The World Health Organization (WHO) has formally notified 12 countries to monitor and trace passengers who disembarked from the hantavirus-stricken MV Hondius cruise ship, warning that more cases could still emerge despite the outbreak being expected to remain limited.

WHO Director-General Tedros Adhanom Ghebreyesus said on Thursday that five confirmed and three suspected cases have been reported so far, including the three deaths. He noted the incubation period for the Andes strain can last up to six weeks, meaning additional cases may still appear in the coming days.

“Given the incubation period of the Andes virus, which can be up to six weeks, it’s possible that more cases may be reported,” Tedros said.The WHO’s emergency director, Abdi Rahman Mahamud, added that the outbreak should remain “limited” provided strong public health measures and international cooperation continue.

The WHO has contacted the following 12 countries regarding passengers who left the ship in Saint Helena:

The MV Hondius is scheduled to arrive off Tenerife in the Canary Islands on Sunday. Spanish authorities are preparing an unprecedented operation to evaluate passengers while keeping them isolated from the local population. Non-Spanish nationals will be repatriated directly to waiting planes, even if they show mild symptoms.

A fourth sick passenger was evacuated and flown to Amsterdam on Thursday. The ship’s operator, Oceanwide Expeditions, said there were currently no new symptomatic cases on board.

The first fatalities were a Dutch couple. The husband died on board on April 11. His wife later died in South Africa. A German passenger died on May 2, and her body remains on the ship.

Argentine authorities said they have not yet confirmed the exact origin of the outbreak, though the ship departed from Ushuaia on April 1 after passengers had visited Chile and Uruguay.

The WHO continues to stress that the Andes strain spreads only through very close and prolonged contact, and the risk to the general public remains low.Contact tracing efforts are ongoing across multiple continents as authorities work to contain what has become an international health alert involving passengers from 23 countries.

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