The first patients evacuated from the Hondius cruise ship landed at Schiphol airport on Wednesday evening, with a second plane now on route.

One passenger was immediately transferred to Leiden Medical Centre and another to Düsseldorf university hospital. The second evacuation flight is carrying a 56-year-old British crew member with hantavirus symptoms. It is not yet known where he will be treated.

The cruise ship’s doctor is among the three evacuated, Spain’s health ministry has said. His condition, which had earlier in the week been described as serious, has improved, the cruise operator Oceanwide Expeditions told the Associated Press.

The outbreak 

The three are the latest of eight suspected cases linked to the m/v Hondius. Three passengers, including a Dutch couple from Haulerwijk in Friesland, have died after falling ill on board.

Three cases have so far been confirmed in laboratory tests: a Dutch woman who died in Johannesburg on April 27, a British passenger airlifted from the ship to the same city, and a man now being treated in Zurich.

Public health service GGD has identified all of the more than 300 passengers who were on the KLM flight from which the deceased Dutch woman was removed shortly before departure last month. They will receive a letter with information about hantavirus and what to do if they develop symptoms.

The virus

Hantavirus is carried by rodents and usually transmitted through contact with their droppings, urine or saliva, or by inhaling contaminated dust. Symptoms typically develop within two to four weeks and can include high fever, breathing problems and, in severe cases, heart and lung failure.

Public health institute RIVM has confirmed through laboratory testing that the strain involved is the South American Andes virus, one of the few hantaviruses known to spread between humans. RIVM puts the case-fatality rate for confirmed Andes virus infections at between 30% and 50%.

Argentina has dispatched experts to Ushuaia to trap and test rodents in the area where the Dutch couple are believed to have contracted the virus, on a bird-watching trip before they boarded.