South Africa has been drawn into a hantavirus-related health scare following confirmation of a rare case linked to an international cruise with multiple fatalities reported.
South Africa’s Department of Health has called for calm, stressing that the risk to the public remains low.
Two passengers from the MV Hondius died after falling ill during the voyage. A 70-year-old male passenger became ill on board and later died on arrival at St Helena Island while his spouse, a 69-year-old female, collapsed at OR Tambo International Airport in Johannesburg while in transit and later died. Laboratory results for the second patient are still outstanding.
A third passenger, a British national, remains in critical condition in South Africa. The patient was medically evacuated to a private health facility in Sandton after his condition deteriorated despite treatment at Ascension.
“His laboratory test results came back positive for hantavirus,” said the Department of Health. “The patient is still in a critical condition in isolation but receiving medical attention.”
The vessel was travelling to the Canary Islands via Cape Verde from Argentina, carrying 147 passengers, including crew, and had visited multiple destinations, including mainland Antarctica, the Falklands, South Georgia, Nightingale Island, Tristan da Cunha, St Helena and Ascension.
The Department of Health said it is working with the National Institute for Communicable Diseases and Gauteng health authorities on contact tracing to identify and monitor individuals who may have been exposed.
“In our view, there is no need for the public to panic because only two patients from the cruise ship have been within our borders,” the Department of Health added. “The World Health Organisation (WHO) is coordinating a multi-country response with all affected islands and countries to contain further spread of the disease.”
The Africa Centres for Disease Control and Prevention (Africa CDC) confirmed that, as of May 4, only seven cases, including the three aforementioned cases, of hantavirus infection have been identified. Among these, three fatalities have been recorded.
Tracing
Airlink operated flight 4Z 132 from St Helena Island to Johannesburg on April 25. The airline was subsequently informed by South Africa’s public health authorities that a passenger on the flight died after arriving in Johannesburg due to hantavirus.
At the time of the flight, no passengers were known to be unwell. Airlink has since provided the Department of Health with the full passenger manifest, including contact details and seating allocations, to support contact tracing efforts.
The airline is also contacting passengers who were on the flight and advising them to reach out to the Department of Health if they have not yet been contacted.
What you need to know
Hantaviruses are rare zoonotic viruses carried by rodents with human infection typically occurring through contact with contaminated urine, droppings or saliva or exposure in environments where rodents are present. According to WHO, and Africa CDC, the disease can initially present with fever, headache, muscle aches and gastrointestinal symptoms but may progress rapidly to severe respiratory illness, including pneumonia and acute respiratory distress.
While infections are uncommon, severe cases can be fatal. There is no specific antiviral treatment or vaccine. Early supportive medical intervention, particularly in intensive care settings, is provided.
Illness onset occurred between April 6-28 and was characterised by fever and gastrointestinal symptoms, followed by rapid progression to pneumonia, acute respiratory distress syndrome and shock. The index case died on April 11 while onboard the MV Hondius. His remains are currently in Saint Helena pending repatriation to the Netherlands.
WHO and Africa CDC pointed out that transmission is primarily environmental rather than person-to-person, which remains rare. The current cluster linked to cruise travel is considered contained with the risk to the general public assessed as low. Routine tourism activities are not typically associated with exposure.
For travellers and operators, prevention centres on basic hygiene and environmental management, including avoiding contact with rodents, ensuring proper food storage, maintaining ventilation in enclosed spaces and using safe cleaning practices in potentially contaminated areas.
