The World Health Organization (WHO) has declared the Ebola outbreak in the Democratic Republic of Congo a public health emergency of international concern, although it does not yet meet the criteria for a pandemic. Nor did the hantavirus outbreak associated with the cruise ship MV Hondius, which was more of a stress test for the functioning of institutions and the health system. What is certain is that both episodes have highlighted that 21st-century health crises require a one health approach, integrating human health, animal health, and the environment: the world is facing global health crises caused largely by respiratory and zoonotic viruses. Catalonia is a pioneer in this comprehensive approach thanks to the Public Health Agency, created in 2009, which is responsible for epidemiological surveillance, has an early warning system, and provides a rapid response to imminent public health emergencies (epidemiological intelligence), as does the agency of the city of Barcelona, operational since 2003. The State Public Health Agency, on the other hand, was not created until last year.At the institutional level, the hantavirus crisis unfolded between self-sufficiency and the misinformed alarmism of the president of the Canary Islands, Fernando Clavijo, illustrated by the hilarious image of rats swimming towards the coast of the Fortunate Islands. But also from the dirigisme and lack of transparency and cooperation of the Spanish government, especially in the early stages. The latter is relevant because, as we have known since the times of covid, healthcare and public health are areas in which the State and the autonomous communities share competencies. It is one thing for the State to have a reinforced intervention title, such as external health care—given that the origin of the crisis was a foreign-flagged ship with passengers of different nationalities—and another for the Canary Islands to be the one with the healthcare resources to carry out epidemiological surveillance.The public image of this episode has in many ways recalled the pattern of the pandemic, also due to the doubts evidenced about who was responsible for making decisions, whether safety measures were voluntary or mandatory, and what legal coverage they had. The contradictions between the Minister of Health, Mónica García, and the Minister of Defense, Margarita Robles, were blatant. While the former affirmed her confidence in the voluntary compliance of the quarantine while warning of the existence of "legal instruments" to impose it, the latter insisted that it was a totally voluntary measure that could not be imposed.

Since November 2023, public health specialist Javier Padilla (Madrid, 1983) has been the Secretary of State for Health. Last week he led the unprecedented operation to disembark the ship MV Hondius in the Canary Islands, affected by a hantavirus outbreak that, to date, has caused ten infections and three deaths. He speaks to ARA via video call.

Just 24 hours after the Spanish government and the World Health Organization (WHO) congratulated each other on the management of the hantavirus outbreak, the provisional toll of this disease is 10 confirmed cases, three deaths, and dozens of people in isolation in different countries in case they develop symptoms. In Spain there is one positive case, which remains stable, while the rest of the Spanish passengers on the cruise ship MV Hondius and those who briefly coincided with an infected woman on a plane from Johannesburg – one at the Hospital Clínico in Barcelona and another in Alicante – have tested negative in all the tests performed. In France, the situation is almost identical, but the only woman who has tested positive is hospitalized in an intensive care unit (ICU) in serious condition, and the professionals attending her are working to improve her prognosis. One of the challenges of this disease is that there is no treatment or vaccine available.

Early Sunday morning, Canal 24 Horas showed the arrival of the cruise ship MV Hondius at the port of Granadilla. The scene from six in the morning was rather calm: nighttime views of the illuminated port and the radar image to see how the ship was advancing towards the coast of Tenerife. We saw the sun rise with the vessel in the foreground. Despite the complexity of the operation to disembark the passengers, the image was one of calm and control. Surely the one provided by the Sunday television schedule, unaccustomed to noise.On Monday morning, the media scandal began. On La 1, the program Mañaneros, unworthy of a public television for its sensationalism and unscrupulous journalistic bias, posed the headlines in terms of a political war. "Hantavirus Management: Who Emerges Strengthened?", "PP's Silence: Success of the Operation?". The narrative revolved around the clash between the PSOE and the PP, and the tensions and disagreements between the Ministry of Health and the Canary Islands government. On La Sexta, on Al rojo vivo, they maintained this confrontation with a bit more subtlety. They highlighted “El PSOE saca pecho” and the headline of the president of the Canary Islands lamenting that they had tried to ridicule him with the hypothesis of swimming rats. In the Atresmedia media, it was striking how they had added graphics to the images of the operation, as if the scene were being observed with a telescopic sight, enhancing the idea of control and danger. As happened with covid, to scenes with people equipped with PPE, masks and other sanitary protectors, action or horror music was added. Since the coronavirus pandemic six years ago, there has been a tendency to take advantage of the post-traumatic stress of viewers in the face of terrible images from hospitals. Infectology has become televisually fascinating, because everything that implies contagion has a very spectacular staging from a sanitary point of view.On Espejo público they incorporated Senator and Secretary General of the PP of Madrid, Alfonso Serrano, to the guest table. Very opportune for analyzing the operation. The most regrettable thing is that while they were discussing with the panelists, they had the President of the Canary Islands, Fernando Clavijo, standing at the edge of the screen for twenty minutes waiting to be interviewed. Standing and with his arms folded, he waited for his turn. Minutes after they dismissed him, he appeared on Telecinco, on El programa de Ana Rosa, to say the same thing. Curiously, in both morning magazines, the PP's directive was noticeable. Serrano on Antena 3 and Quintana on Telecinco criticized the television coverage. “This looks like a reality show!”, “They've set up a studio”, lamented the first, reproaching the presence of cameras and journalists to follow the operation. On El programa de Ana Rosa they titled with sarcasm “Lights! Cameras! Landing!”. It is astonishing to see how those who are supposed to be doing journalism lament the news coverage. And even more so the one that is done from a distance and almost with binoculars. As if the alternative of doing it secretly and without cameras were to be better.

