Spain registers first positive hantavirus case among passengers in quarantine

One of the 14 Spaniards that left the MV Hondius cruise ship on Sunday has tested positive after undergoing a PCR test at the Gómez Ulla hospital in Madrid on Monday.

The Ministry of Health made the announcement at 9pm on Monday, the day after the authorities handling the passengers' evacuation repatriated 93 of them under strict safety measures to prevent contagion.

The Spanish patient "is currently asymptomatic and in good condition", as the ministry has reported. He is staying at the high-level isolation unit of the Madrid hospital.

The other 13 Spaniards have tested negative. Health Minister Mónica García said they "are doing well", although the health authorities are treating them "as if they were confirmed cases", as per protocol.

The ministry warned that "it wouldn't be surprising if some cases appeared among close contacts". García said: "Positive results are part of the infection itself. They've been in contact with people with the virus for many weeks and some have died."

However, the medical handling of the evacuation is not in question, according to the minister, nor is the sincerity of the people who were on the cruise ship, even though they didn't undergo "widespread" PCR tests because "there was no technical capacity or epidemiological reasons".

Head of the WHO (World Health Organization) Tedros Adhanom has stated that the hantavirus incubation period is 42 days. According to science reports, patients can be in quarantine "in a medical facility or at home".

"We can't impose it on every country, but I've seen that they are committed and will do their best," Adhanom said.

Given the long incubation period, García doesn't discard the possibility that other passengers "may show symptoms or test positive" as more time passes.

The Spanish patient is not the only passenger who has tested positive since disembarking the ship. On Sunday afternoon, one of the five passengers who boarded the medicalised plane to France started "feeling unwell". She tested positive that same evening.

The woman had a fever and is currently "in a hospital" in France. The Spanish authorities have not received any updates regarding her condition. The French authorities are tracing the 22 close contacts they have identified, as French Health Minister Stéphanie Rist has reported.

On Monday afternoon, Adhanom justified the decision to evacuate the cruise ship passengers. "The French passenger was in critical condition and could have died had she remained. The evacuation was the right thing to do and they will now receive the help they need," he said.

García said that, when the MV Hondius anchored in the port in the Canary Islands, the health authorities "took everyone's temperature before the passengers disembarked".

"None of them had a fever," she said, adding that the French woman had a fever only when she boarded the plane.

"The virus's progression is very unpredictable. It's normal for people not to show symptoms on the ship and then start to develop them later," García said.

The WHO updated its data on Monday afternoon. At that time, it reported nine cases. With the new result from Spain, the total is now ten. There have been three deaths. There is one suspected case that is not included. None of those evacuated on Monday afternoon had symptoms.

In Spain, the two women who are in isolation because they were in contact with the Dutch woman who died during a flight have tested negative in their respective PCR tests and remain in isolation.

Days before the operation launched on Sunday in the Canary Islands, the European Centre for Disease Prevention and Control had sent an epidemiologist to the cruise ship, which was then anchored in Cape Verde. There, they conducted PCR tests, specifically targeting the three passengers with symptoms and some of their contacts. They sent the diagnostic tests to two laboratories. The ship continued sailing with asymptomatic passengers.

Now, one of the 17 Americans that underwent the test has returned a "weak positive" result. "The person in question did not exhibit symptoms while in Cape Verde," the health authorities stated.

The evacuation of that passenger was "in a separate vessel". He was also under isolation on the plane that took off late Sunday afternoon.

Health officials are "closely monitoring the progress" of the two Americans. "It depends on the tests. They could be inconclusive, as was the case with Covid-19. If that happens, we consider it positive, as do the US authorities," García said.

There is a third, this time "symptomatic", case among the Americans. "The ship's doctors reported that this person exhibited a mild cough on 6 May, which subsided after that day," García said.

Given the passenger's improved condition, the doctors decided not to classify it as a probable case. It was a woman who also had symptoms such as "anxiety" and a "raspy throat".

At the end of the day on Sunday, García said the mission had been a "success from the start". The ship departed at 8pm with 27 people aboard: crew members, a doctor and a nurse of various nationalities. Passengers of other nationalities travelling to Oceania were picked up by a plane the Netherlands had chartered.

"Rest assured. This has nothing to do with Covid-19. We ask for empathy towards the passengers. We are confident that during this quarantine period they will be in the hands of experts in their countries," the WHO said.