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The Hondius is now docked at the Port of Granadilla, as waters were too rough to disembark passengers into the smaller boats. 

As part of the negotiations around the vessel's arrival here, it was agreed that it would stay offshore. However with strong winds the decision was made to dock it. The ship is expected to depart here in an hour or so.

A WHO epidemiologist who is helping manage the hantavirus outbreak from a cruise ship that has been sailing through the Atlantic Ocean happens to have intimate knowledge of the MV Hondius. 

Boris Pavlin was on that very ship last year to celebrate his birthday. 

Pavlin says the cruise ship industry is well-versed in virus outbreaks and getting rid of rodents. 

"This is an expedition vessel designed for ecological tourists to sensitive areas. There can be no shortcuts taken in places where there are bird colonies, and rats would decimate the place." 

The Andes strain of hantavirus has been identified as causing the outbreak. It is known to be transmissable between humans, but Pavlin says he wants to reassure people that person-to-person transmission requires sustained contact. 

"We don’t expect to see a lot of onward cases," he said, adding health officials are "not surprised" additional infections have emerged among former passengers because many were exposed to symptomatic people onboard the ship.

Pavlin noted one of the American passengers had returned an inconclusive test result before leaving the Canary Islands, with one lab finding a "really weakly positive" PCR result and another returning a negative.

"This is difficult to interpret," Pavin said. "The PCR test can be very sensitive. Sometimes it picks up the smallest traces or fragments of the virus." 

He says new samples have since been taken in the U.S. And additional test results are expected soon.

Because that passenger and another mildly symptomatic American were considered to be in a "grey zone," Pavlund says U.S. Officials treated both as potentially infectious during the evacuation flight to Nebraska. 

He said the Americans used a specially configured Boeing 747 equipped with isolation containers to separate the two passengers from others onboard.

U.S. Health officials in contact with all returned passengers from hantavirus-hit ship

U.S. Health officials from the Centers for Disease Control and Prevention and the Nebraska Biocontainment Unit took questions on Monday about how they were ensuring public safety after passengers who had been aboard a cruise ship hit with cases of hantavirus returned to the country.

At the news conference in Nebraska, Dr. Brendan Jackson, a senior advisor with the U.S.'s Centers for Disease Control and Prevention, said U.S. State health departments are conducting daily symptom and temperature checks on returning passengers and have plans in place to ensure they can isolate safely if they become ill.

"This is not a brand new virus," Jackson said, noting there have been previous hantavirus outbreaks in the U.S. "It is a virus that has been known for decades." 

He said that current evidence suggests person-to-person transmission happens when infected people are symptomatic, adding that this gives health officials "one layer of added protection."

Jackson said passengers who are not showing symptoms are not receiving medical treatment, though they may be evaluated or tested if their condition changes. He also noted that current guidance focuses on testing symptomatic people, but authorities are continuing to reassess protocols as they learn more about the outbreak.

Dr. Angela Hewitt of the University of Nebraska Medical Center said doctors are now interviewing evacuees individually about their possible exposure risks before deciding whether broader testing is needed. 

One passenger with a previous "equivocal positive," or ambiguous, test result is being tested in the hospital's biocontainment unit, she said, while decisions on testing others in quarantine will be made on a case-by-case basis.

U.S. And Nebraska health officials said Monday that 18 American passengers were evacuated from the MV Hondius and are now isolating in Nebraska and Georgia.

Sixteen of the 18 passengers are undergoing assessments and monitoring at the University of Nebraska Medical Center (UNMC) in Omaha. The remaining two have been taken to Atlanta for monitoring, one of whom has presented mild symptoms.

One person is in the UNMC's "bio-containment unit" after testing positive for the virus, officials said, but did not present with any symptoms.

Asymptomatic patients will eventually be able to choose whether to stay at the centre in Nebraska for the full 42-day quarantine period or spend the remainder of it in self-isolation at home.

U.S. Assistant Secretary for Health Brian Christine said the Andes strain linked to the outbreak "does not spread easily" and "requires close contact with someone already symptomatic" to spread, and emphasized that authorities are closely monitoring potentially exposed individuals.

