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By Khaleda Rahman and Toby Meyjes
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Americans evacuated from a hantavirus-stricken cruise ship are being quarantined in Nebraska, as health officials said one unnamed American has tested positive for the Andes variant of the virus while another is showing symptoms.
Eighteen Americans were flown to the University of Nebraska Medical Center (UNMC) in Omaha after being evacuated from the MV Hondius, officials said during a news conference on Monday.
Fifteen are staying at the National Quarantine Unit at UNMC, while the passenger who tested positive is being treated in the medical center’s biocontainment unit.
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Two of the passengers—the one who has symptoms and their partner—were transported to Emory Hospital in Atlanta, officials said.
That decision was made to ensure space is preserved in the Nebraska Biocontainment Unit “for anyone who might need it among the other passengers,” said Brendan Jackson, the acting director of the CDC's Division of High-Consequence Pathogens and Pathology.
Travel influencer Jake Rosmarin shared a selfie from inside his room at the National Quarantine Unit in Omaha early Monday, adding in a message that he is "feeling well."
"Hopping back on for a second to let everyone know I’m okay and feeling well," Rosmarin wrote alongside the image on Instagram early Monday. "The repatriation flight was smooth, and I safely made it to the National Quarantine Unit in Omaha. It’s been a very long few days, but hopefully I can start giving more updates again soon."
He added: "A special thank you as well to University of Nebraska Medical Center and the city of Omaha for welcoming us and helping ensure we are safe and cared for. Thank you again to everyone who has been supportive throughout all of this, it truly means a lot."
Of the 18 Americans evacuated from the MV Hondius, one tested positive for the hantavirus but is not showing any symptoms, and another had mild symptoms, the Department of Health and Human Services (HHS) said in a statement on Sunday. A flight carrying the ship passengers landed in the early hours of Monday morning and they were then transferred to waiting buses and driven away from the airport.
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HHS said one passenger who tested "mildly PCR positive" for the virus had been held in a biocontainment unit on the repatriation flight, as was another passenger who has mild symptoms.
The passengers were evacuated from the cruise ship that had anchored on Tenerife in Spain's Canary Islands after a hantavirus outbreak that has left three people dead, and five others who had earlier left the ship infected, but health authorities continue to stress that the risk to the broader public is low.
The World Health Organization (WHO), Spanish Health Ministry, and cruise company Oceanwide Expeditions had earlier said none of the more than 140 people who remained on the Hondius had shown symptoms of the virus.
But since leaving the ship, a French passenger also developed symptoms while on a flight home to France, French Prime Minister Sébastien Lecornu said. French Health Minister Stéphanie Rist confirmed on Monday that the passenger, a woman, had tested positive for hantavirus.
Rist said four other French passengers from the ship tested negative, but will be retested. Health authorities said they have so far identified 22 hantavirus contact cases in France.
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HHS said passengers on the aircraft that landed in Omaha on Monday would be transported to the ASPR Regional Emerging Special Pathogen Treatment Center (RESPTC) at the University of Nebraska Medical Center (UNMC).
The medical school's special unit for treating people with highly infectious diseases was used for COVID-19 patients early in the pandemic and previously for Ebola patients.
The passenger with mild symptoms would be transported from the RESPTC at the UNMC to a second RESPTC, HHS said.
"Upon arrival at each facility, each individual will undergo clinical assessment and receive appropriate care and support based on their condition," a statement from HHS posted on X read.
Kayla Thomas, a spokesperson for the UNMC, said in a statement provided to Newsweek: "One passenger will be transported to the Nebraska Biocontainment Unit upon arrival, while other passengers will go to the National Quarantine Unit [at the UNMC] for assessment and monitoring. The passenger who is going to the Biocontainment Unit tested positive for the virus but does not have symptoms."
Why Are Passengers Being Taken to Nebraska?
The National Quarantine Unit, run by Nebraska Medicine and UNMC, is the only federally funded quarantine unit in the country, designed to house and monitor people who may have been exposed to highly contagious and deadly infections.
It has 20 rooms that "employ individual negative air pressure systems, are single occupancy with en suite bathroom facilities and contain exercise equipment and Wifi connectivity for patients requiring longer stays," according to the UNMC website.
UNMC is also home to the Nebraska Biocontainment Unit (NBU), a highly specialized facility designed to care for those with high consequence infectious diseases.
The NBU is separate from all other units in the hospital, with a secured access main entrance that features pressure-controlled doors. Staff can only enter by security access through a separate entrance. The unit has its own air filtration system to ensure that no infectious particles escape the patient rooms. The NBU was used in the fall of 2014 to receive U.S. citizens with Ebola virus who were evacuated from Africa and again in 2020 to care for U.S. citizens with COVID-19.
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Hantavirus usually spreads when people inhale contaminated residue of rodent droppings, and the disease is not easily transmitted between people. But the Andes virus detected in the cruise ship outbreak may be able to spread between people in rare cases. Symptoms usually show between one and eight weeks after exposure.