One of the fourteen Spanish passengers on the cruise ship MV Hondius isolated at the Gómez Ulla Hospital has provisionally tested positive for hantavirus in the PCR test performed when the group entered this military center in Madrid to undergo quarantine. The other thirteen cruise ship passengers, on the other hand, have tested negative and will undergo a second test within seven days. The positive passenger is a man who, according to the Ministry of Health, is in good health and shows no symptoms. Following protocol, biological samples will be re-analyzed in the coming hours, and if the same result is repeated, he will be transferred to the High-Level Isolation and Treatment Unit (Uatan) of the same hospital, with stricter and more specific conditions for treating infectious diseases. The rest of the passengers will continue in individual rooms. The medical news coincided with the completion of the ship's evacuation operation and the repatriation of all passengers, except for about twenty crew members who have set sail for the port of Rotterdam, in the Netherlands. "Mission accomplished," said the Minister of Health, Mónica García, in a press conference from the port of Granadilla, in Tenerife, where only disinfection of the facilities remains.

As happened six years ago due to the covid-19 pandemic, the hantavirus outbreak has shown that zoonoses, diseases transmitted between animals but with the potential to infect humans, are one of the great threats of the present and future for the health of the population. Although there are some parallels between the current escalation of infections and the covid-19 crisis —mainly the animal origin of the virus—, experts insist that the current situation is very different and assure that hantavirus does not have the capacity to cause a upheaval of the magnitude that coronavirus caused. It is much less contagious and, therefore, it is more unlikely to spread. However, they acknowledge that the growth of global mobility, the rise of extreme climate phenomena and rising temperatures will make the appearance of these types of diseases increasingly frequent.

It seemed we had forgotten the pandemic and that the trauma and consequences of those long months of confinement, isolation, and pain were behind us. It seems clear, however, that there are sequelae, many, and that one of the most obvious is the fear of repeating the experience. Only from this irrational anguish can we understand what a sector of its population has staged in the Canary Islands in recent days, and above all, its main political representative. Being generous, one can think that Fernando Clavijo, Canary president for Coalición Canaria, believes that his population is still terrified by the experience of covid and wants to avoid the possibility, however remote, that the ship MV Hondius could be the start of a new pandemic. This, and only this, would humanly explain his overreaction in recent days, in which he has tried in every possible way to prevent the ship from docking or even, as happened, from anchoring in the port for fear that potential rats could swim ashore and infect the population.

This Sunday was the time to test the efforts of the past week to prepare the evacuation of the passengers trapped on the MSHondius and coordinate their return home with an operation that would guarantee health and safety at all times. The cruise ship arrived at dawn off the Canary coast, and the ship's lights were visible from the port of Granadilla before sunrise. At that moment there were 147 people on board, and during the day 94 have disembarked. Some passengers will still spend one more night on board awaiting the last repatriation flights, which will be completed this Monday for 24 more passengers to return to their countries. After these last departures, only 30 crew members will remain on the cruise ship, who will be in charge of taking it to the port of Rotterdam, in the Netherlands, where the disinfection of the ship will be finalized.

The almost cinematic images left this Sunday by the evacuation of the ship MV Hondius are not the only ones that could be part of a medical thriller. In the middle of the Atlantic Ocean, between Uruguay and South Africa and almost 3,000 kilometers from dry land, a British army team has parachuted onto the archipelago of Tristan da Cunha, home to the world's most remote human settlement. On one of the islands, all volcanic, the tourist expedition that set off all public health alarms made a stop. According to the BBC, one of the passengers on the ship is a British citizen, a resident of the island, who has had symptoms compatible with hantavirus. He is now stable but isolated.

The health crisis triggered by the hantavirus outbreak on the luxury cruise ship ‘MV Hondius’ remains open as new cases of possible infections emerge. At ARA, we try to summarize the state of affairs in these graphics.

