A Canadian in their 70s is the first person in North America to receive a presumptive positive test for the Andes hantavirus linked to the MV Hondius cruise ship, according to Breitbart News citing Canadian health officials. The result came back Friday, May 16. The individual is hospitalized in Victoria, British Columbia.

Three other Canadians who were aboard are in isolation. One in their 70s from Vancouver Island tested negative. The other two — one from Vancouver Island in their 70s, one from British Columbia in their 50s who lives abroad — are being monitored. British Columbia's provincial health officer, Dr. Bonnie Henry, confirmed the results and said officials had planned for exactly this scenario.

The Numbers Right Now

As of the CDC's May 14 update, the outbreak stands at 11 cases total — 9 confirmed, 3 dead. The WHO's last public Disease Outbreak Notice, posted May 4, reported 7 cases and 3 deaths when the ship was still moored off Cabo Verde.

The ship itself docked in Rotterdam, Netherlands on Monday, according to Breitbart News. Remaining passengers had already been offloaded in the Canary Islands — escorted off by personnel in full-body protective gear — and flown to more than 20 countries to begin quarantine.

One of the dead is a Dutch man who had been bird-watching in South America with his wife. His name has NOT been publicly released.

Americans: 18 in Nebraska, 7 at Home

The CDC confirmed on May 14 that 18 American passengers were repatriated on May 10 and are currently housed at the Nebraska Quarantine Unit at the University of Nebraska Medical Center. They're being assessed and will be monitored for a 42-day period — that's the outer edge of the incubation window.

Seven additional American passengers who left the ship earlier are at home, being monitored by their state and local health departments, according to CDC.gov.

ZERO confirmed U.S. cases from this outbreak as of the CDC's last update. The 42-day clock is still running for 18 people sitting in a Nebraska hospital.

CDC Response

The CDC is no longer silent on the matter. Their May 14 page on CDC.gov outlines coordination of repatriation, provision of technical assistance internationally, and operation of port health stations 24/7. That's a significant shift from the 25-day communication blackout reported previously.

What remains unanswered: how the outbreak started. The WHO's May 4 report noted the MV Hondius departed Ushuaia, Argentina on April 1 and made stops across the South Atlantic, including Antarctica, South Georgia, Nightingale Island, Tristan da Cunha, Saint Helena, and Ascension Island. Passengers had contact with "remote and ecologically diverse regions" and local wildlife. The extent of that contact, per WHO, "remains undetermined."

No one has publicly stated the likely source animal.

The Science Behind Andes Virus

Andes virus is a New World hantavirus, meaning it originates in the Americas. It kills approximately 40% of the people it infects, according to medical epidemiologist Daniel Pastula writing for PBS NewsHour via The Conversation.

There is NO treatment. Doctors can only provide supportive care — fluids, ventilators, dialysis. Symptoms begin like the flu, then the lungs fill with fluid. Heart failure follows.

A critical distinction separates Andes virus from other hantavirus strains: Andes virus is the only hantavirus strain known to transmit human-to-human, according to WHO. Every other strain requires direct contact with infected rodent urine, feces, or saliva. Andes virus does NOT require that. This transmission pattern explains why this outbreak on a closed ship is unusual and medically significant.

Incubation runs one to eight weeks. Standard protocol calls for 42-day quarantines.

Coverage Gaps

Most outlets lead with the "low pandemic risk" assurance from health officials — technically accurate, but it obscures the human-to-human transmission capability.

Dr. Bonnie Henry told Canadians not to panic and compared this favorably to COVID. But glossing over the fact that Andes virus spreads person-to-person — unlike virtually every other hantavirus — is a significant omission. The reason this ship outbreak is medically remarkable is precisely because of that transmission mechanism.

Also absent from most coverage: the Fox News segment featuring Dr. Marc Siegel raised the possibility of a false positive in the cruise ship context. Canadian officials are still calling their result "presumptive" — not confirmed. Final confirmation testing is presumably pending.

Current Status

If you weren't on that ship, personal risk is effectively zero. Health officials from WHO, CDC, and Dr. Henry all agree on that.

But 18 Americans are sitting in a Nebraska quarantine unit right now. A Canadian just became the first positive case on this continent. And nobody yet knows exactly where or how a cruise ship full of wildlife tourists picked up a virus with a 40% kill rate in the middle of the South Atlantic.

The containment appears to be working. The questions still aren't answered.