Two Singapore residents have been isolated at the National Centre for Infectious Diseases (NCID) after being on a cruise ship that has now become a hantavirus cluster.
The risk to the general public is “currently low”, said the Communicable Diseases Agency (CDA) in a press release on Thursday (7 May).
Source: Google Maps
The two men, a 67-year-old Singaporean and a 65-year-old Singapore permanent resident (PR), had been on the MV Hondius, CDA said.
They were on board when the cruise ship departed from Ushuaia, a port in Argentina, on 1 April.
It set sail with a total of 114 guests, said its operator Oceanwide Expeditions.
Source: Oceanwide Expeditions
However, one passenger — a 70-year-old Dutch man — died on board the ship on 11 April. His cause of death could not be determined on board.
His body left the ship at St Helena, a British overseas territory in the South Atlantic Ocean, on 24 April, together with his wife.
They were among 30 passengers who disembarked at St Helena that day, which included at least one of the Singapore residents.
Source: Oceanwide Expeditions
On 27 April, Oceanwide Expeditions was informed that the deceased man’s wife had become unwell and also died.
On the same day, another passenger became seriously ill. The Briton was medically evacuated to South Africa and treated in the Intensive Care Unit (ICU) of a hospital in Johannesburg.
He was eventually diagnosed with hantavirus.
On 2 May, another passenger, a German, died on board the MV Hondius. The cause of death has not yet been established.
Meanwhile, the two Singapore residents, who had disembarked from the ship, took a flight from St Helena to Johannesburg on 25 April.
That flight happened to have a confirmed hantavirus case, said CDA.
This case did not travel to Singapore and passed away in South Africa.
The Singaporean returned to Singapore on 2 May, while the Singapore PR arrived in Singapore on 6 May.
Source: Changi Airport on Facebook
CDA was notified about the two Singapore residents on Monday (4 May) and Tuesday (5 May), it said.
They are being isolated and tested for hantavirus at NCID, with their test results pending.
One of them has a runny nose but is “otherwise well”, and the other is asymptomatic.
If they test negative, they will be quarantined for 30 days, as the majority of hantavirus cases become symptomatic within this period.
Source: Google Maps
Before being released from quarantine, they will undergo phone surveillance till the 45th day since they were last exposed — the maximum incubation period for hantavirus exposure.
However, if they test positive, they will be hospitalised for monitoring and treatment.
Contact tracing will then commence, and their close contacts will also be quarantined.
So far, eight cases, including the three deaths, have been linked to the MV Hondius cluster as of Wednesday (6 May), CDA said.
Three hantavirus cases have been confirmed, while the rest are under investigation.
Oceanwide Expeditions said that three people were medically evacuated from the ship on Wednesday, with two of them in serious condition.
The ship is currently en route to Tenerife in the Canary Islands with no symptomatic individuals on board, it added.
Source: Oceanwide Expeditions
It is expected to arrive in the early hours of Sunday (10 May) morning.
Hantaviruses are carried by some rodents and do not usually spread from person to person, according to CDA.
People typically catch the virus when they breathe in dust contaminated with urine, droppings or saliva from infected rodents.
However, the Andes species of the hantavirus can be transmitted among humans. Symptoms of the rare strain include:
The World Health Organisation (WHO) has assessed that the risk to the global population is low.
But it has indicated that human-to-human transmission cannot be excluded, and advised passengers and crew of the MV Hondius to monitor their health and seek medical attention promptly if symptoms develop.
CDA also advised the Singapore public to take precautionary measures when travelling to areas with known hantavirus transmission, such as avoiding contact with rodents and areas contaminated by their urine, droppings, saliva or nesting materials.
Travellers who become unwell should seek medical attention and inform doctors of their recent travel history and potential exposure to rodents or infected people.
Also read: 3 passengers dead in suspected hantavirus outbreak on Atlantic cruise ship, at least 3 others sick
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Featured image adapted from Oceanwide Expeditions and Google Maps.