At least five U.S. states are currently monitoring residents who have returned home from the MV Hondius cruise ship in late April, following the outbreak of the rodent-borne hantavirus that continues to put health authorities worldwide on alert.
The Texas Department for State Health Services (DSHS) said Thursday it was notified by the Centers for Disease Control (CDC) that two state residents had disembarked from the ship and returned to the U.S. before reports of the outbreak.
DSHS said that the residents “are not experiencing any symptoms and did not have any contact with a sick person while aboard the ship,” in a statement. “They have agreed to monitor themselves for symptoms with daily temperature checks and contact public health officials at any sign of a possible illness.”
Georgia’s Department of Public Health has confirmed that it is monitoring two passengers who disembarked the vessel. “The individuals are currently in good health and show no signs of infection. They are following current recommendations from CDC,” a spokesperson told TIME.
In Virginia, one person who was on the ship and has since returned “is currently in good health and is under public health monitoring,” director of communications at Virginia’s Department of Health Maria Reppas told TIME on Friday.
“Our understanding is that fewer than 30 U.S. Citizens were on board the ship. A small number [under five] of other potentially exposed Virginians might be identified in the days ahead,” said Reppas.
Arizona is also reportedly monitoring a resident who left the ship on the island of St. Helena in the Atlantic Ocean on April 24. California’s Department of Public Health is also said to be monitoring an unspecified number of residents, bringing the total of passengers back in the U.S. to at least seven.
These public health departments have said that none of the residents are showing symptoms of the illness, according to multiple reports.
On Friday, the latest suspected case of hantavirus was reported by the U.K. Health Security Agency, in a British national on Tristan da Cunha, one of the stops on the MV Hondius itinerary. The UKHSA also confirmed that two other British nationals have hantavirus and are currently being treated.
Director General of the World Health Organization Dr Tedros Adhanom Ghebreyesussaid on Thursday that five cases had been confirmed as hantavirus, including three deaths.
Ghebreyesus emphasized that the WHO continues to assess the public health risk as low.
Hantavirus is predominantly spread by contact with the urine, droppings, and saliva of rats or mice, according to the CDC. It can also, on rare occasions, spread through scratches or bites from rodents.
The virus generally does not spread through human contact, but the Andes strain, one of the hantavirus family, can spread through droplets among close contacts, Kartik Chandran, professor of microbiology and immunology at Albert Einstein College of Medicine told TIME.
In response to the development, the CDC has reportedly classified the outbreak as a “Level 3” emergency response—the lowest classification—according to multiple reports cited by ABC News.
President Donald Trump confirmed on Thursday that he has been briefed on the virus, without providing further detail as to what the briefings entailed. “It’s very much, we hope, under control,” he told reporters. “I think we’re going to make a full report about it tomorrow.”
Authorities prepare for arrival of MV Hondius in Canary Islands
After three passengers suspected to have hantavirus were evacuated from the vessel in Cape Verde on Tuesday, the cruise ship has continued on its scheduled journey to the Canary Islands.
The Spanish archipelago, which sits 60 miles off the coast of Morocco, is set to receive all remaining passengers and crew onboard the MV Hondius on Sunday.
“They will arrive at a completely isolated, cordoned-off area,” said Spain’s head of emergency services Virginia Barcones on Thursday. “They will board vehicles that are isolated and under guard, and will proceed to a section of the airport that will be completely cordoned off.”
Barcones clarified the procedure so that residents of the Canary Islands “can rest assured that there will be absolutely no possibility of contact” with passengers from the cruise ship.
The scheduled arrival of the MV Hondius in Tenerife this Sunday comes despite pushback from the islands’ president, Fernando Clavijo. On Tuesday, Clavijo said that he “cannot allow” passengers to disembark on the islands, which he claimed would “blindly endanger the safety of the Canary Islands population.”
The Spanish government had previously announced that it would welcome the vessel to its territory, something which Clavijo said went against what he had already agreed upon with health officials on the islands.
A number of national health authorities are preparing to assist passengers once they arrive in Tenerife. According to Barcones, the U.S. is sending a plane to the Canary Islands to repatriate the 17 American citizens still onboard the ship.
The UKHSA said that it will have personnel on the ground, and that “British passengers and ship crew not displaying any symptoms of hantavirus will be escorted by U.K. Government staff to an airport and given free passage back to the U.K.”
Barcones said on Friday that Spain will “guarantee total safety” in the repatriation efforts for all 23 nationalities represented by the passengers and crew of the ship.
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