Journey's end for hantavirus cruise ship as it docks in Rotterdam

A cruise ship that sparked global alarm after a deadly outbreak of hantavirus docked in Rotterdam harbor Monday, with the skeleton crew facing weeks of quarantine.

Twenty-five crew and two medical staff remain on board, some of whom could be seen wearing blue hard hats and white face masks as the ship made its final approach into port for disembarkation and disinfection.

The MV Hondius, operated by Dutch company Oceanwide Expeditions, had been ​carrying around 150 passengers and crew from ⁠23 countries when a cluster of severe respiratory illnesses was first reported to the World Health Organization on May 2.

Three people – a Dutch couple and a German woman – have died ​since the start of the outbreak of hantavirus, a rare virus for which no vaccines or specific treatments exist.

The World Health Organization has scrambled to reassure the world that the outbreak was not a repeat of the Covid pandemic, stressing that contagion was very rare.

However, the virus has an incubation period of several weeks, meaning more cases from the ship's occupants could emerge in the future, Tedros warned.

Where are the hantavirus victims from?

Hantavirus has been confirmed in seven patients, with one other probable case, according to a tally from official sources.

The most recent positive test came from Canada in a patient who was on the Hondius, officials said late Sunday.

After arriving in the Canary Islands on May 10, more than 120 passengers and crew were evacuated from the ship, either to their home countries or to the Netherlands, which has a special responsibility as the ship is Dutch-flagged.

A 65-year-old French woman became symptomatic on the repatriation flight and ended up in critical condition in a Paris hospital with a confirmed case of hantavirus.

Two people, one Dutch and one British, were also urgently evacuated from the ship to the Netherlands and rushed to hospital.

Both are in stable condition and the Briton is well enough to return home for self-isolation, according to Dutch officials.

All others evacuated to the Netherlands from the ship have tested negative for the virus. Some are in quarantine in the Netherlands, others have already flown home.

Are the remaining passengers high-risk?

Everyone still on board is asymptomatic, according to Oceanwide Expeditions, and being closely monitored by two medics on board.

Late Sunday, the WHO said it was maintaining its assessment of the hantavirus outbreak as "low risk".

"While additional cases may still occur among passengers and crew members exposed before containment measures were implemented, the risk of onward transmission is expected to be reduced following disembarkation and the implementation of control measures," it said. 

The people disembarking on Monday comprise 17 from the Philippines, four from the Netherlands (two crew and the two medical staff), four from Ukraine, one from Russia and one from Poland.

Some of them will stay in quarantine facilities at the port, while others will self-isolate at home.

Also on board is the body of a German woman who died during the voyage.

After docking, the ship will undergo thorough cleaning and disinfection procedures, according to the operator.

What were the ship's movements?

The MV Hondius's voyage began on April 1 in Ushuaia, Argentina, taking in remote islands in the South Atlantic Ocean before heading north to Cape Verde. 

The trip was supposed to finish there, but the ship eventually sailed to Tenerife in the Canary Islands for the evacuations by plane.

The MV Hondius presented diplomatic challenges as different countries negotiated over who would receive it and treat its passengers.

Cape Verde refused to take the ship, which remained anchored offshore near the capital Praia as three people were evacuated to Europe by air.

Spain allowed the vessel to anchor off its Canary Islands for the evacuation of passengers and crew but the Atlantic archipelago's regional government fiercely opposed the measure.

Rotterdam port authorities said quarantine facilities had been set up for some of the non-Dutch crew, though it was unclear if they would stay there for the full recommended 42-day quarantine period. The vessel itself was to undergo disinfection.

What is hantavirus? 

Hantavirus spreads from the urine, feces and saliva of infected rodents and is endemic in Argentina, where the voyage began.

Although primarily spread by rodents, it can be transmitted between people ​in rare cases and after prolonged, close contact. Incubation can last about six weeks.

Crew, passengers who already left the ship and ⁠people in contact with them have been quarantined in several countries around the world.

The current outbreak involves ​the so-called Andes virus – the only strain of hantavirus that can spread between people. It has circulated in Argentina and Chile for decades. Ship samples show no meaningful variation in the virus, the European Centre for Disease Prevention and Control has said.

On Friday, the WHO revised its case count to 10 from 11 after an inconclusive US case tested negative. As of May 15, there were 10 WHO-reported cases – eight confirmed and two probable – including the three deaths. 

The WHO recommends monitoring and quarantining high-risk ​contacts for 42 days after exposure, while advising low-risk contacts to self-monitor and seek medical care if symptoms ​develop.

Kiki Hirschfeldt, a spokeswoman for the operator, said it was too early to say what impact the outbreak could have on the appetite for cruises.

"I mean, for as far as we know right now, the virus was brought on board and that can happen in a hotel, in an airplane, in a boat," she said.