10 Canadians connected to hantavirus outbreak on cruise ship. Live updates here.

As more than 140 passengers and crew members prepare to disembark from a cruise ship where a deadly hantavirus outbreak killed three people and sickened others, countries around the world are mobilizing to prevent further spread through coordinated public health responses.

Contact tracing efforts have begun for at least two dozen people from 12 different countries who disembarked the ship early, including two residents of Ontario, who returned home from the ship on April 25. According to doctors the two passengers remain asymptomatic, posing no risk to the general public.

As the MV Hondius heads to the Canary Islands this weekend, health authorities say they are preparing to monitor the potential symptoms of passengers.

Follow below for key updates:

Six cases confirmed as Andes virus: WHO

The World Health Organization said on Friday that six laboratory-tested cases have been confirmed as Andes virus, a type of hantavirus, through virus-specific polymerase chain reaction (PCR) testing, the WHO said.

Four patients remain hospitalized in South Africa, the Netherlands and Switzerland, while a suspected case sent to Germany tested negative.

AFP

Andes virus has heightened transmission capability: expert

Andes virus is an especially contagious form of hantavirus, an infectious diseases physician and medical micro-biologist said Friday.

germ can be spread through salvia, bodily fluids, and droplets from the respiratory system, Dr. Donald Vinh said in an interview with CTV News Channel.

‘In general hantaviruses are transmitted from rodents to humans, but what has been known since the ‘90s is that there’s a specific type of hantavirus, in this case the Andes virus,” Vinh said, “that has been previously shown to have the capacity to spread from one person to another.”

He highlighted cruise ships and airplanes as places with an especially high transmission risk due to poor ventilation. He added that in those tight spaces Andes virus can ride on “respiratory droplets, maybe even some aerosols as well as with saliva,” to spread the infection.

“When we hear about an outbreak on a cruise ship or maybe a secondary transmission case on a plane,” he added, “they’re on closed, poorly ventilated spaces and so this is a concern, this is why the world is being vigilant right now.”

Joe Van Wonderen, CTVNews.ca journalist

Long incubation period challenges

Epidemiologist and cardiologist Dr. Christopher Labos says the 45-day incubation period for hantavirus creates several challenges for health officials.

In an interview with CTV News Channel, he said people feel fine for such a long stretch of time before the virus-specific signs appear, adding passengers disembarking from the ship and going off to different locations and countries means officials have “a lot of other people to contact trace.”

Labos added the long incubation period also means “you have to wait a much longer period of time before you can be sure somebody is uninfected.”

Archie Niari, CTVNews.ca journalist

Daily check-ins with health officials

Dr. Brittany Graham, acting medical officer of health for the Grey-Bruce Health Unit, says local health officials are checking in on the two Ontario residents daily.

“They are well, they’re not experiencing any symptoms of the illness,” Graham said. “And so we are checking in with them while they isolate at home, to confirm that they’re not developing any signs or symptoms of hantavirus.”

She says following up with people who have potentially been exposed to an infectious disease is “something that we do routinely,” in an effort to “prevent any potential spread within the community.”

“So that’s something that we’re very confident we are able to do, so we have the situation well in hand here,” Graham added.

Full story here.

Scott Miller, CTV News London multi-skilled journalist

6 Canadians contacted

In a late-press conference update, public health confirmed they had reached a sixth Canadian who may have been in contact with the virus.

In total, there are 10 affected Canadians, including the four travellers still on the cruise ship.

Luca Caruso-Moro, CTVNews.ca journalist

‘Symptoms that could be hantavirus could be anything’: specialist

Hantavirus produces generic enough symptoms that determining infection is a slow process, according to an infectious disease specialist.

“Symptoms that could be hantavirus could be anything,” Dr. Allison McGeer said Friday in an interview with CTV News Channel.

More cases may appear as test results return and contact tracing is utilized, she added.

“We’re just going to have to wait every time, because it takes sometimes a few days to get test results done and back, to know whether these are real cases or not,” McGeer advised.

“I think its important that we all remain calm about the fact that there are new investigations.”

Joe Van Wonderen,CTVNews.ca journalist

Symptoms could include fever, headaches and nausea

Infectious disease specialist Dr. Lisa Barret told CTV News Channel that officials could be looking for signs or symptoms like “fevers, headaches, feelings of malaise, muscle aches, nausea any GI symptoms and diarrhea” in the six Canadians who are now back in the country as they self isolate.