WHO Director-General Tedros Adhanom Ghebreyesus has reiterated that the general public should not be worried about the outbreak.
"We have been repeating the same answer many times," he said. "This is not another COVID. And the risk to the public is low. So they shouldn’t be scared, and they shouldn’t panic."
Where Are Passengers Being Evacuated To?
Planes arrived in Tenerife to fly out passengers from more than 20 countries in an evacuation effort expected to last until Monday, The Associated Press reported.
All of the passengers were escorted from the ship by personnel in full-body protective gear and breathing masks.
Spanish passengers were the first to leave, and were flown to Madrid and transported to a military hospital. Hours later, a plane that evacuated the French passengers landed in Paris, where it was met by emergency vehicles. French Prime Minister Sébastien Lecornu said after Sunday’s flight that the five passengers would be kept in the hospital "until further notice."
In the U.K., authorities have said passengers will be hospitalized for 72 hours of quarantine, followed by six weeks of self-isolation. Japan’s Foreign Ministry said a Japanese national arrived in Britain on a chartered flight arranged by the British government and will be under health monitoring by British authorities for up to 45 days.
Greece's health ministry said a Greek male evacuee would spend 45 days in mandatory hospital quarantine in Athens.
A Dutch evacuation plane landed in the city of Eindhoven late Sunday. The 26 passengers aboard included eight Dutch citizens, as well as people from India, Germany, Argentina, Belgium, Greece, Portugal, Ukraine, Guatemala, the Philippines and Montenegro, the Dutch Foreign Ministry said.
The Dutch citizens were being taken home by medical transport and will self-quarantine for six weeks. Local health services were arranging quarantine locations for the others.
Australia is also sending a plane, expected to arrive Monday, said Spanish Health Minister Mónica García, who added that the evacuation flight was expected to be the last to leave Tenerife.
Some crew, as well as the body of a passenger who died on board, will remain on the ship, which will sail on to Rotterdam in the Netherlands, where it will undergo disinfection, Spanish authorities said.
U.N. Secretary-General Antonio Guterres commended the Spanish government and those of other countries for their efforts to manage the outbreak.
"While the current public health risk from the virus remains low, it’s important that international health efforts ensure the safety of all, including passengers & crew of the MV Hondius," Guterres wrote on X.
Which US States Are Monitoring Returned Passengers?
Health officials are monitoring seven Americans who returned home after being on the cruise ship in five states—Arizona, California, Georgia, Texas and Virginia.
Dr. Jay Bhattacharya, the acting director of the Centers for Disease Control, said on CNN’s State of the Union on Sunday that the Americans who earlier left the cruise ship have been in the U.S. for roughly two weeks.
"There are already, as you know, Jake, seven Americans that already flew back home I think two or three weeks ago, and are in various states," Bhattacharya told host Jake Tapper.
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Ship’s Captain Shares Message
Jan Dobrogowski, the captain of the Hondius, praised the ship’s crew and passengers and asked for their privacy in a video message released on Monday.
In a video filmed on the ship, Dobrogowski commended the crew and passengers for their conduct during what he called an "extremely challenging" time.
"I've witnessed your caring, your unity and quiet strength amongst everybody on board, guests and crew alike," he said. "And I must commend my crew for their courage and their selfless resolve, that they showed time and again in the most difficult moments. I could not imagine sailing through these circumstances with a better group of people, guests and crew alike."
Dobrogowski said his thoughts are with the passengers who died, adding that he wishes for all passengers and crew members "to be able to go home safely and in good health."
He added: "On behalf of Oceanwide Expeditions, my crew, myself, I ask for privacy and respect to our guests and their families and other crew members in this difficult time. We've sailed through this together across the sea, now we hope to see everybody safely at home."
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How The Outbreak Unfolded
Early in April, a 70-year-old Dutch man, identified last week as ornithologist Leo Schilperoord, developed a feverish illness while traveling on the Hondius in the South Atlantic. He died less than a week later.
More people became sick, including Schilperoord’s wife, Mirjam Schilperoord. She disembarked the ship with her husband’s body at St. Helena on April 24 and deteriorated on a flight to South Africa, where she died on April 26.
A German woman died onboard the ship on May 2.
That same day, hantavirus was first identified in the outbreak after South African health authorities received a positive for the virus from tests performed on a British man in intensive care there.
What Are the Hantavirus Symptoms?
Illness with hantavirus starts with flu-like symptoms, but an infection can rapidly progress and become life-threatening.
Symptoms of hantavirus pulmonary syndrome usually show between one and six weeks after exposure, according to the WHO. However, symptoms may appear as early as one week and as late as eight weeks following exposure.
They include fever, dizziness, chills, headache, muscle aches and gastrointestinal symptoms, such as nausea, vomiting, diarrhea and abdominal pain. That can be followed by sudden onset of respiratory distress and low blood pressure, the WHO says.
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