Hantavirus protocol breach at Dutch hospital as medics race to curb spread

A Dutch hospital has quarantined 12 staff members as a preventive measure after blood and urine from a hantavirus patient were handled without observing strict protocols, according to officials, as medics around the world work to stop the spread of the outbreak.

The 12 will be quarantined for six weeks, the Radboudumc hospital in the city of Nijmegen said, adding that the infection risk was very low and patient care continued uninterrupted.

The quarantine highlights the difficulty of quickly enforcing stricter hospital protocols to manage the hantavirus outbreak linked to the Hondius cruise ship.

The World Health Organization 9WHO) increased its tally of confirmed cases in the outbreak to nine, up by two from the previous day.

The head of the United Nations agency said more cases could come because of the long incubation period, but that this was not a pandemic, and was nothing like COVID-19.

The virus can be deadly, although it does not spread easily from person to person.

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Strict protocols

The Radboudumc hospital admitted its hantavirus patient, a passenger from the cruise ship, on 7 May.

"What happened ... is that strict procedures were followed, but not the very strictest procedures that apply in cases involving this hantavirus," Dutch Health Minister Sophie Hermans told parliament.

"It really is a different situation than with COVID. With the knowledge we have and the measures we are taking, we are confident we can keep this virus under control," Hermans said.

After the last passengers disembarked the ship in Spain's Canary Islands, the Hondius set sail for the Netherlands late on Monday evening with 25 crew, a doctor and a nurse.

It is expected to arrive in the Netherlands by 17 May, ship owner Oceanwide Expeditions said.

Three people- a Dutch couple and a German national have died since the start of the outbreak of the virus, which is usually spread by wild rodents. 

'Possible we might see more cases'

In addition to the nine confirmed cases, the WHO recognises two ‌suspected cases - one ⁠person who died before being tested, and one on Tristan da Cunha, a remote South Atlantic island where there were no tests available.

So far, all are considered to have been contaminated on the cruise trip, or before boarding the ship.

All suspected cases have been isolated and placed under strict medical supervision, minimising any risk of further transmission, WHO chief Tedros Adhanom Ghebreyesus said.

All passengers who had disembarked the ship at earlier stages in the cruise had been located, Tedros said, adding it was up to their respective countries to implement protocols to prevent the virus from spreading.

Test of international coordination

Four people who have been under observation in Italy for possible hantavirus infection have all tested negative, the Italian health ministry said on Wednesday.

Tests were conducted on an Argentine tourist hospitalised with pneumonia, a man from the southern Italian region of Calabria who was in voluntary isolation, a British tourist located in Milan and a companion travelling with him.

Tests conducted in hospitals in Rome and Milan came up negative for all four people, the health ministry statement said.

"The risk connected with the virus remains very low in Europe and therefore also in Italy," it added.

The Argentine tourist had left an endemic area in her home country on 30 April and travelled to Italy on a Buenos Aires-Rome flight before later going to Sicily, where she was hospitalised for pneumonia.

The Calabrian man on 25 April had briefly come into contact on a plane with a Dutch woman who later died from the virus.

The British tourist had also come into contact with the Dutch woman on a different flight and was put into quarantine, while his companion was also taken to hospital as a precaution.

Britain said on Tuesday it'll bring 10 people from remote island territories of Saint Helena island and Ascension Island, to the UK for precautionary isolation. They include cruise ship passengers and medical staff who had contact with confirmed cases. According to the Health Security Agency, the individuals were already isolating and not showing symptoms.

According to the cruise company's website, 32 guests and one crew member disembarked from the vessel at Saint Helena and two guests had a medical evacuation via Ascension Island.

The governor of Saint Helena, Ascension and Tristan da Cunha said in a statement on Monday that resident medical staff on Ascension Island who had treated a confirmed case were being relocated to Britain as a precaution, with replacement clinicians flown in to maintain healthcare on the island.

On Saint Helena, Governor Nigel Phillips said a small number of people who had travelled on the cruise ship were assessed as higher-risk contacts. While the likelihood of illness remained low, UKHSA advised they should also be moved to Britain to complete their self-isolation.

The British government did not immediately respond to a request for comment for further details.

Meanwhile, Spain announced late on Monday that a Spaniard had tested positive, one of 14 quarantining at a military hospital in Madrid. It said on Tuesday that definitive tests had confirmed negative results for the 13 others in quarantine.

The confirmed cases also include a French passenger who tested positive after the ship docked in the Canary Islands on Sunday and was in intensive care but in a stable condition.

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Hantavirus Virus Outbreak Cruise Ship Infection WHO Public Health Spain Canary Islands World Health Organization Dutch hospital