Archie Niari, CTVNews.ca journalist

‘There is no validated test’

When asked if any Canadians have been tested for hantavirus, Dr. Joss Reimer said that “there is no validated test for asymptomatic individuals.”

Reimer added that if any symptomatic cases emerge, officials have connected with provinces and territories “to come up with a plan where they identify a specific hospital that has the capabilities to manage complex viruses like this.”

Kayla Thompson, CTVNews.ca journalist

How will Canada proceed with repatriation?

Health officials confirmed that the country is preparing to repatriate the four remaining Canadians onboard the MV Hondius “as soon as possible once they disembark the ship on Sunday.”

Officials say they are involved in daily meetings and planned coordination with the CDC, WHO and European Centre for Disease Prevention and Control (ECDC) to plan the safest way for Canadians to return home.

Kayla Thompson, CTVNews.ca journalist

All Canadians asymptomatic

The three Canadians who are isolating at home, and all four Canadian passengers still onboard, are asymptomatic, public health officials say.

Luca Caruso-Moro, CTVNews.ca journalist

3 other Canadians came in contact with virus

Health investigations are also underway by local authorities regarding three additional Canadians, two in Alberta and one in Ontario, who were on a flight recently where “they may have had brief contact with (a) confirmed case,” said Canada’s chief public health officer, Dr. Joss Reimer on Friday.

The three Canadians have “since returned to Canada” she added.

Kayla Thompson, CTVNews.ca journalist

Spread in Canada not expected

“Onward spread in Canada is not expected,” said Canada’s chief public health officer, Dr. Joss Reimer.

She reiterated that the three Canadians who are back in the country following potential exposure have been asked to isolate. There is no evidence that asymptomatic patients can spread the virus, she also said.

Luca Caruso-Moro, CTVNews.ca journalist

Two passengers are in isolation in Ontario

Two Ontario residents who were onboard a ship with an outbreak of hantavirus are from the same household in Grey-Bruce counties and are isolating at home now, Ontario’s top doctor tells CTV News.

Dr. Kieran Moore told CTV News Toronto in an interview the two arrived back in Ontario on April 25 and are being observed for a 45-day period.

However they remain asymptomatic.

“It’s just the two that we’re monitoring on a daily basis to ensure they remain asymptomatic,” Moore said. “They’re not cases, they’re contacts from the ship, and I just want to assure everybody they have no symptoms at present.”

Ontario is not expecting any more patients from the ship, Moore said.

Moore said he believes it’s unlikely the two might have passed hantavirus to anyone since their return as there is still no indication they have it themselves.

Joshua Freeman, CP24.com, journalist

What happens next to the remaining passengers?

Spanish authorities are preparing to receive the remaining passengers and crew members on Tenerife. Officials said Friday that passengers will be evacuated in small boats to buses only once their repatriation flights are ready to take them.

The United States has agreed to send a plane to the Canary Islands to pick up its citizens, as will the British government.

Other countries have not yet made their plans public, and it is not clear how long boat passengers will have to wait for their flights.

Spain has requested medically equipped planes for passengers experiencing symptoms, Virginia Barcones, the country’s head of emergency services, said Friday.

The Associated Press

‘This is our expertise’: Ontario’s top doctor

Dr. Kieran Moore said he wants to reassure people this is not another round of COVID-19.

“I have tremendous empathy to the public. I hope it doesn’t trigger too many individuals, but I do want to assure Ontarians, we have a plan. We’ve become experts in this type of activity, on contact tracing, on monitoring, on testing and ensuring Ontarians get the right care at the right time. So we’re on it. We are not traumatized by this. This is our expertise.”

The Canadian Press

U.S. in direct contact with passengers

U.S. will offer repatriation flight for Americans on board the cruise ship

The State Department says it is in direct contact with a number of American citizens on board the cruise ship and will offer them a special flight home from Tenerife when the vessel arrives there this weekend.

The department said Friday that U.S. diplomats will be available to provide consular services in Tenerife to the Americans on board and has arranged the special repatriation flight in coordination with the Centers for Disease Control and Prevention, the Department of Health and Human Services and the Spanish government.

The Associated Press