Christine said the U.S. Centers for Disease Control and Prevention (CDC) activated its emergency operations centre, deployed medical teams and issued guidance to health officials across the U.S. After the outbreak emerged.

"No one who poses a risk to public health is walking out the front door onto the streets of Omaha," said Nebraska Governor Jim Pillen. 

Ontario Health Minister Sylvia Jones confirmed a Canadian couple who were on board the MV Hondius and live in Grey Bruce, Ont., are self-isolating at home. 

Taking questions from reporters Monday, Jones said the couple have not developed any symptoms of the virus. 

She said a third Ontarian in Peel Region is now also self-isolating. All three are being monitored by their local public health units. 

The minister was asked whether the three are being tested. She said Dr. Kieran Moore, Ontario's chief medical officer of health, suggested testing may not be an effective monitoring method for people who have not developed symptoms. 

"That's why these three individuals are self-isolating so we can see if there are any symptoms that come forward," Jones said. 

Reuters

A Swiss crew member of the MV Hondius is in quarantine in the Netherlands, and a Swiss national is self-isolating in Switzerland, Swiss authorities said on Monday.

The cases are in addition to that of a Swiss man who travelled on the cruise who tested positive for the Andes strain of the hantavirus, a spokesperson for the Federal Department of Home Affairs and Federal Office of Public Health said. 

He is currently being treated at a hospital in Zurich and his wife is self-isolating, according to authorities.

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As Canadian passengers from the hantavirus-hit MV Hondius cruise ship are back home isolating, there are concerns about a potential spread of the illness. For The National, Erica Johnson puts viewers' questions to infectious diseases specialist Dr. Lynora Saxinger.

In an update Monday, the World Health Organization said it has confirmed seven cases of the Andes hantavirus among people who were passengers on board the cruise ship.

But the agency later updated its overall tally of reported cases to nine, a WHO spokesperson told Reuters by email, after France reported that a French passenger evacuated from the MV Hondius had tested positive for the virus.

The 70-year-old Dutch who died on April 11 while aboard the ship died before he could be tested.

Reuters

Four German contacts from the MV Hondius are being monitored in a special isolation unit at Frankfurt University Hospital after arriving overnight, German health authorities said on Monday.

A health ministry spokesperson told Reuters the patients, all currently without symptoms, would later be transferred to Berlin, Baden-Wuerttemberg, Bavaria and Schleswig-Holstein, where regional authorities will take over their care.

The hospital said the four were brought in between midnight and 1 a.m. Local time for medical checks and laboratory testing in Frankfurt and Marburg.

So far, there were "no indications of illness," Timo Wolf, head of the special isolation ward for highly pathogenic infections in Frankfurt, said in a statement.

Reuters

The condition of a British man who was admitted to a hospital in Johannesburg after falling ill with hantavirus aboard the MV Hondius is gradually improving, a South African health ministry spokesperson said on Monday.

"The British patient is clinically improving but still ill," spokesperson Foster Mohale told Reuters. "This means his condition is improving, gradually so."

The man was medically evacuated to South Africa on April 27 after presenting with a fever, shortness of breath and signs of pneumonia. He disembarked from the cruise ship at Ascension Island in the Atlantic Ocean.

French Health Minister Stéphanie Rist said earlier today that the four other French passengers repatriated from Tenerife continued to test negative for the virus and are in isolation. 

Rist said authorities have identified 22 people in France as close contacts linked to the outbreak, including eight who were on a flight from St. Helena to Johannesburg on April 25, taken by the Dutch woman who died days after her husband died from the virus. 

They also include 14 French nationals who were on a flight between Johannesburg and Amsterdam with the same woman later that day.

Epidemiologist Arnaud Fontanet warned the French woman who tested positive showed "a rather rapid progression" of the illness and said the mortality rate for hantavirus is "30 to 50 per cent of infected cases." He added that officials should expect "isolated cases in the coming weeks" because the virus can incubate for up to six weeks or longer.

French officials sought to calm fears of a wider outbreak, releasing a statement saying, "there is no reason today to alarm the French population" and stressing the government is acting "with the greatest vigilance" to break possible chains of transmission.

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