MPs raise alarm over border health gaps after hantavirus cases linked to ship

New concerns about South Africa’s ability to detect and contain infectious diseases at its borders have been raised in parliament, following two hantavirus-linked deaths tied to an international cruise ship outbreak.

Members of the portfolio health committee on Wednesday pressed health minister Dr Aaron Motsoaledi on the country’s surveillance systems, questioning whether gaps allowed potentially infected travellers to enter without adequate containment measures.

The briefing comes after a suspected hantavirus cluster aboard a Dutch-flagged cruise vessel sailing in the Atlantic Ocean resulted in two deaths and a third patient now in intensive care in Johannesburg.

EFF MP Naledi Chirwa said the incident exposed worrying weaknesses in South Africa’s preparedness. “There is concern about how our health surveillance systems allowed potentially affected travellers to enter without full containment protocols, especially after the lessons we were assured were implemented following the Covid-19 outbreak,” she said.

She also questioned why samples were being transferred between institutions such as the National Institute for Communicable Diseases (NICD) and National Health Laboratory Service (NHLS), adding: “We are worried that Africa continues to be a recipient of outbreaks while remaining reactive rather than proactive.”

Health authorities have identified 62 contacts linked to the cases, including cruise passengers, health-care workers and support staff. So far 42 have been traced

Motsoaledi outlined a timeline of events:

the World Health Organisation (WHO) was alerted on May 2 through the International Health Regulations National Focal Point in the UK about a cluster of severe acute respiratory illness on the vessel, which was carrying 147 people from 23 countries.
The ship had departed Ushuaia in southern Argentina on April 1 en route to Cape Verde.
A 70-year-old Dutch passenger developed symptoms on April 6 and died on board five days later. His body was later removed from Saint Helena.
His wife, 69, who disembarked on the island with gastrointestinal symptoms, collapsed while transiting through OR Tambo International Airport and died on arrival at a Kempton Park hospital on April 26.
A third patient from the UK developed severe respiratory illness and was medically evacuated to South Africa on April 27. He remains in intensive care but is stable.

Health authorities have identified 62 contacts linked to the cases, including cruise passengers, health-care workers and support staff. So far 42 have been traced.

Laboratory testing on May 2 confirmed hantavirus infection, prompting the National Institute for Communicable Diseases (NICD) to test residual samples from the deceased passenger in South Africa, which also returned positive.

It is a zoonotic disease transmitted mainly through contact with infected rodent excreta such as urine, droppings or saliva. Person-to-person transmission is extremely rare and only occurs under very close contact conditions
— Dr Aaron Motsoaledi, health minister

Motsoaledi stressed that hantavirus is not new and is primarily found in the Americas, particularly in countries such as Chile, Argentina, Brazil and Paraguay, but also occurs in parts of Europe and Asia.

“It is a zoonotic disease transmitted mainly through contact with infected rodent excreta such as urine, droppings or saliva. Person-to-person transmission is extremely rare and only occurs under very close contact conditions,” he said.

He added that the strain identified, the Andes strain, is the only one known to allow limited human-to-human transmission, though such cases are uncommon.

Symptoms typically appear within one to six weeks and initially resemble flu, including fever, headache, fatigue and gastrointestinal distress. In severe cases, the disease can progress to hantavirus pulmonary syndrome, which has a high mortality rate, or haemorrhagic fever with renal complications.

Lessons must be learnt

DA MP Michele Clarke raised additional concerns about protocols governing cruise ships and the decision to transport an ill passenger on a commercial flight, potentially exposing other travellers.

Committee chair Faith Muthambi said while there was no need for public panic, oversight remained critical. “We acknowledge the work done by the department and the NICD, but it is our responsibility to ensure systems are functioning optimally and that lessons are learnt,” she said.

The ship’s operator, Oceanwide Expeditions, said in an update on Tuesday evening that two specialised aircraft were en route to Cape Verde to evacuate the two crew members who require medical care to the Netherlands.

The ship, Hondius, then intends to proceed to the Canary Islands, either Gran Canaria or Tenerife, which will take three days of sailing.

The WHO is investigating possible human-to-human transmission on the ship.