The World Health Organization said Thursday there were now five confirmed hantavirus cases from the Atlantic cruise ship outbreak, with three more suspected -- and warned further cases were possible.Despite the three fatalities, the WHO insisted that the outbreak on the MV Hondius was not the start of an epidemic, or a repeat of the spread of Covid-19.The UN health agency said it expected the outbreak to be limited -- so long as public health measures are properly implemented."So far, eight cases have been reported, including three deaths. Five of the eight cases have been confirmed as hantavirus and the other three are suspected," WHO chief Tedros Adhanom Ghebreyeus said."The species of hantavirus involved in this case is the Andes virus, which is found in Latin America," he told a press conference in Geneva.He stressed that "none of the remaining passengers or crew on the ship are currently symptomatic".But given that the incubation period of the Andes virus -- the only species of hantavirus that spreads between people -- can be up to six weeks, he warned that "it's possible that more cases may be reported".- Morale on ship improving -The Dutch-flagged ship left Ushuaia on the southern tip of Argentina on April 1 for a cruise across the Atlantic Ocean to Cape Verde off the coast of West Africa.On Wednesday it set sail north from Cape Verde towards Tenerife, from where the passengers should finally be able to be repatriated.Tedros said he had been in regular contact with the ship's captain, including earlier Thursday."He told me morale has improved significantly since the ship started moving again," he said.The WHO's emergency alert and response director Abdi Rahman Mahamud added: "We believe this will be a limited outbreak if the public health measures are implemented."The disease is usually spread from infected rodents, typically through urine, droppings and saliva.The Andes strain of hantavirus is the only one with documented human-to-human transmission.Tedros said that prior to boarding the ship on April 1, the first two cases -- a Dutch couple who have both died -- had travelled through Argentina, Chile and Uruguay on a bird-watching trip, which included visits to sites where the species of rat known to carry Andes virus was present.The WHO was working with Argentina -- which followed the United States in quitting the agency -- to trace the couple's movements.He said 2,500 diagnostic kits would be sent from Argentina to laboratories in five countries.- 'This is not Covid' -The WHO's epidemic and pandemic preparedness and prevention director Maria Van Kerkhove was the agency's technical lead on Covid-19 throughout the coronavirus crisis."This is not the start of an epidemic. This is not the start of a pandemic," she said, explaining: "This is not Covid; this is not influenza -- it spreads very, very differently.The WHO is awaiting the results of full genome sequencing of the virus from South Africa, Switzerland and Dakar, which will help determine the clustering pattern compared to previous outbreaks -- with a high level of detail."It will give us a sense of whether or not we are seeing some changes," said Anais Legand, a WHO technical expert on viral haemorrhagic fevers, with Van Kerkhove adding that "nothing unusual" had been detected so far in the virus.Legand said the RNA of the virus could be detected in a case "from the first day of onset" of symptoms, which typically occur two to three weeks after exposure to the virus.Van Kerkhove added that the patient in intensive care in South Africa was "doing better", while the two patients in hospital in the Netherlands following evacuation from Cape Verde were in a stable condition.rjm-bur/nl/ach(Adds WHO news conference in paragraphs 5-7)* Authorities seek to trace passengers who disembarked before outbreak was detected* Three people have died, eight believed to have contracted virus* Ship heading to Spain's Tenerife* Human-to-human transmission is uncommonBy Bart H. Meijer, Olivia Le Poidevin and Ingrid MelanderAMSTERDAM/GENEVA, May 7 (Reuters) - Countries worldwide sought to prevent further spread of the hantavirus on Thursday, after an outbreak on a cruise ship, by tracking those who had already disembarked before the virus was detected and anyone in close contact with them since. Three people - a Dutch couple and a German national - died in the outbreak on the MV Hondius. In total, five people are confirmed to have contracted the virus, with another three suspected cases, the World Health Organization said. Hantavirus is usually spread by rodents but can in rare cases be transmitted person-to-person.All passengers who disembarked in St. Helena in the South Atlantic Ocean, where the ship made a stop on April 24, have been contacted, the ship's operator said, adding this included people from at least 12 countries, among them seven British citizens and six from the U.S. The first confirmed case of hantavirus in this outbreak came in early May.'THIS IS NOT COVID'The WHO repeated that the risk to the general public was "low" even if the Andean strain of the virus, found in several victims, can in rare cases be transmitted among humans. "This is not coronavirus, this is a very different virus," Maria Van Kerkhove, WHO director of epidemic and pandemic management, told a press conference. "This is not the same situation we were in six years ago." The WHO said it was working on step-by-step guidance for when the dozens of passengers remaining on the ship, which is sailing to the Canary Islands, arrives there on Saturday or Sunday and the passengers disembark and travel home. None of these passengers currently have any symptoms.CONTACT TRACING, MONITORING The United States' Centers for Disease Control and Prevention (CDC) said it was closely monitoring the situation, adding that the risk to the American public was extremely low at the time.The Georgia Department of Public Health said it was monitoring two asymptomatic residents who had returned home after disembarking from the cruise ship.The Arizona Department of Health Services said it was monitoring one resident, who was also on the ship, and was not symptomatic. According to the New York Times, California was monitoring a number of residents who had been on the ship.One French citizen has been in contact with a person who had fallen ill but was not showing symptoms, officials said.CONTACT TRACINGOceanwide Expeditions said they were now working to establish details of all passengers and crew who embarked and disembarked on various stops since March 20.The Dutch couple who have died, and who are believed to be the first hantavirus cases of this outbreak, only boarded on April 1.Dutch airline KLM said it had taken the Dutch woman off a plane in Johannesburg on April 25 due to her deteriorating medical condition. She died before she could reach the Netherlands.According to broadcaster RTL, a KLM stewardess who had been in contact with her has now been admitted to a hospital in Amsterdam after showing possible hantavirus symptoms.Crew and passengers who helped the Dutch woman who passed away are being called daily for health checks, Dutch authorities told public broadcaster NOS.EVACUATIONS, TESTSThree patients were evacuated from the ship on Wednesday. Two have been admitted to a hospital in the Netherlands, while another one was transferred to Germany for medical care.Martin Anstee, an expedition guide, was one of the two evacuees in hospital in the Netherlands, according to Sky News, and told them he was "doing okay" but "there are still lots of tests to be done".The Duesseldorf University Clinic, treating the German evacuee, said she was not a confirmed case but rather a contact and was undergoing tests.In Switzerland, a person admitted to hospital on Monday was stable but showed symptoms consistent with a hantavirus infection, the hospital said.A Danish citizen who was aboard the Hondius has returned home and has been advised to self-isolate as a precaution, Danish health authorities said. (Reporting by Madeline Chambers in Berlin, Olivia Le Poidevin in Geneva, Jennifer Rigby in London, Stephanie Van Den Berg in The Hague, Toby Sterling, Bart Meijer and Charlotte Van Campenhout in Amsterdam, John Revill in Zurich; Writing by Ingrid Melander; Editing by Alexandra Hudson)
