A French passenger who later tested positive for hantavirus after flying back to France had initially been told her symptoms were likely anxiety, according to Spain’s health ministry.
The expedition cruise ship MV Hondius, where an outbreak was reported, arrived in Tenerife on Monday, May 10. Nearly 120 passengers and 23 crew members were taken off the vessel.
Among those evacuated were five French passengers who were transported to a hospital in Paris. French officials have confirmed that one of them has tested positive for the virus.
So far, three people — a German citizen and a Dutch couple — have died. Authorities have confirmed eight infections linked to the ship.
The Hondius departed southern Argentina on April 1. Five days into the trip, a 70-year-old Dutch man became ill and later died on board. The World Health Organization subsequently said it was looking into a potential hantavirus outbreak connected to the voyage.
Hantavirus is most commonly associated with exposure to rodents. While person-to-person transmission can occur, it is considered uncommon.
Spanish health minister Javier Padilla Bernáldez said the French woman had experienced flu-like symptoms while still on the ship, but they were not treated as a likely hantavirus case at the time.
“They were not thinking that these symptoms were compatible with hantavirus,” she told the Guardian.
“Why? Because what she was telling [them] was [that she had] an episode of coughing some days ago that had disappeared, and what she was having at that moment was kind of like stress or anxiety or nervousness. So it was not catalogued [as hantavirus].”
WHO director-general Dr Tedros Adhanom Ghebreyesus later said the patient was now in “critical condition”.
French health minister Stephanie Rist added that the woman’s condition deteriorated overnight on Sunday and that she is being cared for in a specialist infectious diseases unit in Paris.
Officials have also reported that an American passenger tested positive after returning to the United States, while a Spanish citizen is said to be a suspected case.
With passengers now dispersed internationally, health responses vary by country. In the US, 16 of the 18 returning passengers are being assessed at the University of Nebraska Medical Center in Omaha.
The remaining two were transported home in a biocontainment unit and are being evaluated at Emory University’s Regional Emerging Special Pathogen Treatment Center in Atlanta.
Despite the heightened precautions, the US Department of Health and Human Services has said the overall risk to the public remains very low.
HHS also said those who were on the cruise will be given individual care plans, determining whether they should isolate at home or stay in a dedicated facility.
The BBC reports those decisions will take into account factors such as symptoms, overall health, and home circumstances.
In the UK, returning passengers have reportedly been instructed to self-isolate for 42 days after hospital checks.