Referred to as “case 1” in the World Health Organization (WHO) disease outbreak news, the first person who died after an infection with Hantavirus on the cruise ship MV Hondius. He is officially considered a “probable case”, as no microbiological tests were performed to confirm the reason for his illness.
He and his wife had boarded the cruise ship in Ushuaia, Argentina, on 1 April, after more than three months of travel in Argentina, Chile, and Uruguay. According to WHO, he developed symptoms on 6 April and died on board on 11 April.
On 4 May, almost a month after his death, the WHO said it was reacting to a suspected hantavirus outbreak on the ship, which by that time was off the West African island nation of Cape Verde.
Case 2, “an adult female, who was a close contact of case 1,” left the ship in Saint Helena on 24 April with gastrointestinal symptoms. Her condition worsened during a flight to Johannesburg, South Africa, on 25 April, and she died the following day in a clinic in Johannesburg. Microbiological tests confirmed an infection with Andes hantavirus, the only hantavirus known to be transmissible between humans.
Obituaries in local Dutch newspaper
American media have identified the couple. According to reports by the New York Post, Cases 1 and 2 are a married Dutch couple, Leo Schilperoord, 70, and his wife Mirijam, 69, both retired ornithologists.
The local newspaper of their hometown, Haulerwijk, in the North of the Netherlands, printed obituaries listing the corresponding dates of death.
“During their return journey after a trip through South America, we were deeply saddened to learn of the passing of our neighbours. Their deaths so close together affect us deeply. We wish their family and loved ones much strength during this difficult time,” reads one of the obituaries published by the local Neighbourhood Association.
Hypothesis of where the infection happened
In the days before embarking on the cruise, the couple visited a landfill site in Ushuaia, southern Argentina, known for attracting birdwatchers. One hypothesis is that this may have been where the infection occurred.
Local authorities have rejected this claim, reportedly made anonymously by national health officials, to the Associated Press, stating that they have never recorded a single case of hantavirus, let alone the Andes strain, in the area surrounding the landfill in Tierra del Fuego, Argentina.
Juan Facundo Petrina, the province’s Director General of Epidemiology and Environmental Health, said to the Associated Press that the rodent species responsible for transmitting the virus is not present in the region.
The European Centre for Disease Prevention and Control (ECDC) says the current hypothesis is that at least one passenger was exposed to the Andes virus while spending time in Argentina or Chile before boarding the ship. It adds that the passenger may have subsequently transmitted the virus to others onboard.
A long incubation period
Hantavirus is typically transmitted through contact with rodent droppings and is not easily passed from person to person.
However, the Andes virus, a hantavirus primarily found in South America that is linked to the cruise ship outbreak, may, in rare cases, spread between humans. Symptoms, such as fever, chills, and muscle aches, usually appear one to eight weeks after exposure, according to WHO.
It can cause a severe lung infection called Hantavirus Pulmonary Syndrome, which can worsen quickly and become life-threatening.
Secondary infections among healthcare workers have previously been documented in healthcare settings, although they remain uncommon. Transmission appears most likely during the early phase of illness, when the virus is considered more transmissible.
The WHO also notes that evidence remains limited due to the scarcity of outbreaks involving sustained human-to-human transmission.
Both WHO and ECDC say the risk to the general population is low, since the Andes virus spreads only in very close personal settings between people.
