Three people have died and three others affected after a Netherlands-based cruise ship in the Antlantic Ocean was hit by a suspected outbreak of hantavirus.
The World Health Organization, which is conducting detailed investigations including further laboratory testing and epidemiological analysis, has confirmed one case of hantavirus infection, with five additional suspected cases.
A British tourist is being treated in a South African hospital after testing positive for the virus on the cruise ship.
Here is information about the virus.
Spread by rodents
Hantavirus is primarily spread by rodents but can be transmitted between people in rare cases, according to WHO.
People most typically become infected when virus in rodent droppings, saliva and urine becomes airborne, such as when areas where rats and mice have nested are swept out.
According to CDC, it can also spread through a bite or scratch by a rodent, but this is rare.
Hantaviruses cause two syndromes. Hantaviruses found in the Western Hemisphere, including in the U.S., can cause hantavirus pulmonary syndrome (HPS). The most common hantavirus that causes HPS in the U.S. is spread by the deer mouse.
Hemorrhagic fever with renal syndrome (HFRS) is a group of clinically similar illnesses caused by hantaviruses found mostly in Europe and Asia. However, Seoul virus, a type of hantavirus that causes HFRS, is found worldwide, including in the United States.
Signs and symptoms
Hantavirus Pulmonary Syndrome (HPS)
HPS is a severe and potentially deadly disease that affects the lungs. Symptoms of HPS usually start to show 1 to 8 weeks after contact with an infected rodent.
Early symptoms can include:
- fatigue
- fever
- muscle aches, especially in the large muscle groups like the thighs, hips, back, and sometimes shoulders
About half of all HPS patients also experience:
- headaches
- dizziness
- chills
- abdominal problems, like nausea, vomiting, diarrhea, and abdominal pain
Four to 10 days after the initial phase of illness, the late symptoms of HPS appear. These symptoms include coughing and shortness of breath. Patients might experience tightness in the chest as the lungs fill with fluid.
HPS can be deadly. Thirty-eight per cent of people who develop respiratory symptoms may die from the disease.
Hemorrhagic Fever with Renal Syndrome (HFRS)
HFRS is a severe and sometimes deadly disease that affects the kidneys. Symptoms of HFRS usually develop within 1 to 2 weeks after exposure. In rare cases, they may take up to 8 weeks to develop. Initial symptoms begin suddenly and include:
- intense headaches
- back and abdominal pain
- fever/chills
- nausea
- blurred vision
- People may have flushing of the face, inflammation or redness of the eyes, or a rash. Later symptoms can include:
- low blood pressure
- lack of blood flow (acute shock)
- internal bleeding (vascular leakage)
- acute kidney failure, which can cause severe fluid overload
