Symptoms of hantavirus as British national left seriously ill after cruise outbreak

A suspected outbreak on a cruise ship has left three dead.

Meanwhile, a British man is in intensive care as three people have died as a result of the outbreak of the virus, two of whom are Dutch nationals.

The British tourist is being treated in intensive care in Johannesburg while another three passengers fell ill, two of whom are on board.

The reported outbreak happened on the MV Hondius cruise ship, as it was travelling between Argentina and Cape Verde.

Oceanwide Expeditions, the operator based in the Netherlands, has confirmed that it is managing “a serious medical situation”.

According to media reports, the cruise ship departed about three weeks ago with around 150 passengers and stopped in the Antarctic and other locations on ​its way to Cape Verde.

What is hantavirus and how is it treated?

The rodent-borne virus known as hantavirus can either mostly affect the lungs or kidneys, and there are no specific drugs to treat ⁠it.

Treatment for hantavirus focuses on supportive care, while in severe cases, it includes putting patients on ventilators.

According to the Centers for Disease Control and Prevention, hantavirus is spread mainly by rodents and are not from person-to-person.

People get hantavirus from contact with rodents like rats and mice, especially when exposed to their urine, droppings, and saliva.

It can also spread through a bite or scratch by a rodent, but this is rare, according to CDC.

Where is hantavirus most common?

While around 150,000 cases of the disease are reported each year worldwide, only "very few cases of hantavirus infection have been confirmed in the United Kingdom" as per the government website.

Cases tend to be most concentrated in China, Russia, Scandinavia and the US.

What are the symptoms?

Hantavirus can cause two serious infections in humans:

• Hantavirus pulmonary syndrome (HPS)
• Haemorrhagic fever with renal syndrome (HFRS)

As per the Centre for Disease Control and Prevention, symptoms for HPS are:

Early symptoms:

• fatigue
• fever
• muscle aches, especially in the large muscle groups like the thighs, hips, back, and sometimes shoulders

About half of all HPS patients also experience:

• headaches
• dizziness
• chills
• abdominal problems, like nausea, vomiting, diarrhea, and abdominal pain

Symptoms include coughing and shortness of breath. Patients might experience tightness in the chest, as the lungs fill with fluid.

Thirty-eight percent of people who develop respiratory symptoms may die from the disease.

As per the Centre for Disease Control and Prevention, symptoms for HFRS are:

• intense headaches
• back and abdominal pain
• fever/chills
• nausea
• blurred vision

People may have flushing of the face, inflammation or redness of the eyes, or a rash. Later symptoms can include:

• low blood pressure
• lack of blood flow (acute shock)
• internal bleeding (vascular leakage)
• acute kidney failure, which can cause severe fluid overload

The survival rate of HFRS can vary depending on the virus causing the infection.

Less than 1% die from the Saaremaa, and Puumala viruses which are found in Scandinavia and western Europe, while the Hantaan (Asia) and Dobrava (Balkans) have a 5-15% fatality rate.

The Seoul virus is worldwide and also has a less than 1% fatality rate.

Treatment

There is currently no specific treatment for a hantavirus infection with the best course of care being to support the patient with rest, hydration and treatment for other symptoms as per the CDC.

This can be support for breathing difficulties such as intubation, a procedure where a tube is placed in the lungs from the mouth.

Some patients with HFRS may need dialysis to treat kidney disruption.