A cruise ship is waiting for help after 3 people died in a suspected outbreak of the rare hantavirus

CAPE TOWN, South Africa (AP) — A cruise ship with nearly 150 people aboard was waiting for help off the coast of Cape Verde in the Atlantic Ocean on Monday after three passengers died and three other people were left seriously ill in a suspected outbreak of the rare hantavirus, according to the World Health Organization and the ship's operator.The MV Hondius, a Dutch ship on a weekslong polar cruise from Argentina to Antarctica and several isolated islands in the South Atlantic, had requested help from local health authorities Sunday after making its way to the island of Cape Verde, off the West Africa coast. But no one has been allowed to disembark, Netherlands-based operator Oceanwide Expeditions said.Cape Verde's Health Ministry said Monday that for now, it will not allow the ship to dock because of public health concerns and that it would stay in open waters close to shore.Hantavirus is a rodent-borne illness spread by contact with rodents or their urine, saliva or droppings. WHO says that while it is rare, hantavirus may spread between people.It was unclear how an outbreak could have started, and the WHO said it was investigating while working to coordinate the evacuation of two sick crew members. Another sick person — a British man evacuated to South Africa on April 27 — is the only one to have tested positive for the virus, authorities said. He is in critical condition and isolated in intensive care, according to local health officials.The body of one of the passengers who died — a German — remains on the ship, according to an Oceanwide Expeditions statement. A 70-year-old Dutch man died onboard April 11, and his 69-year-old wife died later after leaving the ship, officials said.Among the 87 remaining passengers, 17 are Americans, 19 are from the U.K. and 13 from Spain, according to the company. Sixty-one crew members, including the two who are ill, also are onboard.Cruise operator says 2 sick crew members urgently need medical careTwo sick crew members — one British, one Dutch — have respiratory symptoms and need urgent medical care, Oceanwide said in its statement.Cape Verde has sent a medical team of two doctors, a nurse and a laboratory specialist to the ship over three trips, said Dr. Ann Lindstrand, a WHO official in Cape Verde.She told The Associated Press in an interview that they were planning for medical evacuations, in which passengers would be taken from the ship via ambulance to an airport and flown out of Cape Verde.“It’s been very tricky for Cape Verdean authorities,” Lindstrand said. “What they have to deal with is a public health event. And of course, they have been thinking about the protection of the population here.”But Oceanwide said it was still awaiting permission from local authorities in Cape Verde to evacuate passengers and crew members and it would consider moving to one of the Spanish islands of Las Palmas or Tenerife.The Dutch Foreign Ministry said it was also looking into evacuating some people from the ship.WHO said it was working with local authorities and Oceanwide to conduct a “full public health risk assessment.”“Detailed investigations are ongoing, including further laboratory testing, and epidemiological investigations,” WHO said. “Medical care and support are being provided to passengers and crew.”WHO said that while only one case was confirmed through tests, the other five cases — the three deaths and two ill crew members — were suspected to be hantavirus.Lindstrand told AP there was a possible new case on the ship, in a person showing mild fever symptoms, but health workers were still assessing.The cruise started in ArgentinaThe ship left Ushuaia in southern Argentina on April 1, according to Argentine provincial authorities, for its cruise to Antarctica, the Falkland Islands, South Georgia and other isolated islands in the South Atlantic.While Oceanwide Expeditions didn’t specify this trip's itinerary, the company advertises 33-night or 43-night “Atlantic Odyssey” cruises on the Hondius.The ship has 80 cabins and a capacity of 170 passengers, and it typically travels with about 70 crew members, including a doctor, the company said.The Dutch man was the first victim, and he presented with fever, headache, abdominal pain and diarrhea, officials said. His body was taken off the vessel nearly two weeks later on the British territory of Saint Helena, some 1,200 miles (1,900 kilometers) off the African coast, and was awaiting repatriation.His 69-year-old wife was transferred to South Africa at the same time but collapsed at a Johannesburg airport and died at a hospital, the South African Department of Health said.The ship then sailed on to Ascension Island, an isolated Atlantic outpost about 800 miles (1,300 kilometers) to the north, where the sick British man was taken off the ship and evacuated to South Africa on April 27. He later tested positive for hantavirus.South African officials have started contact tracing but say there's no need to panicThere was no information from authorities on the possible source of the suspected outbreak. A previous hantavirus outbreak in southern Argentina in 2019 killed at least nine people. It prompted a judge to order dozens of residents of a remote town to stay in their homes for 30 days to halt the spread.South Africa’s National Institute for Communicable Diseases was conducting contact tracing to identify whether people were exposed to infected cruise ship passengers. The 69-year-old woman who died was trying to catch a flight home to the Netherlands at Johannesburg’s main international airport, one of the busiest in Africa, when she collapsed.But the health department urged people not to panic, saying WHO was “coordinating a multicountry response with all affected islands and countries to contain further spread of the disease.”Hantavirus has no specific treatment or cure, but early medical attention can increase the chance of survival.Hantaviruses cause two serious syndromes, according to the U.S. Centers