Argentina has become a key point on the map to explain the hantavirus outbreak identified on board the cruise ship MV Hondius. The ship departed from the southernmost city in the Latin American country, Ushuaia, in the province of Tierra del Fuego. Since the World Health Organization (WHO) reported the first cases and the first deaths related to the infection, much effort has been invested in tracing the origin of this outbreak, unknown in a large part of the world, but not in the Andes mountain range area, where the population coexists with it and from which the strain's name originates. Both the Argentine government and the government of Tierra del Fuego province are investigating how the focus could have been declared; however, local administration officials state that the possibility of the first contagion being in Ushuaia is "practically nil", as it is not an endemic area for hantavirus. In fact, there has never been a registered case in Ushuaia. "We are experiencing a smear campaign," say the city government with some concern. The reason is clear: nearly 21% of Ushuaia's population lives directly or indirectly from tourism. The historical endemic area of the Andes strain of hantavirus is a bit further north, in Andean and still Patagonian provinces such as Neuquén, Río Negro, and Chubut. There is also incidence in the northwest of the country, in the province of Salta.Hantavirus is transmitted by contact with the long-tailed mouse, a wild animal that lives in rural and mountainous areas, through excrement or urine. The most common route of transmission is the inhalation of contaminated particles that remain suspended in the air when sheds are swept in country houses, or when firewood or garbage is moved in enclosed spaces. That is why the government of Tierra del Fuego wants to "disregard the rumor" that patients zero would have been contaminated at the landfill while observing birds. "It is what is said, but we do not have the source, and the Ministry of Health cannot confirm it; therefore, it is only a rumor," they state.Calm and strict protocols

Be that as it may, in Argentina hantavirus is a well-known disease and treated with extreme caution. Axel Tomás, an infectologist at the University of Córdoba, explains to ARA that isolation protocols are very strict, and that for this reason hantavirus has never been a massive public health problem in the country. In this regard, the expert reinforces that the disembarkation of the cruise ship in the Canary Islands is key: What is indeed particular about the Andes strain is its high lethality —which is above 30%— and the fact that it is transmitted between humans, and not only from mice to humans, as was thought until 2018, when a case in the province of Chubut proved paradigmatic for the scientists investigating it: 34 people got infected at a birthday party and 11 died. It was confirmed there that, indeed, the Andean variant can be transmitted from person to person.

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The complex operation that this Sunday must evacuate the passengers and part of the crew of the MVHondius has involved great diplomatic efforts to coordinate the actions of the different countries, but also to allay the fear of hantavirus and the reluctance for the cruise ship to approach the Canary coast. Concerns that have also served to fuel political attacks. The outbreak totals six positive cases – including the three fatalities – so the ship will arrive in port without any new infections having been confirmed.

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Perhaps you think someone made a mistake by mixing in the title of this article the Pope's upcoming visit to Spain with the episode of the ship on which cases of hantavirus have been detected, which have caused the death of three people so far. But the decision to relate these two events is entirely voluntary, even though they are matters of very different significance. We are awaiting Leo XIV's messages with great interest, I would say more than ever in recent years of papal travels, surely due to the singularity of the moment we are living in the West and, more broadly, everywhere due to the stage of changes and uncertainties that humanity is going through. The pontiff has placed himself – or we have placed him – at the center of world attention, as a voice that the vast majority wants to hear to feel reaffirmed in their desires for progress, peace, and social well-being. It is clear that there have always been conflicts and dangers – even open wars, like the one in Ukraine – but the awareness of how much we are taking steps backward is more intense and recent. It is linked to the erratic way the North American administration has been conducting itself under the direction of its president, Donald Trump, and to the consequences of his way of acting.

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Health and emergency authorities are working against the clock to prepare for the arrival of the MV Hondius this weekend in the Canary Islands. The luxury cruise ship, the focus of the hantavirus outbreak, will anchor in the port of La Granadilla, in Tenerife, and from there passengers and crew will be transported to their home countries. In fact, the Spanish government has assured that no one will disembark without prior confirmation that their plane is ready to take off. On board are passengers and crew of 23 different nationalities, from within and outside the European Union, and since Thursday meetings have been held to also organize repatriations.

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Almost the only unknown that remains to be known about the arrival operation of the luxury cruise ship MVHondius on the island of Tenerife is the time it will drop anchor to remain anchored until the Spanish authorities order the disembarkation. The good sea conditions have meant that the ship is making good progress and this Friday it was said that the vessel would arrive on Saturday afternoon and not Sunday morning, as had been planned. Despite this advancement, the night will be allowed to pass before the machinery is started to disembark the 151 people on board, counting 147 passengers and crew and four professionals who boarded in Cape Verde to assist them. For the moment, the toll of the outbreak remains at five confirmed infections, in addition to the three who have died, and the World Health Organization (WHO) is confident that no more passengers will test positive.

