International evacuation operation launched as MV Hondius hantavirus outbreak escalates

The US government is preparing a large-scale medical repatriation operation for 17 American passengers still aboard the MV Hondius cruise ship as the vessel approaches Tenerife amid the ongoing hantavirus outbreak.

The expedition vessel is expected to arrive off the coast of Tenerife in the Canary Islands early on Sunday, where Spanish authorities are coordinating a tightly controlled evacuation involving more than 140 passengers and crew remaining onboard.

The Centers for Disease Control and Prevention (CDC) has deployed epidemiologists and medical personnel to Tenerife to carry out exposure risk assessments before passengers disembark. The operation is being coordinated alongside the US State Department, the Department of Health and Human Services, and Spanish authorities.

Dr Ryan Copeland, Regional Medical Director for Middle East at International SOS, has commented in response to the recent hantavirus outbreak that planning for such transfers must “account for critical factors such as the pathogen’s characteristics, incubation period, transmission mode, and the patient’s clinical stability”.

Following medical screening, American passengers will be transported on a dedicated charter repatriation flight to Offutt Air Force Base in Nebraska before transfer to the University of Nebraska Medical Center’s National Quarantine Unit – a federally funded high-containment facility designed to manage exposure to serious infectious diseases.

A second CDC response team will meet passengers in Nebraska to continue public health monitoring and assessment procedures. Officials said none of the Americans onboard are currently displaying symptoms.

The incident has rapidly evolved into a significant international air medical and public health response involving maritime evacuation planning, infectious disease containment, quarantine coordination, and cross-border patient management.

The World Health Organization (WHO) has now confirmed six laboratory-confirmed cases of hantavirus linked to the outbreak, all identified as the Andes strain – the only known hantavirus capable of limited human-to-human transmission. Three deaths have been reported among eight officially recognised cases.

Spanish authorities are also investigating an additional suspected case involving a woman in Alicante who travelled on the same flight as a passenger who later died in Johannesburg after leaving the vessel. If confirmed, the total number of confirmed and suspected cases linked to the outbreak would rise to nine.

The WHO continues to assess the overall public risk as low, although it considers the risk to passengers and crew onboard the ship to be moderate.

British authorities are meanwhile coordinating the return of 22 UK passengers, who are expected to undergo testing onboard before being transferred directly from the ship to dedicated flights back to the UK. Returning passengers are expected to self-isolate for 45 days.

Officials in Tenerife said the evacuation process must be completed within a narrow operational window due to worsening weather conditions forecast around the island. Authorities warned that deteriorating sea conditions could force the vessel to leave the area for several weeks if disembarkation is delayed.

Security and medical infrastructure has been increased around the port of Granadilla ahead of the ship’s arrival, with Spanish officials emphasising that passengers will remain separated from local residents throughout the transfer operation.