferred to the airport on a smaller vessel.

Britain has chartered a repatriation flight from Tenerife for UK passengers and crew.

"Established infection control measures will be put in place at every step of the journey to ensure the safe repatriation of British passengers on board," said UK Health Security Agency (UKHSA) Chief Scientific Officer Robin May.

The ship called at several remote British islands in the South Atlantic along the way, including Saint Helena.

The UKHSA said there was a suspected case on Tristan da Cunha, one of the world's most isolated settlements with around 250 people.

Limited evacuation window

The evacuation of a hantavirus-struck cruise ship in the Canary Islands must happen between Sunday and Monday because adverse weather conditions will force it to leave, the Spanish archipelago's regional government said.

"The only window of opportunity we have to carry out this operation is around 12 o'clock on Sunday morning and until conditions change from Monday," regional government spokesman Alfonso Cabello told reporters.

"Otherwise, the ship must leave and no operation could be carried out again in theory... until the end of May," he said, citing wind and swell.