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None of the cruise passengers still on board At this point, health authorities have three people under surveillance due to the hantavirus outbreak in Spain: the woman with symptoms in Alicante who is considered a suspected case and must remain in isolation, and the two women identified as contacts – and therefore not considered suspected cases –: the woman living in Catalonia and a South African tourist who spent a week in Barcelona but had already returned to her country. Thus, there is only one possible contagion under consideration — that of the woman from Alicante — which will need to be confirmed or ruled out with a microbiology test.

]]> The Dutch cruise ship MV Hondius, where the hantavirus outbreak has been detected and which carries 144 passengers on board, has already covered almost half of its journey from Cape Verde to Tenerife, where it expects to arrive between Saturday night and Sunday morning. It is now west of Nouadhibou (Mauritania). According to the position provided by its AIS localization system, the GPS identifier that all ships over 300 tons (and all passenger ships, without distinction) are obliged to carry, the MV Hondius has sailed some 427 nautical miles (790 km) since leaving Praia on Wednesday afternoon.

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The Spanish government is shining with the public differences of opinion maintained by the Ministries of Health and Defense on whether quarantine is mandatory or not for people who have been in contact with infected individuals by hantavirus. And it is true that the procedures for the outbreak were activated late and poorly, and here we are, urgently searching for passengers who were in contact with the infected and counting cases of people who have isolated themselves in Singapore or are under surveillance in the United States. But what I find unbearable is the political outcry, practically hysteria, surrounding the case. The Canary Islands government does not want the ship in port (as if they were not bringing the affected people to port); Ayuso – who is now dedicated to imitating Pedro Sánchez to play on the international stage as a reference for the most rancid right-wing and goes to Mexico to defend Hernán Cortés to see if she provokes a global scandal – wonders why they have to bring affected people to Madrid (as if they didn't have a reference hospital there), and the PP goes around shouting "This is chaos!" It is a shame, because we know that hantavirus is not like covid – the WHO has said so –, and we live in a developed country, a member of the European Union, with the capacity to treat this disease. We come from a pandemic in which many people suffered a lot and became very anxious, which triggered mental illnesses, and now what would be appropriate would be to have a sense of state. When a crisis is still open, one must think twice about the messages and leave the criticism for when it is resolved.Regarding open crises, the war in Iran continues but has already reached levels of confusion that begin to resemble that Gila war, where a general would pick up the phone and ask for the enemy. At this moment, officially, the ceasefire holds, but the United States and Iran continue to exchange attacks. Trump doesn't know how to end this war, to which he was dragged by Israel, which is making gasoline more expensive for him and, therefore, angering his voters. That's why he continues to say things from the height of a bell tower, opening controversies and alternative fires, such as when he said that the Pope was endangering many Catholics because he didn't care if Iran had the atomic bomb. But the Pope put him in his place with a sentence destined to go down in the history of his pontificate: “If anyone wants to criticize me for announcing the Gospel, let them do so with the truth, because the Church has spoken out against all nuclear weapons for years, and there is no doubt about it.” Very well said.Another political crisis: teaching unions have reported detecting undercover police officers at teachers' assemblies. An explanation from the Government is urgently needed. It would be unacceptable, typical of an authoritarian regime. This morning, when asked about the matter on SER, President Illa brushed it off saying the minister would provide explanations, implying the president knows nothing and has no reason to know anything. It doesn't look good, especially in the midst of the labor conflict between teachers and the department, as it seems they were spying on them. I certainly think explanations are needed.

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Hantavirus is so called because, although it is ancient, the first outbreak of the disease that was scientifically studied was contracted by North American soldiers patrolling near the Hantan River during the Korean War, in the 1950s. It is a known virus with several families: human transmission is only known in the so-called Andes hantavirus, which is what affected the passengers of the MV Hondius. It does not have the virulence of COVID, that of the flu or, even less so, that of measles, but the mortality rate if left untreated is indeed high. According to the World Health Organization (WHO), there are five confirmed cases, three of which have resulted in death, and three more symptomatic cases awaiting PCR results. The possibility of a ninth case has also emerged, which would be a flight attendant who was in contact with a woman who died. If confirmed, it would be worrying, as it would be the first person to have been infected without being on board the ship.

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The hantavirus outbreak aboard the luxury cruise ship MV Hondius –with eight confirmed cases, three of which have already died– was caused by the Andes strain, which is the only one that is also transmitted between humans during close contact. However, there is a precedent from 2018 of another outbreak in Argentina with 34 cases and 11 deaths following a birthday party in which it was demonstrated that super-spreading events can occur. These events occur when an infected person, either due to a high viral load or high social activity, can transmit the virus to several people at once; a type of contagion that, it must be said, is very unusual with this type of virus. According to the conclusions of a study published in The New England Journal of Medicine six years ago, there were at least three people from that outbreak classified as super-spreaders because each infected more than four people.

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