A French citizen on a repatriation flight began showing symptoms of hantavirus after being evacuated from the cruise ship that was hit with the deadly outbreak, the country’s prime minister said Sunday afternoon. Passengers began disembarking Sunday morning after the ship docked in Spain’s Canary Islands.
Officials previously said that no one aboard the ship was showing symptoms of hantavirus, which is typically transmitted by rodents. Patients involved in the outbreak have tested positive for a rare strain that can be transmitted from person to person.
Since the ship’s docking, passengers have carefully been evacuated by nationality and placed on repatriation flights. Spanish nationals disembarked first, then boarded a plane for Madrid, where they were taken to a military hospital. French and British passengers have also been evacuated.
AP 
The French passenger was on the repatriation flight when they began showing symptoms, French Prime Minister Sébastien Lecornu said on social media. Lecornu did not say if the passenger had yet been tested for hantavirus, or what the passenger’s symptoms are. All five passengers “were immediately placed in strict isolation until further notice,” and will undergo testing, he said.
There have been at least nine confirmed or suspected cases of hantavirus linked to the outbreak on the ship, including three fatalities: A Dutch couple and a German woman.
The MV Hondius, was carrying nearly 150 people from more than 15 countries, including 17 Americans, had set sail earlier this week from Cape Verde to Granadilla, after Spain agreed to take the ship.
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A complex and careful disembarkation
Oceanwide Expeditions, the ship’s operator, said that all passengers and a portion of the approximately 60 crew members would evacuate the ship using launch boats that carry a maximum of five to 10 people each.
People were then checked for symptoms. Passengers and crew members had no contact with the local population on Tenerife before they were taken to their evacuation flights, authorities said. A video shared by Spain’s defense ministry shows the inside of one repatriation flight, revealing surfaces wrapped in plastic and crew members wearing protective gear.
The operation in Tenerife is being supervised by Spain’s health and interior ministers as well as the World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus.
Although health officials have said risks from the cruise outbreak remain low for the general public, those disembarking and port workers wore face masks, hazmat suits, respirators and other protective gear during the evacuation process.
After disembarkation, a skeleton crew will take on supplies and then begin the journey to Rotterdam, Netherlands, which is expected to take about five days, Oceanwide Expeditions said. The body of a passenger who died on board will also remain on the ship, which will be disinfected once it arrives in Rotterdam, according to Spanish authorities.
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Quarantine protocols
U.S. nationals were Sunday’s last evacuation group. The CDC said it was sending a team of epidemiologists and medical professionals to the Canary Islands to “conduct an exposure risk assessment for each American passenger and provide recommendations for the level of monitoring required.”
After being removed from the Hondius, 18 people are being flown back to the U.S. in a plane that was sent by the U.S. Centers for Disease Control and Prevention and the Department of Health and Human Services. The medical repatriation flight will land at Offutt Air Force Base in Omaha, Nebraska, and the Americans will be taken to a special biocontainment unit at the University of Nebraska Medical Center.
CBS News was tracking a flight that left Atlanta, Georgia, on a direct course for Tenerife South Airport, just 10 minutes from Granadilla. The U.S. and Spanish governments would not comment on the flight, but a local resident on Tenerife remarked that the island “never” gets any direct flights from the U.S. across the Atlantic Ocean. That flight departed from the Canary Islands around 6 p.m. ET and appears to be headed to Dulles International Airport outside of Washington, D.C., before heading on to Nebraska.
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Michael Wadman, medical director of the National Quarantine Unit at the University of Nebraska Medical Center, said that each American will have their own room while they quarantine for an unspecified amount of time.
Centers for Disease Control and Prevention acting Director Dr. Jay Bhattacharya told CNN’s “State of the Union” that seven Americans who left the cruise have been in the U.S. for roughly two weeks, and they are living across the country. One of the Americans who has returned home is a Northern California resident, according to the Santa Clara Public Health Department.
Each country has come up with their own quarantine plan. British authorities said U.K. passengers and crew will be hospitalized for observation once they are flown home, while the 14 Spaniards will be under quarantine at a military hospital in Madrid.
In France, Lecornu said in addition to isolating the passengers on the repatriation flight, he will issue a decree “to implement appropriate isolation measures for close contacts and to protect the general population.”
Officials insist the public is at low risk
Hantaviruses are a family of diseases that are spread to people from rodents through urine, droppings or saliva, according to the CDC. It can take up to eight weeks after contact for symptoms to develop.
WHO says that the Andes strain of the virus, which is found in Latin America, is the only one that is known to be able to transmit the virus through human-to-human contact, with Tedros assessing the public risk as “low.”
He told CBS News at a briefing Sunday morning that Americans “shouldn’t worry” about the impending return of cruise passengers who are U.S. citizens and encouraged people to put their trust in health officials.
“This is not another COVID, and the risk to the public is low. So, they shouldn’t be scared and they shouldn’t panic,” said Tedros. He also said several years of scientific evaluations of the virus and its behavior, in addition to how the virus has behaved so far in this particular outbreak, have informed that judgement.
Tedros‘ assessment was echoed by the acting CDC director. Former FDA Commissioner Scott Gottlieb said Sunday on “Face the Nation with Margaret Brennan” that U.S. passengers being brought home are likely reaching the peak of the virus’ incubation cycle this week and “nearing the end of the transmission window.”
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Outbreak timeline
The source of the outbreak remains under investigation. Prior to boarding the ship, the Dutch couple who died, a 70-year-old man and his 69-year-old wife, are believed to have spent weeks traveling through Argentina, Chile and Uruguay on a bird-watching trip in areas where the species of rodent known to carry the Andes virus is present, Tedros said.
The man developed symptoms on April 6 and died on the ship on April 11, WHO said, but no samples were taken because his symptoms were similar to those of other respiratory viruses, and hantavirus was not suspected at the time.
His wife then went ashore when the ship docked on the British territorial island of St. Helena. She showed serious symptoms on a flight to Johannesburg, South Africa, on April 25, and died in South Africa the following day, WHO said. Testing confirmed she had contracted hantavirus.
The German woman showed symptoms on April 28 and died aboard the ship on May 2, according to WHO.
Three other patients were flown off the ship to the Netherlands for emergency medical care this week, and a Swiss man who began showing symptoms after disembarking the ship was receiving care in Zurich. A British man was medically evacuated to South Africa, while another British national who had disembarked the ship is hospitalized on the island of Tristan da Cunha, a British territory.
Oceanwide Expeditions said 32 passengers from about a dozen countries had disembarked the Hondius in St. Helena, including the Dutch woman who died days later. Those American passengers who returned to the U.S. prior to the discovery of the outbreak were being monitored by state health agencies in California, Georgia, Texas, Virginia and Arizona.
The Hondius set sail for its cruise April 1 from Ushuaia, Argentina, which took it to several islands in the south Atlantic, including the South Georgia and South Sandwich Islands, Tristan da Cunha, Gough Island and then St. Helena from April 21 to April 24.
The vessel then anchored off the coast of Cape Verde, an archipelago located off West Africa, for several days before heading to the Canary Islands.
