WHO Sees No Sign of Larger Hantavirus Outbreak from Infected Cruise Ship

The head of the World Health Organization said there is "no sign" of a larger hantavirus outbreak after the evacuation of the last passengers from a disease-stricken cruise ship.

WHO Director-General Tedros Adhanom Ghebreyesus warned Tuesday that "the situation could change" and more confirmed virus cases could emerge. He spoke at a press conference in Madrid.

The MV Hondius left Spain's Tenerife island on Monday and heads to the Dutch port of Rotterdam. Two flights carrying the final group of 28 passengers landed in nearby Eindhoven on Tuesday.

Three people have died after traveling on the ship. An American and a French national who returned home earlier tested positive. Overall, seven cases have been confirmed.

Twelve employees at a Dutch hospital in Nijmegen are in quarantine after possible exposure while treating an evacuated passenger. The hospital said Monday this was precautionary, as the workers did not follow strict protocols when handling the patient's blood and urine samples.

Ghebreyesus said, "At the moment, there is no sign that we are seeing the start of a larger outbreak. But of course the situation could change and, given the long incubation period of the virus, it's possible we might see more cases in the coming weeks." He added that "our work is not over" to contain the outbreak from the cruise ship.

Hantaviruses are usually carried by rodents, but human transmission of the Andes strain is possible. The WHO believes some passengers contracted it in South America. Symptoms include fever, extreme fatigue, muscle aches, stomach pain, vomiting, diarrhea and shortness of breath.

WHO officials have said the risk of a major outbreak is very low.

The Dutch-flagged vessel should arrive provisionally on the evening of May 17 after a six-day sail to Rotterdam. Exact procedures upon arrival are under discussion, operator Oceanwide Expeditions said, but the ship will undergo sanitation.

The final six passengers -- four Australians, one Briton and one New Zealander -- and some crew left Monday. Overall, 122 passengers and crew have been repatriated to the Netherlands and home countries on government-chartered flights over the past few days.

As of Monday evening, 27 people remained on board: 25 crew and two medical staff. They included 17 from the Philippines, four from the Netherlands (including the medical staff), four from Ukraine, one from Russia and one from Poland.

Ukraine's foreign ministry said its citizens would help transfer the ship to the Netherlands and quarantine at a medical facility on arrival. They showed no signs of illness.

Seventeen Filipino crew arrived in the Netherlands Tuesday morning, per the Philippine Embassy.

Spain's health ministry said one Spaniard quarantining in Madrid after evacuation tested provisionally positive Monday.

French Health Minister Stéphanie Rist said a woman was isolating in Paris with deteriorating health; 22 contacts are being traced.

The US health department said a second American on Sunday's repatriation flight showed mild symptoms. Both returned in biocontainment units out of caution.

Two British nationals with confirmed cases are being treated in the Netherlands and South Africa.

An elderly Dutch man was the first passenger to die on board April 11. He developed symptoms early and is believed to be the first infected, but died before testing.

His wife left the ship April 24 at St. Helena island and flew to South Africa. She died two days later in a Johannesburg clinic. Both women were confirmed cases.