"We do believe that there may be some human-to-human transmission that's happening among the really close contacts [on board]," Maria Van Kerkhove, an epidemiologist with the WHO, said at a press conference Tuesday. "The husband and wife, people who've shared cabins, etc. So, again, our assumption is that has happened."
MV Hondius, a Dutch ship with nearly 150 people aboard, had been awaiting help off the coast of Cape Verde in the Atlantic Ocean after the African island refused to let it dock over public health concerns. However, the Spanish government said Tuesday the ship could sail to the Canary Islands for a "full investigation" and "full disinfection."
The WHO also later announced in a statement that it had officially requested, in coordination with the European Union, that Spain host the Hondius in the Canary Islands.
"The European Centre for Disease Prevention and Control (ECDC) is conducting a comprehensive examination of the ship to determine which individuals require urgent evacuation within Cape Verde itself," the WHO said. "The remainder will continue their journey toward the Canary Islands, where they are expected to arrive within three to four days."
Once it arrives in the Canary Islands, the passengers and crew will undergo medical screenings before they are repatriated to their own countries, the WHO said, noting Cape Verde "lacks the capacity to carry out this operation."
Besides the three fatalities — two of whom died on board and a third who died shortly after disembarking — there are four other suspected or confirmed cases of the virus, one of whom is a British national who was evacuated from the boat and is now in intensive care in South Africa, according to the WHO.
The other three cases who are still aboard the ship will first be evacuated to Cape Verde, and then on to the Netherlands so they can receive medical care, the ship's operator, Oceanwide Expeditions, said in a statement Tuesday.
Hantavirus is typically spread by contact with rodents or their urine, saliva or droppings, but the WHO said that while it is rare, the Andes strain of the hantavirus may spread between people. The agency believes the virus has been passed from person to person on the stricken ship, which was on a weekslong polar cruise from Argentina to Antarctica and several isolated islands in the South Atlantic. When humans catch the virus, it has a mortality rate of up to 50%.
Van Kerkhove, the WHO's epidemic and pandemic preparedness and prevention director, told journalists on Tuesday that Spanish authorities "have said that they will welcome the ship to do a full investigation, a full epidemiologic investigation, full disinfection of the ship and of course ... assess the risk of the passengers that are actually on board."
The Spanish Ministry of Health told CBS News its epidemiologists would conduct a review of the ship Tuesday afternoon.
"This intervention is intended to assess the condition of the people on board, determine whether there are more individuals with symptoms, and identify any high-risk or low-risk contacts," the ministry said in a statement. "This will help inform decisions regarding repatriation processes and the ship's route."
Passengers face possible eight-week quarantine
Ann Lindstrand, the WHO's representative in Cape Verde, told CBS News' Ramy Inocencio on Tuesday that there is no risk of a pandemic-level threat with the hantavirus, given the low likelihood of human-to-human transmission.
She confirmed three people would be medically evacuated to the Netherlands sometime on Tuesday, adding the condition of the patients was "reassuring." They are recovering and are stable, having been attended to by medical teams from Cape Verde on the vessel in the last few days, she said.
She said Spanish and Dutch authorities are "intensely discussing" what will happen next to the passengers on board, who have been told to remain in their cabins as much as possible.
"If there is the need for a quarantine, that will be a decision of the health authorities in Spain or Holland at that point in time, with the close collaboration with the advice of WHO," Lindstrand said.
The quarantine, if necessary, could be as much as two months, since the incubation period for hantavirus is between one and eight weeks, she said, adding, "eight weeks in a horribly long time to be in quarantine." Lindstrand said she is in touch with a volunteer doctor on the boat who told her passengers were "coping surprisingly well," though they are anxious to know their next port of call.
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