One French passenger and one from the US test positive after being evacuated from the vessel in the Canary Islands.

A French woman and an American man have tested positive for hantavirus infections as countries around the world repatriate passengers from a cruise ship hit by a deadly outbreak.

French Health Minister Stephanie Rist said on Monday that a French passenger who was on the MV Hondius cruise ship tested positive for the virus and her condition was deteriorating, the Reuters news agency reported.

“What is key is to act at ⁠the start and break ⁠the virus transmission chains,” Rist told France Inter radio, pointing to the “decree ⁠that came out today that will allow us to ⁠strengthen isolation measures for ⁠contact cases and to protect the population”.

Another four French passengers have so far tested negative, and authorities have identified 22 contact cases.

The US Department of Health and Human Services said on Sunday that an American on a repatriation flight had tested “mildly positive” for the virus and another had mild symptoms. Both were travelling “in the plane’s biocontainment units out of an abundance of caution” and all 17 MV Hondius passengers on board would undergo clinical assessment upon arrival in the US.

The two new cases bring the total number of confirmed cases to 10. The World Health Organization (WHO) has so far confirmed two deaths and one probable death, and as of Friday, four people were hospitalised with one in intensive care in South Africa.

The MV Hondius was anchored near the Canary Island of Tenerife after being stranded for weeks following an outbreak of the hantavirus on the luxury cruise ship. Health authorities have been locating and monitoring passengers who disembarked from the ship before the outbreak was identified.

Investigations into the source of the outbreak are ongoing.

The evacuation ⁠of passengers from the cruise ship will be completed on Monday with flights to Australia and the Netherlands, Spain’s health minister said.

One flight to Australia will evacuate six passengers ⁠from Tenerife and another to the Netherlands will take 18 passengers. Both flights are to also carry passengers from other countries that did not send their own repatriation flights, officials said.

Hantaviruses can cause severe respiratory illness and are usually spread by rodents but can also, in more rare cases, be transmitted between people. Symptoms can begin between one and eight weeks after exposure and include headaches, fever, chills, gastrointestinal issues and respiratory distress.

The fatality rate of the Andes strain of the hantavirus, identified in the ship’s outbreak, can reach 40 to 50 percent, particularly among elderly people.

The WHO has recommended a quarantine of 42 days for the cruise passengers. Experts are stressing the need for calm, noting that the virus is far less contagious than COVID-19.

Robin May, chief scientific officer at the United Kingdom Health Security Agency, said the risk to the public was “extremely low”, the Press Association news agency reported.