World Health Organisation chief Tedros Adhanom Ghebreyesus said on Tuesday, "our work is not over" to contain hantavirus after evacuations from a cruise ship hit by a deadly outbreak of the illness.

The fate of the MV Hondius has sparked international alarm after three passengers died in an outbreak of the rare virus, for which no vaccines or specific treatments exist, with a French woman also in a critical condition.

Yet health officials have stressed that the global public health risk is low and rejected comparisons to the start of the Covid-19 pandemic.

"There is no sign that we are seeing the start of a larger outbreak," Tedros told a joint news conference with Spanish Prime Minister Pedro Sanchez in Madrid after overseeing the evacuation in Spain's Canary Islands.

"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," Tedros said of the Andes variant, the only one known to be transmissible between humans.

Among living patients, all of whom are passengers or crew of the ship, seven cases have been confirmed and an eighth is listed as "probable", according to a tally of official figures.

The affected nationalities include the United States, Britain, France, Spain, Switzerland and the Netherlands.

One of the five French passengers flown back from the ship was on Tuesday in intensive care on a ventilator battling a "severe" case of the rare disease, according to Dr Xavier Lescure.

She was older than 65 and had pre-existing conditions, the doctor told a press conference at the health ministry, without elaborating.

More than 120 passengers and crew on the MV Hondius were flown out from Spain's Canary Islands on Sunday and Monday, and countries have adopted different health measures for their returning evacuees.

Most have followed the WHO's guidelines, which include a 42-day quarantine and constant monitoring of high-risk contacts because the incubation period can take six weeks.

According to the Dutch authorities, the 26 passengers who landed back on Sunday on the first flight from the Canary Island of Tenerife to the Netherlands had tested negative.

All 26 underwent "thorough medical screening," the Dutch National Institute for Public Health and the Environment said on Tuesday, and despite the negative tests must quarantine. Two more repatriation flights landed later in the Netherlands, carrying 28 more evacuees who will also undergo isolation.

Tedros said he hoped countries would "follow the advice and recommendations we are making," but acknowledged that nations were free to decide their own health protocols.

Insisting that his government had the situation "under control," French President Emmanuel Macron called on Tuesday for strong European coordination with the World Health Organisation, while speaking at a summit in Kenya.

The MV Hondius presented diplomatic challenges as different countries negotiated over who would receive it and treat its passengers.

Cape Verde refused to receive the ship, which remained anchored offshore of the capital Praia as three people were evacuated to Europe by air last week.

Spain allowed the vessel to anchor off the Canary Islands for the evacuation of passengers and crew on Sunday and Monday, but the Atlantic archipelago's regional government fiercely opposed the measure.

Defending his government's policy, Sanchez said the "world does not need more selfishness or more fear. What it needs are countries that show solidarity and want to step forward."

The MV Hondius left the island of Tenerife with a skeleton crew on Monday and will be disinfected upon arrival in the Netherlands on Sunday.

Hantavirus spreads from the urine, faeces and saliva of infected rodents and is endemic in Argentina, where the MV Hondius set sail on April 1 for a cruise across the Atlantic Ocean to Cape Verde. (AFP)



Edited by Robert Kemp